PrEP Initiation

The Baltimore City Health Department and MICA’s Center for Social Design collaborated on an initiative to help with PrEP (pre-exposure prophylaxis) initiation for their patients at their two Sexual Health Clinics. PrEP is a preventative for HIV (human immunodeficiency virus) infection, a virus and associated disease which holds a lot of stigma.

The six-month long project focused on how we could design with and for both the PrEP providers and patients.

︎ Baltimore City Health Department

︎ Center for Social Design

︎ Design Research, Service Design

︎ August - December 2021

How might we support BCHD Sexual Health providers and patients with PrEP Initiation?

To start, we considered equity centered community design practices and set intentions for our process. We then researched PrEP’s history and science as well as access and barriers to it in Baltimore. We looked into medical mistrust in Baltimore, the LGTBQIA community, and the Black community as they were key communities in the primary patient population.

Then, we went through the draft PrEP Protocol, and we created flow charts to better understand the process. From there, we each took turns visiting the two clinics, doing material audits, and talking with PrEP RNs.

Credits:
Course Instructor: Becky Slogeris
Team: Dhvani Shah, Ellie Bazurto, Allyson Kim, Elizabeth Emmett, Dejia Danhi, Matt Coles, Larissa Hawkins

Research

After our secondary research, we developed three main guiding questions and brainstormed methods for each question. Over the course of several weeks, we developed interview questions for each of our core stakeholders and conducted interviews.

Then we worked in teams to pull out themes from a variety of data points. We word-smithed the themes to make sure they represented the data accurately. From there, we pulled out insights, sources of tensions within the data, and then developed opportunities, or how might we questions.

Synthesis

To aid in our understanding, we developed two journey maps: one for providers and one for patients. We used these to highlight pain points and bright spots in their processes. Additionally, we developed design principles which set the trajectory of our designs.

Design Principles

Engage and Empower ︎Engage with and empower patients and providers through support in the PrEP Initiation process

Recognize the Stigma ︎Sexual health, HIV/AIDS, and the LGBTQIA+ Community have all been stigmatized. Recognize the stigma and check your own personal biases

Thing Big Picture ︎Consider the possible long-lasting mpact when ideating and designing

Be Progressive ︎ Use inclusive language in messaging and visuals that remain sex positive and without judgment

Acknowledge the History ︎Acknowledge the history of HIV/AIDs and the LGBTQIA+ communit and the inherent medical mistrust

Streamline & Simplify ︎When possible, streamline the process for all stakeholders to increase accessibility

Ideation

We held a co-creation session with patients, providers, and administrators from the BCHD to ideate on the opportunities we developed during synthesis. We organized those ideas into categories for us to unpack in prototyping.

Prototyping & Implementation

We prototyped several of the ideas and, as a team, gave feedback to each other and narrowed down our prototypes. From there we made higher fidelity prototypes and shared them with BCHD staff and patients. They gave us feedback which led us to refine our prototypes. We returned to get more feedback as well as conducted user-testing. Now a few members of our team are working to finalize and implement them in the clinics.