Dr. Sarah Wilson and Community Collaborator Mr. Joaquín Carcaño awarded EHE supplement to address PrEP uptake and maintenance among Latines

Last month, as part of their support of the Ending the HIV Epidemic in the U.S. (EHE) initiative, NIH announced 66 awards to institutions participating in the NIH-funded Centers for AIDS Research (CFAR) and the NIMH AIDS Research Centers (ARC) programs. This was the fourth year of NIH investments in EHE-focused research projects. These new awards total $26 million and will support research in 33 of the EHE priority jurisdictions to strengthen research-community collaborations and enhance the implementation science knowledge base needed to end the HIV epidemic. All projects involve partnerships between CFAR/ARC investigators and local health officials and community groups in one or more EHE jurisdictions.

Sarah (Sadie) Wilson, Assistant Professor in the Department of Psychiatry & Behavioral Sciences, and Associate Director of the SBS Core, received an award with Co-PI Joaquín Carcaño, Director of Health Equity Policy at Latinos in the South. Their project, Equity-focused implementation mapping to improve PrEP uptake and maintenance among Latines, is one of the supplements awarded in the category of equity-focused approaches to reduce HIV-related health disparities. Their project will be based in Mecklenburg County, which is currently the only EHE priority jurisdiction in North Carolina.

Latine communities (a gender-inclusive term for individuals with Latin American heritage) are disproportionately affected by the HIV epidemic in the United States. Specifically, Latines who could benefit from pre-exposure prophylaxis (PrEP) are less likely than the general population to be prescribed PrEP (14% vs. 23%). Despite the efficacy of PrEP, there are a number of barriers to successful adoption and sustainability of PrEP usage among Latines who would benefit from this medication. These include multi-level barriers: structural (e.g., lack of health insurance), community-level (e.g., PrEP awareness, HIV stigma, LGBTQ+ stigma), and individual (e.g., trauma, acculturative stress).

Given health equity-related barriers to receiving PrEP, their study seeks to convene a workgroup that is focused on including the community, engaging with community, and consulting experts to create a plan to increase the rates at which Latines in Mecklenburg County who could benefit from PrEP start on the medication and keep taking it. The team will study the acceptability and feasibility of this community- and equity-focused approach.

The project team, led by Dr. Sarah Wilson and Mr. Joaquín Carcaño, has extensive experience in implementation science, HIV prevention community-level interventions, and health equity research. Mr. Carcaño is a native of the Rio Grande Valley along the Texas-Mexico border and a queer, transgender Mexican-American man. During his time in Austin getting his Bachelor’s degree, he was a volunteer hospice worker at a residential hospice for those in the final stages of AIDS-related illnesses. In 2016, Mr. Carcaño became the lead plaintiff in the North Carolina HB2/HB142 lawsuit which restricted access to public facilities for the transgender community and removed anti-discrimination protections for the LGBTQ community. In August 2018, he joined the Latino Commission on AIDS, Latinos in the Deep South staff as the Director of Community Organizing working regionally from North Carolina to Louisiana. He is a member of Nuestra Voz, the LGBTQ community advisory board of El Centro Hispano in Durham, North Carolina, is a board member of Equality NC, and is a recent addition to the Southern AIDS Coalition board of directors. He has a long history of successful collaboration with Dr. Wilson on local community LGBTQ+ fundraising events. Dr. Wilson is the Duke CFAR Associate Director of the Social and Behavioral Sciences Core, and leads the Duke CFAR in community engagement efforts.