# P-273. User and Community Reflections and Recommendations on the Promise of HIV Molecular Epidemiology

## TL;DR

This study explores how public health officials and at-risk communities view HIV Molecular Epidemiology, highlighting the need for trust, privacy, and ethical practices to support its use in public health.

## Contribution

The study provides community-centered insights and recommendations for improving the ethical and effective implementation of HIV Molecular Epidemiology.

## Key findings

- HME can aid in outreach and linkage but faces challenges due to community mistrust around privacy and criminalization.
- Training for public health officials must include trauma-informed care, privacy protections, and cultural understanding.
- Clear communication and relationship-building are essential for engaging communities in HME efforts.

## Abstract

HIV Molecular Epidemiology (HME) uses viral genetic pol sequences to identify transmission networks and guide public health responses. While HME offers promises for addressing rapid or ongoing HIV transmission, concerns about privacy, informed consent, and potential criminalization have limited community trust and hindered widespread implementation. This study aims to explore the perceptions of public health officials (PHOs) and priority populations to inform community-centered HME practices.Characteristics of public health officials (PHOs)HME = HIV molecular epidemiologyDemographics of priority populationsMSM = men who have sex with men, TGW = transgender women, PrEP = pre-exposure prophylaxis, HME = HIV molecular epidemiology

Characteristics of public health officials (PHOs)

HME = HIV molecular epidemiology

Demographics of priority populations

MSM = men who have sex with men, TGW = transgender women, PrEP = pre-exposure prophylaxis, HME = HIV molecular epidemiology

We conducted virtual focus groups discussions (FGD) with PHOs and Black cisgender women, Black and Latino men who have sex with men (MSM), and Latina/Latino transgender women (TGW) in Metropolitan Atlanta using a community-engaged, multi-method design. Participants were recruited in partnership with local trusted community-based organizations and prior to each FGD, watched a video explaining HME. Discussions explored (1) perceptions on HME, (2) key attributes for PHOs involved in HME, (3) HME-related training for PHOs, (4) HME communication practices, and (5) ethical HME practice. Data were analyzed using descriptive statistics and reflexive thematic analysis.

Key considerations that emerged in discussions about HME with public health officials (PHOs) and priority populationsThe first column represents the five domains defined for the thematic analysis of qualitative data. The following columns list key HME-related perceptions and perspectives of PHOs and members of priority populations who participated in the research, organized by qualitative domains, with representative quotes in italics and converging views placed in between

Key considerations that emerged in discussions about HME with public health officials (PHOs) and priority populations

The first column represents the five domains defined for the thematic analysis of qualitative data. The following columns list key HME-related perceptions and perspectives of PHOs and members of priority populations who participated in the research, organized by qualitative domains, with representative quotes in italics and converging views placed in between

We conducted 18 FGDs among 92 research participants (Figure 1, Table 1). Our data showed that (1) HME holds promise for outreach and linkage but must overcome community mistrust tied to privacy, stigma, and criminalization fears; (2) lived experience, cultural understanding, and empathy must guide HME; (3) PHOs’ HME training must integrate trauma-informed care, privacy protections, community voices, and continuous skill-building; (4) simple, relatable communication and relationship-building are necessary for meaningful community engagement with HME, and that (5) ethical HME requires consent and dialogue, given existing fears about data misuse (Figure 2).

Community-centered HME depends on transparency, individual agency, cultural sensitivity, engagement, and commitment. Strengthening trust requires centering lived experience, protecting privacy, enhancing current PHO training, and communicating HME-related information clearly. These elements are necessary for the successful implementation of HME in outreach, linkage, and public health equity.

All Authors: No reported disclosures