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HIV PrEP medication for marginalized individuals

HIV PrEP medication for marginalized individuals

ADVISOR
Agnes Pyrchla
Christy Camp, RN  

DURATION
9 Weeks

TEAM
Anci Sun

MENTORS
Catherine Tran

MY CONTRIBUTIONS
Design Research
User Experience Design
Rapid Prototyping 

DURATION
8 Weeks

ADVISOR
Agnes Pyrchla
Christy Camp, RN  

DURATION
9 Weeks

GETPrEP is a non-profit service to help marginalized individuals to connect with PrEP navigators, remove barriers to PrEP uptaking, and access medication.

LinkedIn is a unique social and professional networking platform that helps individuals look for new opportunities and connect with other professionals.

Our desire to reshape the relationship between LinkedIn Groups and the newsfeed was born out of our interactions using the platform as job seekers during the COVID-19 pandemic. We sought to understand how LinkedIn used its unique position as a professional networking and social service to drive engagement, build community, and ultimately — help job seekers land their next role.

GETPrEP is a non-profit service to help marginalized individuals to connect with PrEP navigators, remove barriers to PrEP uptaking, and access medication. 

INTRODUCTION

INTRODUCTION

HIV is a virus that attacks the body’s immune system. It is spread by contact with certain bodily fluids of a person with HIV. The only way to know if you have HIV is to get tested; knowing the status is essential for making healthy decisions. Abstinence (not having sex), never sharing needles, and using condoms prevent risks of HIV. Still, pre-exposure prophylaxis (PrEP) is another effective tool have reduced the number of new HIV transmissions.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

HIV is a virus that attacks the body’s immune system. It is spread by contact with certain bodily fluids of a person with HIV. The only way to know if you have HIV is to get tested; knowing the status is essential for making healthy decisions. Abstinence (not having sex), never sharing needles, and using condoms prevent risks of HIV. Still, pre-exposure prophylaxis (PrEP) is another effective tool have reduced the number of new HIV transmissions.

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PrEP is a daily pill to prevent acquiring HIV. It is recommended for men who have sex with men (MSM), intravenous drug users (IDUs), and anyone at high risk for HIV infection. 

  • PrEP is 99% effective if taken as prescribed by sex. It also reduces the risk of HIV from injection drug use by at least 74%. 
  • The growth in PrEP use has played a part in recent decreases in new HIV diagnoses.
  • PrEP increases attention to screening and treatment of STIs.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

PrEP is a daily pill to prevent acquiring HIV. It is recommended for men who have sex with men (MSM), intravenous drug users (IDUs), and anyone at high risk for HIV infection. 

  • PrEP is 99% effective if taken as prescribed from sex. It also reduces the risk of HIV from injection drug use by at least 74%. 
  • The growth in PrEP use has played a part in recent decreases in new HIV diagnoses.
  • PrEP increases attention to screening and treatment of STIs.

PROBLEM SPACE

PROBLEMS SPACE

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The number of PrEP users in the U.S. increased by 23% from 2020 to 2021, continuing a trend of consistent growth in PrEP use since 2012. However, the main finding of the PrEP use data by race/ethnicity shows the enormous gap between the need and use of PrEP which needs better access and more programs specifically focused on individuals and communities disproportionately affected by HIV. Region disparity also heavily impacts the *PrEP-to-need ratio.

PROBLEM STATEMENTS

PROBLEM STATEMENTS 

How might we advocate a better way to access and enroll in the PrEP process for a marginalized individual?

How might we create a community of transparency to remove the shame and stigma of regional disparities to make them feel secure?

APPROACH

APPROACH

1. Learn about PrEP medication with more people.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

1. Learn about PrEP medication with more people.

To gain knowledge about PrEP in awareness and uptaking for insights with different target audiences.

2. Understand the cultural norm and discover social problems.

To discover the barrier of PrEP medication for marginalized individuals on system thinking.

3. Create key values to deliver for solution explorations.

To test and validate concepts for measuring impacts.

1. Learn about PrEP medication with more people.

To gain knowledge about PrEP in awareness and uptaking for insights with different target audiences.

