1 PROJECT SUMMARY/ABSTRACT:
2 This K23 award will allow Ronnie M. Gravett, MD, to train under multidisciplinary, expert mentorship to become
3 an independent patient-oriented outcomes researcher dedicated to improving the HIV outcomes affecting sexual
4 minority persons in the Deep South. HIV disproportionately affects men who have sex with men (MSM) in the
5 Deep South, a region in the United States with the highest burden of new HIV diagnoses. Pre-exposure
6 prophylaxis (PrEP) effectively prevents HIV acquisition among MSM, but there is a significant lag in PrEP uptake
7 and persistence in the Deep South when compared to other regions of the US. Barriers, such as systemic racism,
8 stigma, and homonegativity, prevent MSM from adequately accessing and using this effective strategy. The high
9 burden of HIV and inadequate PrEP uptake are NIH priorities that need novel strategies to address, such as
10 empowering and effective PrEP promotional strategies to increase PrEP uptake. Yet, there is a critical gap in
11 understanding HIV prevention messaging that is informed by the greater context of the intersecting identities and
12 known barriers to PrEP uptake among MSM in the Deep South. To address this gap, this project will examine
13 preferences for PrEP promotional messaging in order to create authentic and informative PrEP messages
14 through crowdsourcing, an innovative strategy wherein a group solves a common problem and the solution is
15 given back to the group. Integrating constructs of Andersen’s Behavioral Model of healthcare utilization and
16 community engagement into a human-centered design model will serve as the framework for this project. This
17 project will address the gap through the following specific aims: 1) explore preferences for PrEP messaging
18 content among MSM in the Deep South through qualitative interviews, 2) using a discrete choice experiment
19 (DCE), define the preferred attributes for PrEP messaging content to inform the format for the crowdsourcing
20 open call, and 3) compare MSM preferences for crowdsourced services to standard services to inform a digital
21 intervention designed to increase PrEP uptake among MSM in the Deep South. Crowdsourced content created
22 during this project will be compared to health authority content to show that community-derived content is
23 preferred by MSM. The training plan will combine formal coursework, intensive seminars, and expert mentorship
24 focused on the following topics: 1) quantitative, qualitative, and mixed methodologies, 2) design and conduct of
25 discrete choice experiments, and 3) crowdsourcing to create authentic PrEP promotional messaging. This K23
26 award will support the development of affirming, effective content to improve HIV prevention strategies among
27 MSM while also providing mentorship from renowned content and methodological experts, structured,
28 multidisciplinary training in a collaborative environment, and the avenue for Dr. Gravett to develop into an
29 independent physician investigator and leading expert in HIV prevention among sexual minorities in the Deep
30 South.
