Geospatial perspectives on health: The PrEP4Love campaign and the role of local context in health promotion messaging.

Pre-exposure prophylaxis (PrEP) remains one of the most effective biomedical interventions for the prevention of HIV transmission. However, uptake among populations most impacted by the HIV epidemic remains low. La rge-scale awareness and mobilization campaigns have sought to address gaps in knowledge and motivation in order to improve PrEP diffusion. Such campaigns must be cognizant of the historical, physical, and structural contexts in which they exist. In urban contexts, neighborhood segregation has the potential to impact health outcomes and amplify disparities. Therefore, we present novel geospatial approaches to the evaluation of a Chicago-based PrEP messaging campaign (PrEP4Love) in a 2018 cohort of men who have sex with men and transgender women, contextualizing results within the localized infrastructure and public health landscape, and examining associations between geographic location and campaign efficacy. Results revealed notable variance in rates of PrEP uptake associated with campaign exposure by Chicago planning area, which are likely explained by the historical and contemporary impacts of racist structures on physical environment and city infrastructure. Findings have important implications for the evaluation and implementation of future messaging campaigns, which should take the unique historical, structural, and geospatial factors of their particular settings into account in order to achieve maximum impact.

PrEP4Love: The Role of Messaging and Prevention Advocacy in PrEP Attitudes, Perceptions, and Uptake Among YMSM and Transgender Women.

BACKGROUND: Despite high efficacy, use of pre-exposure prophylaxis (PrEP) remains low among young men who have sex with men (MSM) and transgender women (TW), primarily because of barriers such as stigma and resource awareness. We evaluated a social marketing campaign known as PrEP4Love that works to eliminate PrEP stigma; and awareness gaps through targeted advertising. SETTING: Chicago, Illinois. METHODS: Participants were enrolled within a cohort study of young MSM and TW (RADAR). Data were collected between June 2017 and April 2018 from HIV-negative individuals attending a follow-up visit. Surveys assessed demographics, PrEP attitudes and perceptions, and PrEP4Love campaign awareness. Associations between PrEP4Love awareness and PrEP perceptions, uptake, and behaviors were assessed using multiple logistic regression controlling for age, race/ethnicity, gender, sexual identity, and ever having used PrEP. RESULTS: Of 700 participants, the majority (75.9%) indicated seeing PrEP4Love ads in Chicago. Those who had seen ads were more likely to be out to their providers (odds ratio = 1.95; 95% confidence interval: 1.17 to 3.23) than those who had not, and those who had conversations were significantly more likely to have initiated the conversation themselves. Individuals who had seen ads were more likely to have taken PrEP in the last 6 months (odds ratio = 1.87; 95% confidence interval: 1.15 to 3.16) and more likely to believe their friends and the general public approved of and used PrEP. CONCLUSION: Social marketing campaigns are promising interventions that have the potential to alleviate barriers to HIV prevention, particularly among MSM and TW. Future research should evaluate the impact of these initiatives at multiple time points.

Evaluation capacity building-Results and reflections across two years of a multisite empowerment evaluation in an HIV prevention context.

As the need for rigorous evidence of program efficacy increases, integrating evaluation activities into program implementation is becoming crucial. As a result, external evaluators are placing increased focus on evaluation capacity building as a practice. However, empirical evidence of how to foster evaluation capacity in different contexts remains limited. This study presents findings from an evaluation capacity survey conducted within a multisite Empowerment Evaluation initiative, in which an external evaluator worked with 20 project teams at diverse community agencies implementing HIV prevention projects. Survey results revealed representatives from project teams (n = 33) reported significantly higher overall evaluation capacity after engaging with the external evaluator on planning and implementing their evaluation. Improvements differed across organization type, intervention type, staff position, and reported engagement on various activities throughout the course of the evaluation. Results indicated empowerment evaluation and other stakeholder-focused evaluation approaches are broadly applicable when evaluation capacity building is a desired outcome, particularly when able to engage project staff in the planning of the evaluation and in delivering technical assistance services. Accordingly, efforts should be made by program funders, staff, and evaluators to encourage active engagement starting in the early stages of program and evaluation planning.