Revitalizing HIV Prevention Programs: Recommendations From Those Most Impacted by HIV in the Deep South.

Abstract

The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM's access to HIV prevention, treatment and care interventions. We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM's engagement in HIV prevention interventions. Interviews were conducted between July 2018 and February 2020. Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated. The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process. We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness. Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.