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Developing Status-Neutral Approaches to Increase Uptake of Long Acting Injectable PrEP and ART Among Black and Latinx Men with Less Than Optimal Adherence in Southern California

Award Number: R21MH139447
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/15/2026
PERIOD OF PERFORMANCE END DATE: 07/14/2028

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Developing Status-Neutral Approaches to Increase Uptake of Long Acting Injectable PrEP and ART Among Black and Latinx Men with Less Than Optimal Adherence in Southern California - Project Summary The proposed project will explore barriers and facilitators of HIV care and prevention service engagement and new intervention approaches to increase long-acting antiretroviral treatment (LAI-ART) and pre exposure prophylaxis (LAI-PrEP) uptake and persistence among 18-45-year-old Black and Latinx sexual minority men (B/LSMM) in San Diego, San Bernardino, and Riverside Counties, California, three EHE jurisdictions. This research will focus on B/LSMM with suboptimal care engagement, PrEP/ART adherence, or unknown or detectable viral load. Black and Latinx SMM bear a disproportionate burden of HIV in the US, accounting for 38% and 32% of new diagnoses among SMM, respectively. PrEP uptake is lower among B/LSMM than white SMM in California, and B/LSMM living with HIV (B/LSMM+) have lower overall ART adherence, and viral suppression. Of the 61 health jurisdictions in California, San Bernardino and San Diego Counties rank 46th and 48th in viral suppression rates and, in 2020, most Black (54%) and Latinx (52%) people with HIV (PWH) in Riverside County had received an AIDS diagnosis. Long-acting injectable forms of PrEP (LAI-PrEP) and ART (LAI-ART) have the potential to overcome some known barriers to oral PrEP and ART adherence such as missing daily PrEP and ART doses due to substance use or depression or lacking a safe and private place to store pill bottles. To date, little is known about the barriers and facilitators of LAI uptake among B/LSMM. For the proposed study we will adopt the CDC’s status neutral approach to elucidate the impact of these socio-structural inequities on LAI-PrEP and LAI-ART uptake. New strategies are needed to increase uptake of LAIs among those who can most benefit, such as B/LSMM with less than adequate care engagement and oral ART and PrEP adherence. Guided by intersectionality, syndemics theory, and the Health Equity Implementation Framework, this project has two aims. Aim1: Qualitatively explore knowledge, attitudes, and perceived barriers and facilitators of LAI-PrEP and LAI-ART uptake and identify acceptable and appropriate approaches to increase uptake among B/LSMM who report less than optimal oral PrEP/ART adherence. We will conduct 30 in-depth qualitative interviews with B/LSMM, evenly stratified by race and HIV status, and three focus groups (one in each EHE priority county) with staff and clinicians from community-based organizations serving B/LSMM. Aim2: Quantitatively assess knowledge, barriers, and facilitators of LAI-PrEP and LAI-ART uptake among B/LSMM and assess interest and acceptability of potential intervention approaches.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $441,215 )
2026	2026	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Mental Health Research Grants	000	1	7/15/2026	NEW	$441,215
														Subtotal = $441,215

Grand Total All Awards = $441,215

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Developing Status-Neutral Approaches to Increase Uptake of Long Acting Injectable PrEP and ART Among Black and Latinx Men with Less Than Optimal Adherence in Southern California

Award Number: R21MH139447

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/15/2026

PERIOD OF PERFORMANCE END DATE: 07/14/2028

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