- Sarit Golub
The New York City Department of Health and Mental Hygiene (DOHMH) has started an exciting new project that integrates PrEP navigation services into the standard of care at eight sexually transmitted disease (STD) clinics throughout the city. The new navigation program has tremendous potential to improve access to PrEP services for individuals who need it most. Many cities across the U.S. are interested in adopting this type of STD clinic-based PrEP program, and NYC can serve as a model to help inform and develop those efforts.
At the same time, it is a significant challenge to implement an innovative, large-scale program at eight STD clinics that are already extremely busy and juggling multiple competing demands. Traditional "evaluation" efforts track program activities, but often don't dig deeper to understand how a program really works in practice. Because it is so innovative, it is critical to understand how and why this program is helping patients, and identify any "gaps" or challenges in the model that could be changed to better meet the needs of specific patient populations.
Project IMPrOVE is a collaboration between NYC DOHMH and the Hunter HIV/AIDS Research Team (HART) of City University of New York. The goal of Project IMPrOVE is to learn from the implementation process of this new PrEP navigation program and better understand what works and what doesn't. But the real focus of Project IMPrOVE is to understand why. Project IMPrOVE is designed to ask three types of questions:
- Are there aspects of the PrEP navigation program that need to be changed to better serve patients or better integrate the program into the existing workload of the clinic?
- Are there specific types of clients who are more or less likely to be helped by the PrEP navigation program? What program modifications or alternative strategies would help better reach them?
- What happens to clients once they are connected to clinical referral sites? What makes certain sites successful in engaging and retaining clients that are referred? What additional support, training, or resources are needed to improve the referral process?
Over the next two years, the research team at Project IMPrOVE will be working with STD clinics to answer these questions and provide concrete suggestions for improving the program. In collaboration with our STD clinic partners, we will collect data from clients, staff, and referral sites. The objective of Project IMPrOVE is not only to improve NYC's PrEP navigation program, but also to provide a template for dissemination of a successful model that could be adopted by STD clinics across the country.