From Tanzania to Washington, DC: Application of the Consolidated Framework for Implementation Research and ADAPT-ITT Model to Guide the Development of a Community-Based PrEP Intervention for Black Adults

Waimar Tun, Population Council, Washington, DC, USA.
Jennifer Gomez-Berrospi, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Samuel Janson, University of Washington School of Public Health, Seattle, WA, USA.
Demarc Hickson, University of Washington School of Public Health, Seattle, WA, USA.
Christian Morris, Us Helping US, People Into Living, Inc., Washington, DC, USA.
Julie Pulerwitz, Population Council, Washington, DC, USA.
Mamaswatsi Kopeka, Building Research for Implementation Science to Drive Growth and Equity (BRIDGE) Research Lab, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Jesse Yao, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Rikiyah Mixson, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Amanda McHale, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Rachel Macey, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Christian Buchanan, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Bukola Rinola, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Naana Koranteng-Yorke, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Deanna Kerrigan, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Oluwaseun Adebayo Bamodu, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Donaldson F. Conserve, Building Research for Implementation Science to Drive Growth and Equity (BRIDGE) Research Lab, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. dxc341@gmail.com.

Document Type

Journal Article

Publication Date

10-13-2025

Journal

AIDS and behavior

DOI

10.1007/s10461-025-04902-9

Keywords

Academic-community partnerships; Community-based PrEP; HIV prevention; Health disparities; Implementation science; Mobile health services

Abstract

While HIV incidence in Washington, DC has declined overall, significant racial disparities persist. Pre-exposure prophylaxis (PrEP) remains underutilized among Black adults due to multiple barriers including medical mistrust, stigma, and structural barriers to access. Using the Consolidated Framework for Implementation Research (CFIR) and ADAPT-ITT model, we conducted in-depth interviews with opinion leaders (n = 28) including community-based organization leaders, health department representatives, healthcare providers, and current/potential PrEP users to guide the adaptation of a community-based HIV treatment intervention from Tanzania to create a community-based PrEP intervention for Black adults in Washington, DC to address the aforementioned barriers. Data analysis employed thematic content analysis with CFIR construct mapping to identify implementation barriers and facilitators. Key implementation facilitators included: mobile service delivery in high-need areas (Wards 7-8), comprehensive health service integration, culturally matched staffing, flexible evening/weekend hours, and multi-channel outreach via social media and community venues. Major barriers included privacy concerns in mobile settings, social determinants of health challenges, and multilayered stigma. Drawing on these findings, we developed the adapted cbPrEP intervention with the six components featuring: (1) mobile service delivery platform, (2) comprehensive service integration, (3) community-centered staffing model, (4) privacy and confidentiality protocols, (5) multi-channel outreach strategy, and (6) wraparound support services including insurance navigation. This study demonstrates the value of using implementation science frameworks to adapt evidence-based interventions while centering community voices. The resulting cbPrEP intervention model shows promise for increasing PrEP access among Black adults in Washington, DC through culturally responsive, community-based service delivery.

Department

Prevention and Community Health

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