"PrEP a double-edged sword": Integrating implementation science methodology with Photovoice to guide culturally-tailored pre-exposure prophylaxis (PrEP) programs for Latino/a and non-Latino/a men who have sex with men in South Florida.

BACKGROUND: DiversiPrEP is a culturally-tailored PrEP program for LMSM offered in South Florida. DiversiPrEP navigates LMSM through their PrEP journey, including education, deciding if PrEP is relevant for them, payment, and accessing/maintaining PrEP use. DiversiPrEP includes five ERIC strategies (Increase Demand, Promote Adaptability, Alter Client Fees, Intervene with Clients to Enhance Uptake and Adherence, and Tailor Strategies). DESCRIPTION: Photovoice was used to conduct five two-part focus groups with LMSM (n = 12) and Non-LMSM (n = 12). In the first session, trainers provided guidance on selecting and contextualizing photos to generate CFIR themes. Then, participants captured photos that embodied their lived experiences accessing PrEP. In the second session, using SHOWeD, participants discussed photos, identifiedhow photos relate to culturally relevant issues. Triangulation approaches compared/contrasted themes between LMSM and Non-LMSM. RESULTS: Five central themes emerged around barriers and facilitators to PrEP services: 1) the need for normalizing PrEP messages within the MSM community, 2) the need for normalizing PrEP messages outside the MSM community, 3) the need for expanding PrEP knowledge, 4) different motivations for using PrEP, and 5) the presence of structural barriers that limit PrEP access. This study compared similarities and differences of barriers and facilitators to PrEP use between Latino/a and non-Latino/a MSM. Similarities included the built environment (outer setting) as a barrier, the need for normalizing PrEP messaging within and outside of the MSM community, and the need to expand PrEP knowledge. Differences between Latino/a and non-Latino/a MSM were found in assessing the motivation and personal drivers (inner setting) for initiating PrEP associated with how participants viewed their responsibilities to self or others. CONCLUSIONS: Photovoice with focus groups identified CFIR constructs that can guide the large-scale implementation of a client-centered PrEP service model with telehealth for both Latino/a and non-Latino/a MSM. Implementing client-centered accessible PrEP programs is an essential step to promoting sexual-health equity.

Applying culturalist methodologies to discern COVID-19's impact on communities of color.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted communities of color (CoC) amid increasing incidents of racial injustices and racism. In this article, we describe our culturalist methodologies for designing and implementing a multi-ethnic, interdisciplinary national needs assessment developed in partnership with CoC. Instead of a typical western-centric social science approach that typically ignores and perpetuates structural racism and settler colonialism, the research team implemented culturalist and community-partnered approaches that were further contextualized to the context of structural racism and settler colonialism. The culturalist approach yielded two sets of themes both related to the impact of the pandemic on CoC. The first set involved syndemic factors that contribute to the adverse impact of COVID-19. These include historical trauma; racism, racial stress, and discrimination; and cultural mistrust. The second set consisted of factors that potentially mitigate the impact of the COVID-19. These include cultural protective factors; community engagement; communal ethos, and data disaggregation. Our methodologies and the resulting findings encourage research praxis that uplifts the shared effects of the social determinants of health while honoring unique cultural and contextual experiences-a lesson that social science researchers largely have yet to learn.

HBCUs' preparedness planning and responses to reopening campuses safely during the COVID-19 pandemic: Needs, assets, and insights for future emergencies and disasters.

Managing the health and safety risks surrounding COVID-19 in congregate settings, such as on college campuses, and minimizing viral transmission should be on the dashboard of Higher Education Leadership. Understanding that the risk will not be zero, like other academic institutions, Historically Black Colleges and Universities (HBCUs) have given great thought to making their campuses, which are considered high-risk settings, safe enough to warrant returning to campus. We queried HBCU leadership via an online survey sent to all 102 HBCUs about their safety plan for the fall 2020 resumption of on-campus activities. While data show that there are 102 HBCUs, we were informed that two HBCUs were permanently closed during our data gathering period. Thus, the sample size was 100. Specific areas queried included risks management plans, mitigation steps, policy changes, and human capacity resources. We also asked these leaders to identify vulnerabilities and other factors they considered in planning a safe reopening. Findings indicated that as these academic institutions grappled with balancing between risks and benefits of reopening, they also had to recognize the numerous scenarios and multifaceted approaches required. Recommendations are presented for supporting HBCUs in the future to surmount obstacles and implement culturally responsive solutions that best serve their campuses and surrounding communities in which these academic institutions are anchored.