Strengthening PrEP Access for Latinx Men: Lessons from a Community-Based Implementation
Addressing HIV Disparities in Florida
Efforts to reduce HIV transmission among Latinx men who have sex with men (MSM) face significant challenges due to disparities in pre-exposure prophylaxis (PrEP) access and adherence. Miami-Dade County, Florida, where the rate of new HIV diagnoses is four times the national average, remains a high-priority area for intervention. Community-based organizations (CBOs) play a crucial role in bridging these gaps. A recent study evaluated the implementation of DiversiPrEP, a culturally tailored PrEP program, across three CBO locations in Miami-Dade and Broward Counties. The findings highlight the program's strengths while identifying key challenges that must be addressed for improved service delivery.
Key Factors Supporting PrEP Implementation
Researchers identified several facilitators that contributed to the success of DiversiPrEP. One of the most critical was individualized PrEP navigation services, where each client was assigned a dedicated care coordinator. This contrasts with traditional healthcare models, where patients interact with multiple providers for testing, prescription navigation, and adherence support. By maintaining a single point of contact, DiversiPrEP reduced administrative barriers and strengthened provider-client relationships.
Another strength was the creation of welcoming, community-focused spaces where staff reflected the demographics of the priority population. Many staff members were bilingual, Latinx, and had personal or family experiences with immigration and healthcare barriers, making them well-positioned to address client concerns. The program also engaged the community through targeted outreach at LGBTQ+ venues, social media campaigns, and community events, improving PrEP awareness and uptake.
Challenges in PrEP Service Delivery
Despite these strengths, structural barriers posed significant challenges to the successful implementation of DiversiPrEP. One major obstacle was federal funding restrictions on covering lab and testing costs, which made it difficult for CBOs to provide no-cost testing for clients. While some organizations secured alternative funding sources, inconsistent availability of free testing remained a challenge.
Another critical barrier was advertising services to Latinx MSM who were unfamiliar with CBOs. Reaching individuals outside of established networks proved difficult, as many potential clients lacked awareness of available PrEP services. Additionally, the lack of external signage and municipal restrictions on advertising limited visibility for walk-in clients seeking information about PrEP.
Furthermore, technology limitations in appointment scheduling and pharmacy coordination created additional hurdles. Many clients struggled with automated pharmacy communications, which required answering calls to confirm prescription refills. As a result, gaps in adherence were reported. To address this, DiversiPrEP staff recommended implementing automated text reminders for clinical appointments and medication refills, a feature that has since been incorporated.
Implications for Public Health and Policy
This study underscores the importance of culturally tailored interventions in addressing HIV disparities among Latinx MSM. By creating safe, accessible spaces and offering personalized support, CBOs can significantly improve PrEP uptake. However, to optimize service delivery, sustainable funding solutions for PrEP-related lab costs and enhanced technology integration are necessary.
For policymakers and public health advocates, these findings highlight the need for expanded financial support and streamlined insurance navigation. Existing funding mechanisms, such as the 340B Drug Pricing Program, state and federal HIV assistance programs, and manufacturer patient assistance programs, can help mitigate costs but require better integration to ensure sustainability. Additionally, scaling up successful models like DiversiPrEP to other high-incidence regions could further reduce HIV transmission rates among underserved populations.
Source
Self, K.J., Johnson, A., Craker, L. et al. Strengthening PrEP services at community-based organizations for Latinx men who have sex with men: an implementation science approach. Arch Public Health 83, 72 (2025). https://doi.org/10.1186/s13690-025-01560-0.