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

Rebecca L. Mauldin*, Tamara Al Rawwad, Muhammad Amith, Lisa M. Kuhns, John A. Schneider, Kayo Fujimoto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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

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

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

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