2. Understand the cultural norm and discover social problems. 

To discover the barrier of PrEP medication for marginalized individuals on system thinking.

3. Create key values to deliver for solution explorations.

To test and validate concepts for measuring impacts.

Discover

Discover

USER INTERVIEWS

User-Interview_PreP

I interviewed eight people with different target audiences to learn how they started using PrEP medication, their journey with beginning it, and how it has evolved by creating initial research guides. Not just limited to PrEP uptaking, I found unique characteristics and themes in the context to understand different cultural and social layers based on their uncovered stories.

ASSUMPTIONS & HYPOTHESES

Debrief
1. PrEP coverage is unevenly distributed.
“[...] a lot of insurance companies don't cover it. The people that have difficulty are typically people in the middle.” — P2
“If you have no insurance and no income, you basically got it for free. The Black and Latino groups have the lowest PrEP use rates. I think it's the inequities of the healthcare system." — P4
2. The regional and cultural disparities may have stigmas on healthcare providers.
“People in rural areas may not have a good community where people are talking about PrEP and things like that when we do not have the same awareness or understanding of their risk levels.” — P7
"San Francisco has a history of welcoming all kinds of queers people that don't fit in elsewhere. I also think that's one of the best parts about the city besides." — P3
3. Those who talk about sexual activities more have a better awareness.
“You may on unveil some really interesting nuances to the way that our society talked about what good sex health looks like that itself could be a crucial conversation.” — P1
"People who belong to the LGBTQ community in India don't come out openly because of the social stigmas or taboos about how society will accept them. [...] how we can combat this infection so we can tell them about the use of PrEP." — P8

Define

Define

KEY OBSERVATIONS

1. There are many underlying barriers for individual seeking PrEP in preventative care.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

1. There are many underlying barriers for individuals seeking PrEP in preventative care.

2. San Francisco has worked to create campaigns to bridge the gap between public awareness and misinformation.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

2. San Francisco has worked to create campaigns to bridge the gap between public awareness and misinformation.

3. More talk and discussing sexual taboos give the empowerment of control to make right decisions on PrEP.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

3. More talk and discussing sexual taboos give the empowerment of control to make right decisions on PrEP.

SYSTEM MAPPING

The-Iceberg-Model
Group-27

To understand the deep root cause of the problem, I used an iceberg model to discover the patterns of behavior, supporting structures, and mental models that underlie a particular event in barriers to PrEP access. The basic flow of PrEP care consists of three stages: Awareness, Uptake, Adherence & Retention. Awareness is how individuals learn detailed information through campaigns/education and social media advertisements for making plans. Uptake involves healthcare services to test HIV/STIs and prescribe PrEP medications. Adherence & Retention are monitored with follow-up visits and prescriptions. I identified the main actors and parts to understand the relationship between individuals and the three stages.

DISCOVERY

DISCOVERY

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Scheduling PrEP enrollment at the health & wellness center helped to learn how it works in a particular experience. HIV/STIs testing was the critical registration step because the PrEP medication must be HIV-negative before and while taken. A nurse practitioner demonstrated the procedure and briefly explained further steps. My overall observations were:

  • First-time visitors can make an appointment through the website without a complex health questionnaire which takes lesser than 3 min.
  • Those uninsured with an income of less than the Federal Poverty Line ($63,000) are eligible to get the medication for free with the PrEP navigation team. However, there are copay assistance programs available to those who have insurance.
  • The patient portal invitation link was sent to the email address to see the lab test results.
  • LGBTQ-friendly environment makes feel comfortable and engaged in removing the stigma which gives thrust. 

