Crowdsourcing Ideas for the Implementation of Long-Acting Injectable PrEP among Sexual Minority Men in Chicago through an Innovation Tournament.

Background: Reducing HIV incidence requires the effective implementation of evidence-based prevention practices. In Chicago, HIV disproportionately impacts sexual minority men (SMM). Long-acting injectable cabotegravir (CAB-LA) offers a new form of evidence-based HIV prevention, thus requiring a strategic implementation approach. To maximize uptake of CAB-LA in Chicago, co-designing implementation strategies with end-users is critical. This research employed the participatory method of an innovation tournament to inform implementation of CAB-LA among SMM, particularly Black and Latino populations.

Methods: A virtual innovation tournament was conducted in English and Spanish to enable participants to share ideas on how to implement CAB-LA for SMM 12 years and older in Chicago. Innovation tournaments follow a three-step process: 1) participant submission of ideas in response to a prompt, 2) participant feedback on ideas, and 3) evaluation of ideas by a committee. Participants ≥ 13 years old were recruited through physical advertisement (e.g., banners on public transportation), digital advertisement (e.g., social media), and in-person advertisement (e.g., clinic). A committee of constituents with diverse expertise convened to evaluate the ideas on acceptability, appropriateness, feasibility, and impact. Ideas were coded by strategy type (implementation vs dissemination).

Results: Forty-two participants completed 54 submissions comprised of 73 discrete ideas. Participants proposed both dissemination (56.2%) and implementation (42.5%) strategies. Ideas described strategies to increase awareness (e.g., campaign on social media and dating apps, identification of LGBTQ ambassador), reduce cost (e.g., shot subsidization, transportation voucher), integrate care (e.g., STI services, pharmacies), and partner with community spaces (e.g., pop-up clinics, schools). The top three ideas based on committee scores suggested implementation through at-home visits, education of providers with queer patients, and administration in pharmacies.

Discussion: Given that the co-design of implementation strategies often does not involve the participation of individuals with lived experiences, this work will center the voices of those who will benefit most. Specifically, this research will contribute to the production of implementation strategies co-designed with end users, which can guide plans for CAB-LA integration in Chicago and provide insights for other regions. As the first innovation tournament focused on HIV prevention, this research can provide a framework for participatory approaches across the care continuum.