Table II.
Recommended Components for a Community-Vetted Peer Navigation (PN) Implementation Strategy for Latino MSM in San Diego, CA
| Implementation Strategies | Barrier/Facilitator Addressed or Leveraged and Example Quotations |
|---|---|
| Peer-Led Intervention | Barriers Addressed: Intersectional Stigma, Medical Mistrust, Discrimination (Outer Context: Service Environment/Policies) |
| Peer Recruitment and Referral | "If…a flyer or something reached us by a relative or acquaintance who is already going to the clinic, then we feel secure that it is well-established and a place with open doors where we trust to go and ask questions" (Latino male, Phase I ) |
| Peers Build Trust and Reduce Stigma | "Diffusion of information is important because people are scared to go to a clinic or they feel shame because they don't speak English, they don't have documents [(legal status)], or don't know what will happen…[we] need to let people know not to worry about it" (Latino male, Phase I ) |
| Peers Utilize Latino Social Network | "[Have] other Latinos referring them so that they know it's safe and confidential. Using the Latino social network" (Latino male, Phase I ) |
| Disseminate Information | Barriers Addressed: Lack of HIV Prevention and Care Information (Outer Context: Availability and Accessibility of Public Health Information) |
| Community HIV Campaign | "All the information that I have seen about HIV [and] PrEP [is] in the clinics…I have not seen any ads on the street or in transportation" (Latino male, Phase I ) |
| Tailored Messaging | "Creating a viral message, an attractive campaign…using language that is easy to understand…Staff who are in the field are used to using big words and people sometimes are not at that level, and they get scared" (Latino male, Phase II ) |
| Public & Discrete Messaging | "Use something that is informative, and that offers…anonymity; like a QR code…I see it in public transportation, on the street…I take it without no one seeing me and [without] feeling judged" (Latino male, Phase II ) |
| Social Media Platforms | Barriers Addressed: Expanded Reach and Diffusion of Innovation (Bridging Factor: Network/Communication Channels) |
| Social Media Recruitment and Intervention | "Creating the Facebook page…from men to men…the administrator will input prevention messages, it could be a good way to engage clients with services…an informal platform to make friends and talk to clients like if they were friends" (Latino male, Phase II ) |
| Dating Apps Recruitment and Intervention | "I suggest using…[the] Grindr app or other dating [with] an announcement like "the virus doesn't kill, but your fear of getting tested does,"…it is a reality, the virus doesn't kill us, but the fear of receiving care is what leads people not to treat HIV on time" (Latino male, Phase II ) |
| Tailored HIV Educational Material | Barriers Addressed: Need for Linguistically and Culturally Appropriate Material (Innovation Factor: Culturally, Linguistically Competent; Relevant Intervention Content) |
| Spanish Language | "The vast majority of clients that we see, especially in South Bay, are mono-lingual Spanish speakers who obviously feel more comfortable with any type of service in Spanish" (Staff, Phase I ) |
| Reading Level | "It's best that the material is set at like a sixth grade level…and it's a lot of phrasing…that even some native English speakers get confused with before even translating it into Spanish" (Staff, Phase I ) |
| Sexual Orientation Stigma | "They want the services but they do not want it to be openly homosexual, to have even more confidentiality. There's a stigma attached to just being openly gay with a lot of Latinos. So that's a very big issue." (Staff, Phase II ) |
| PN Program Structure | Barriers Addressed: Need for PN Management, PN Representation, and Team Integration (Inner Context: Staffing, Organizational Characteristics) |
| Dedicated PN Manager | "We don't have a dedicated staff position to run our peer navigation program…so talking about organizational structure, if we had resources…that could fund a dedicated staff position or even a small team to actively recruit,…navigate, and train, and make sure none of our [PNs] are falling through the cracks" (Staff, Phase I ) |
| PN Reflect Population | "If…they don't have a social security number, then that limits them from being a peer volunteer and stipends and all that…But maybe…include peers that actually reflect our population." (Staff, Phase II ) |
| PN Pay and Team Integration | "If we were to get a volunteer with incentives or hire a peer navigator, having benefits and…ideally, paying them and keeping them as part of the team." (Staff, Phase II ) |
Source: Proyecto Compadre (2019-2020)