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

Scheduling PrEP enrollment at the health & wellness center helped to learn how it works in a particular experience. HIV/STIs testing was the critical registration step because the PrEP medication must be HIV-negative before and while taking. A nurse practitioner demonstrated the procedure and briefly explained further steps. My overall observations were:

  • First-time visitors can make an appointment through the website without a complex health questionnaire which takes lesser than 3 min.
  • For those who are uninsured and with an income of less than the Federal Poverty Line ($63,000) are eligible to get the medication for free with the PrEP navigation team. However, there are copay assistance programs available to those who have insurance.
  • Patient portal invitation link sent to email address to see the lab test results.
  • LGBTQ-friendly environment makes feel comfortable and engaged to remove the stigma which gives thrust. 
Group-28

"The PrEP navigators are one of the most important pieces in connecting peoplee to PrEP. You can't have a PrEP program without a PrEP navigator."

KEY INSIGHTS

KEY INSIGHTS

1. PrEP is not just medication for HIV prevention. It is a part of the culture about sexual positivity.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

1. PrEP is not just medication for HIV prevention. It is a part of the culture about sexual positivity.

2. Connecting people with HIV PrEP providers facilitates conversation to identify those who have fallen out of care for initiation.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

2. Connecting people with HIV PrEP providers facilitates conversation to identify those who have fallen out of care for initiation.

3. Building a community of transparency and trust remove the shame and stigma within individuals.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

3. Building a community of transparency and trust remove the shame and stigma within individuals.

JOURNEY MAP

JOURNEY MAP 

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BEHAVIORAL ARCHETYPE

BEHAVIORAL ARCHETYPE 

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Behavioral archetype represents motivation or behavior to define user types in the current situation of PrEP uptake. "Unaware Risk Taker" represents the unmet need of people who are sexually activated but have low access to PrEP medication resources, which I want to solve.

Based on our research, we created a hypothetical user model (Shannon), who is a data scientist at Startup. Shannon has been thinking of leaving her current job and has started passively looking for other data science roles. She’s always been a passive user but has started data science groups to start reaching out to other data science professionals. She hopes that joining these groups and engaging with other users will help her find her next opportunity.

Behavioral archetype represents motivation or behavior to define user types in the current situation of PrEP uptake. "Unaware Risk Taker" represents the unmet need of people who are sexually activated but have low accessibility to PrEP medication resources, which I want to solve.

Develop

Develop

EXPLORE POTENTIAL OPPORTUNITIES

EXPLORE POTENTIAL OPPORTUNITIES 

sketchesjpg
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I explored potential opportunities by defining the meaning of marginalized individuals. One of the possible solutions was a digital environment that utilizes informational facilities providing free PrEP in a low-income community and an educational campaign to create awareness. To make it tangible on the state or national levels, it needs to connect providers and marginalized individuals to solve systematic problems in health care services to help deliver the entire medication process so they can return to services without hesitations.

We gathered the insights from our researches to conceptualize the following initial ideas.

  • Expanding the groups container on the newsfeed.
  • Adding filters to the recommendations tab.
  • Allowing users to tag groups when creating posts.
  • Promoting groups of interest on the newsfeed.
  • Showing top interactive users in groups.
  • Adding more filters to the followers section.

I explored potential opportunities by defining the meaning of marginalized individuals. One of the possible solutions was a digital environment that utilizes informational facilities providing free PrEP in a low-income community and an educational campaign to create awareness. To make it tangible on the state or national levels, it needs to connect providers and marginalized individuals to solve systematic problems in health care services to help deliver the entire medication process so they can return to services without hesitations.

COMPETITIVE AUDITS

COMPETITIVE AUDITS 

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FINDING VALUES

FINDING VALUES

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Implementation strategies aim to create greater PrEP access and adoptions. The prevention model currently includes national, state, and local levels of public health collaborating with and supporting clinics and nonclinical community services to ensure that PrEP is available. However, the lack of providers and national levels of public health makes it hard to engage with individuals, which potentially causes discontinuation.

Group-33

HIV Pre-Exposure Prophylaxis (Prep) Care System.” Centers for Disease Control and Prevention (CDC).

Based on our research, we created a hypothetical user model (Shannon), who is a data scientist at Startup. Shannon has been thinking of leaving her current job and has started passively looking for other data science roles. She’s always been a passive user but has started data science groups to start reaching out to other data science professionals. She hopes that joining these groups and engaging with other users will help her find her next opportunity.

