Mentored Scientist Award

The Dominican Republic (DR) has the highest HIV prevalence of any Spanish speaking country in Latin America and the Caribbean. Substantial social vulnerabilities underpin this epidemic, including poverty, food insecurity, immigration, and stigma, with significant disparities among key populations.

Moreover, while 94% of people living with HIV (PLHIV) in the DR are aware of their status, only 63% are on antiretroviral therapy (ART) and 57% achieve viral suppression, undermining the potential of Undetectable=Untransmittable. Pre-exposure prophylaxis (PrEP) offers a potent strategy for HIV prevention, yet its uptake remains low due to stigma and limited awareness. This proposal aims to generate formative data from PLHIV experiencing ART adherence challenges for a partner-based PrEP referral program. Leveraging an ongoing cluster randomized controlled trial of an urban gardening and peer nutritional counseling intervention to improve adherence, of which the named mentor (Palar) is mPI, this research will explore acceptability and appropriateness of the referral program across three specific aims: Aim 1 will leverage the ongoing longitudinal qualitative cohort and interview up to 25 PLHIV not in sero concordant partnerships to understand perspectives of partner-based referral programs. These findings will influence Aim 2, a module will be added to the planned survey among 500 participants to identify the components of a PrEP partner-based referral program that are potentially acceptable, appropriate, and feasible. In Aim 3, we will conduct semi-structured interviews with HIV care providers (n=20) and policymakers (n=3-5) to assess their perspectives on integrating partner-based referrals into existing HIV care. This research aligns with the national HIV/AIDS strategic priorities and aims to generate critical preliminary data to inform future intervention development. Moreover, the research contributes to my training goals of developing biomedical interventions for PrEP promotion and uptake among harder-to-reach populations, and will contribute to a subsequent mentored scientist award to continue this timely work.