"African-born immigrant men are an understudied and underserved population in HIV prevention efforts in the United States. Despite the availability of effective HIV prevention tools such as routine HIV testing and pre-exposure prophylaxis (PrEP), African-born immigrant men face unique and intersecting barriers— including stigma, confidentiality concerns, immigration-related fears, language barriers, and limited access to culturally responsive services—that hinder engagement with HIV prevention. Addressing these gaps is critical to advancing health outcomes, achieving local and national HIV prevention goals, and ultimately ending the HIV epidemic in the United States.
The overall goal of this project is to identify multilevel barriers and facilitators influencing HIV prevention uptake among African-born immigrant men and to co-design a culturally responsive, community-integrated HIV prevention intervention informed by implementation science. Guided by the Intervention Mapping framework, this community-engaged pilot study will generate actionable knowledge and intervention products to support future NIH-funded implementation research.
Aim 1 will characterize individual-, interpersonal-, and structural-level determinants influencing HIV testing, PrEP awareness, and treatment uptake among African-born immigrant men. We will administer a 30–40- minute self-administered, web-based survey to a community-based sample in the Washington, DC metropolitan area. Survey measures will assess HIV testing history, HIV-related knowledge, perceived risk, PrEP awareness and interest, stigma, healthcare access, and immigration-related stressors. In parallel, we will conduct a scoping review of the U.S.-based literature on HIV among African-born immigrant men to describe the existing evidence base and identify conceptual and methodological gaps. Findings from Aim 1 will be synthesized into a determinant matrix identifying priority, modifiable barriers, and facilitators.
Aim 2 will use participatory co-design and Intervention Mapping to culturally develop an evidence-based HIV prevention intervention. African-born immigrant men, key opinion leaders, community leaders, and peer navigators will be engaged through structured co-design workshops to define performance objectives, select theory-informed strategies, and adopt/adapt intervention components. Outputs will include culturally tailored materials, delivery strategies, and an implementation package designed to support future feasibility, acceptability, adoption, and sustainability in real-world community settings.
The expected outcomes of this project include: (1) a detailed understanding of multilevel determinants influencing HIV prevention uptake among African-born immigrant men; (2) a culturally designed, community-integrated HIV prevention intervention package; and (3) a pilot-ready implementation blueprint to support a future NIH R34 pilot, and subsequently an R01 application. By integrating community expertise with rigorous implementation science methods, this project has the potential to improve HIV prevention uptake, reduce disparities, and inform scalable HIV prevention strategies locally and nationally."
Project Summary provided by investigator.