I created the new collaboration model based on the advantages of government programs, CBOs & community health centers, and commercial services. Integrating telehealth could help deliver PrEP, especially in rural areas, to increase adoption and retention. PrEP navigators are essential to help marginate individuals track follow-up for engagement with privacy. Educational campaigns and resources will also raise awareness to fix misconceptions about stigma and promote sexual health.

I created the new collaboration model based on the advantages of government programs, CBOs & community health centers, and commercial services. Integrating telehealth could help deliver PrEP, especially in rural areas, to increase adoption and retention. PrEP navigators are essential to help marginate individuals track follow-up for engagement with privacy. Educational campaigns and resources will also raise awareness to fix misconceptions about stigma and promote sexual health.

We added and removed concepts from the initial ideas to work toward delivering a straightforward and interactive experience between LinkedIn Groups and the newsfeed. We moved our work into Adobe XD to explore the following concepts in more detail.

 “However, the high rate of discontinuation in key demographic and clinical subgroups disproportionately impacted by HIV suggests that healthcare access alone is not sufficient. [...] barriers of these important populations to keep them engaged in PrEP care.”

VALUE PROPOSITION

VALUE PROPOSITION

For marginated individuals who have difficulty accessing PrEP medications, our services help to coordinate coverage and educate how it works so you can prescribe medication with benefits in retention with community partners.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

For marginated individuals who have difficulty accessing PrEP medications, our services help to coordinate coverage and educate how it works so you can prescribe medication with benefits in retention with community partners.

EXPERIENCE PRINCIPLES

EXPERIENCE PRINCIPLES

1. Accessibility
Easy PrEP enrollment to connect PrEP navigators for entering the first footsteps.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

1. Accessibility
Easy PrEP enrollment to connect PrEP navigators for entering the first footsteps.

2. Welcoming
Create an intimate experience to remove shame and stigmas to promote sexual positivity.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

2. Welcoming
Create an intimate experience to remove shame and stigmas to promote sexual positivity.

3. Trust
Build privacy and a community of transparency for uptaking PrEP within individuals.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

3. Thrust
Build privacy and a community of transparency for uptaking PrEP within individuals.

Deliver

Deliver

SOLUTIONS

Desktop-13-1

01. A Landing page to connect with PrEP navigators with useful resources.

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

A Landing page to connect with PrEP navigators with useful resources.

02.  Easy registration with a PrEP navigator to make a consultation. The virtual meeting link will provide through the contact information.

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

Easy registration with a PrEP navigator to make a consultation. The virtual meeting link will provide through the contact information.

Desktop-21

03. Consult with a PrEP navigator to discuss the next steps. A PrEP navigator will help you with the PrEP enrollment and provide an invitation code for the patient portal. 

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

Display the top interactive members in groups.

This capability allows users to see the top contributors in the groups they’re part of. Making this capability visible will encourage new and existing users to participate, connect, and engage with other members. 

Consult with a PrEP navigator to discuss the next steps. A PrEP navigator will help you with the PrEP enrollment and provide an invitation code for the patient portal.

Conclusions

Conclusion

NEXT STEPS

1. Conduct more concept validation to PrEP navigators and people to implement key features of the solutions.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

1. Conduct more concept validation to PrEP navigators and people to implement key features of the solutions.

2. Explore the ideas of a patient portal to visualize HIV/STIs testing results and follow-ups after the connection of PrEP navigators in retention.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

2. Explore the ideas of a patient portal to visualize HIV/STIs testing results and follow-ups after the connection of PrEP navigators in retention.

3. Refine a conceptual model for advocating new PrEP delievery systems to governance programs through health care providers and pharmacies.

After these interviews, we discovered patterns in how candidates, job seekers, and employers described their experiences with LinkedIn. Based on these insights, we generated HMW (How Might We) questions that we then grouped under the following categories:

  • Engagement
  • Connection
  • Customization
  • Information
  • Job Search
  • Motivation 
  • Organization

3. Refine a conceptual model for advocating new PrEP delievery systems to governance programs through health care providers and pharmacies.