Improving Personalized Communication Among Pharmacy Staff Caring for PrEP seekers: Development and Pilot of an Anti-stigma Intervention using Implementation Science

Project Summary/Abstract The overall goal of my K23 award research program is to adapt an existing effective anti-stigma intervention to improve communications between US pharmacy staff and people seeking PrEP. Communications from healthcare professionals that lead to experiences of stigma reduce initiation and ongoing use of pre-exposure prophylaxis (PrEP). These communications are a form of stigma, or experiences of judgement that are inextricably linked to multiple aspects of an individual’s personal characteristics. Existing anti-stigma interventions are effective but do not focus on US contexts, pharmacy settings, or acknowledge multiple overlapping experiences of stigma. During this K23 award, in Aim 1 I will qualitatively ask pharmacists, pharmacy technicians, and people seeking PrEP what their experiences and preferences are for non-judgmental communication while obtaining PrEP in a pharmacy, with special attention to experiences of multiple overlapping stigma experiences and relying on the implementation science framework Consolidated Framework for Implementation Research. In Aim 2 I will use the Assessment, Decision, Adaptation, Production, Topical experts-Integration, Training, and Testing (ADAPT-ITT) framework to systematically adapt an existing effective anti-stigma intervention to develop PRISM-P (PrEP-Related Intervention for Stigma Mitigation among Pharmacy staff). In Aim 3, I will pilot PRISM-P among pharmacy staff in Northern California independent pharmacies in Ending Human Immunodeficiency Virus (HIV) Epidemic jurisdictions, to understand whether pharmacy staff find the intervention to be feasible and acceptable, and if participants have decreased incorrect beliefs towards PrEP-seekers. I will record pharmacy staff interactions with simulated patients seeking PrEP, to describe changing pharmacy communications from baseline and post-intervention. To achieve the proposed research aims and to transition to career independence, I will require significant training and mentorship in (1) knowledge of pharmacy interventions, stigma and their applications in HIV prevention and, (2) expertise in personalized communication in healthcare, and (3) expertise in applied implementation science methods. An experienced mentor team will guide my research and training. Dr. Saberi (co-primary mentor) is a pharmacist with HIV prevention expertise. Dr. Seidman (co-primary mentor) is an obstetrician-gynecologist and reproductive infectious disease specialist, with expertise person-centered care. Dr. Bauermeister (co-mentor), has expertise in stigma theories and HIV prevention research. Dr. Chang (co-mentor) is an expert in healthcare communication research and skills training. Dr. Liu (co-mentor) is an expert in implementation science in HIV prevention trials. Dr. Steward (consultant) is an expert in implementation science theories and frameworks. Guided by this excellent team, the training and research plan in this K23 award will ultimately support an R-level proposal of a type 1 hybrid effectiveness-implementation trial to test PRISM-P’s ability to reduce stigma and assess participants’ adherence.