Community-clinic linkages for promoting HIV prevention: organizational networks for PrEP client referrals and collaborations

ABSTRACT

Community-clinic linkages may help communities increase HIV pre-exposure prophylaxis (PrEP) uptake. Referrals from community-based organizations may be particularly important for linking Black men who have sex with men (MSM) to PrEP. This study describes PrEP referral and HIV/STI prevention networks among organizations that serve MSM in Houston, TX (N = 40), and Chicago, IL (N = 28), and compares network positions of organizations based on percentage of Black/African American clients. A majority of organizations conducted PrEP awareness/promotion activities, but fewer made PrEP referrals, with little overlap between the collaboration and referral networks. The networks tended to have a densely connected core group of organizations and more a peripheral group of organizations linking into the core with relatively few times among themselves; this core/periphery structure is efficient, but vulnerable to disruptions. The percentage of Black/African American clients organizations served was not related to most measures of network centrality. However, in Houston’s collaboration network, higher Black-serving organizations tended not to hold as influential positions for controlling communications or flows of resources. The findings indicate a potential to leverage collaborations into PrEP referral pathways to enhance PrEP promotion efforts and identify opportunities to address racial disparities in PrEP uptake.

KEYWORDS:

• Social network analysis
• pre-exposure prophylaxis (PrEP)
• health disparities
• young black men who have sex with men
• PrEP referral networks

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this publication was supported by Gilead Sciences, Inc. [grant number IN-US-276-D120], and in part by the National Institute of Mental Health of the National Institutes of Health [grant number 1R01MH100021]. In addition, this work was supported by the UTHealth Innovation for Cancer Prevention Research Training Program under Grant Cancer Prevention and Research Institute of Texas [grant number RP160015]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Cancer Prevention and Research Institute of Texas, or Gilead Sciences.