This study evaluates a proposed community-based implementation strategy to scale up screening, identification, and intervention on Health-Related Social Needs (HRSN) among persons on Long-Acting Injectable Pre-exposure Prophylaxis (LAI-PrEP). To do so, (1) screening for HRSN will occur at provider visits every 4 months, (2) navigation and establishment of connections with community resources through collaboration with two established community-based organization (CBO) partners, and (3) development of a tracking system integrated into the Electronic Medical Record (EMR) for monitoring and assessment of referral outcomes.

Inclusion Criteria:

For Patient participant group: In order to be eligible for participation in this study, an individual must meet all of the following criteria:

• 18 years of age or older
• Does not have HIV AND vulnerable for HIV infection per WHO, NHS, and CDC recommendations
• On or initiating LAI-PrEP as part of standard of care prior to study participation
• Identify as either a Black/Latine cisgender woman OR Black/Latine MSM OR Transgender or Nonbinary Individual
• Capacity and willingness to provide consent

For Medical Staff participant group: In order to be eligible for participation in this study, an individual must meet all of the following criteria:

• 18 years of age or older

• Works with patients who go to the Bellevue Pride Center

• Be employed at NYU Langone Health or NYC H+H/Bellevue as one of the following occupations

  • Physician
  • Clinical Pharmacist
  • Nurse
  • Medical Phlebotomist
  • Social Worker/Navigator
  • Community Health Worker
  • Medical Leader (i.e., director of services)

For CBO Partner participant group: In order to be eligible for participation in this study, an individual must meet all of the following criteria:

• 18 years of age or older
• Works with patients who go to the Bellevue Pride Center
• Be employed at one of the established CBOs
• Capacity and willingness to provide consent

For Patient Who Declines LAI-PrEP participant group: In order to be eligible for participation in this study, an individual must meet all of the following criteria:

• 18 years of age or older
• Declines LAI-PrEP as part of standard of care
• Capacity and willingness to provide consent

Exclusion Criteria:

For Patient participant group: An individual who meets any of the following criteria will be excluded from participation in this study:

• Less than 18 years old
• Known HIV seropositive status or test positive at screening
• Does not identify as one of the listed priority populations
• Not fluent in either English or Spanish
• Not interested in HIV PrEP
• Not willing to consent for study participation
• Does not reside within New York State
• Pregnant or planning to become pregnant at the time of consent.
• Without capacity to consent to participate in the study

For Medical Staff participant group: An individual who meets any of the following criteria will be excluded from participation in this study:

• Do not work with patients who go to the Bellevue Pride Center

• Is not employed at NYU Langone Health or NYC/H+H Bellevue as one of the following occupations

  • Physician
  • Clinical Pharmacist
  • Nurse
  • Medical Phlebotomist
  • Social Worker
  • Community Health Worker
  • Medical Leader (i.e., directors of services)

For CBO Partner participant group: An individual who meets any of the following criteria will be excluded from participation in this study:

• Does not work with patients who go to the Bellevue Pride Center

For Patient Who Declines LAI-PrEP participant group: An individual who meets any of the following criteria will be excluded from participation in this study:

• Less than 18 years old
• Interested in initiating LAI-PrEP as part of standard of care or on LAI-PrEP

There are multiple participant groups:

• Patients on or initiating LAI-PrEP as part of standard of care
• Medical Staff who work with patients on LAI-PrEP
• CBO Partner who work with patients on LAI-PrEP
• Patients who decline LAI-PrEP as part of standard of care

Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices) will be shared. Requests should be directed to Robert.pitts@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.

Immediately following publication. No end date.

Investigators whose proposed use of the data has been approved by an independent review committee ("learned intermediary") identified for this purpose (individual participant data meta-analysis) will be granted access. Requests should be directed to Robert.pitts@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.