Grant: CIHR Fellowship

Pre-exposure prophylaxis (PrEP) is the leading front-line strategy to therapeutically prevent HIV. While global South populations have been instrumental in advancing this therapeutic innovation through research participation, the beneficiaries of these drug technologies disproportionately reside in the global North. For example, while Peru contributed over half of the participants globally for the watershed iPrEx trial demonstrating the efficacy of PrEP for HIV prevention, Peruvians today still do not have access to affordable and sustainable PrEP through public institutions. To improve this gap, this postdoctoral project will examine the social and structural determinants that promote PrEP research but limit the translation of prevention strategies into Peruvian health policy. To do so, qualitative and quantitative methods will be used to address three specific aims. First, to examine policy factors supporting PrEP research versus translation of prevention findings into national HIV strategy, I will conduct 25 interviews with policy-makers across various Peruvian public institutions. Second, to assess social factors linked to delays in the provision of HIV prevention among marginalized communities, I will conduct surveys with approximately 100 participants across 10 key civil society organizations and 10 follow-up interviews with key informants at these organizations. Third, to assess how structural determinants at the global-level shape PrEP implementation in Peru I will conduct a document analysis and 15 interviews with key informants across pharmaceutical companies and multilateral agencies (e.g., the Global Fund, Gates Foundation). Utilizing knowledge translation and exchange, each stage of research will engage key knowledge users and community advocates. Findings on ways to improve HIV prevention technology integration into the Peruvian public system will be disseminated through peer-reviewed publications reports for government and grassroots organizations.