Adapting an Inner-City PrEP Peer Change Agent Intervention for the Suburbs

Abstract

HIV remains a public health challenge, despite investments in treatment and prevention tools to reduce new HIV infections and end the epidemic. Many evidence-based biomedical and behavioral interventions target urban sexual minority men, including men who have sex with men. There is a dearth of HIV-prevention interventions, particularly those that seek to increase uptake of pre-exposure prophylaxis (PrEP), that have been adapted for sexual minority men in the suburbs. PrEP Long Island, a peer change agent intervention to increase PrEP use among suburban sexual minority men, was adapted from a similar intervention, PrEP Chicago. PrEP Long Island study protocol documents were based on publicly available documents outlining the PrEP Chicago intervention. We present the choices and rationales for our decisions on when, to what extent, and how to geographically adapt a public health intervention. While most guidance on intervention adaptations is related to cultural and linguistic considerations, more recommendations are needed for place-based changes, including how well intervention fidelity functions as well as strategies for adapting evaluation materials.