Creating systems change to support goals for HIV continuum of care: The role of community coalitions to reduce structural barriers for adolescents and young adults

Boyer, Cherrie B.; Walker, Bendu Cooper; Chutuape, Kate; Roy, Jessica; Fortenberry, J. Dennis; Interventions, Aids

doi:10.1080/15381501.2015.1074977

Cited by 13 publications

(3 citation statements)

References 45 publications

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“…Therapy requires linkage to care, and while not part of this study, it is notable that the ATN has done separate work in this area. Innovative implementation programs such as the Strategic Multisite Initiative for Identification, Linkage and Engagement or SMILE have been described elsewhere 14 and will be detailed further in forthcoming publications. Still, once linked to care at ATN sites and engaged in care, youth in our study were able to achieve a noteworthy treatment milestone of 97% treated.…”

Section: Discussionmentioning

confidence: 99%

HIV Continuum of Care for Youth in the United States

Lally

Berg

Westfall

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Discussionmentioning

confidence: 99%

HIV Continuum of Care for Youth in the United States

Lally

Berg

Westfall

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…In order to meet enrollment criteria, participants must (1) be a cisgender male between ages 30 and 65; (2) identify as an ethnic or racial minority; (3) have HIV; (4) identify as gay, bisexual, or queer; (5) read and understand English; (6) have access to a computer capable of downloading and running the virtual environment software; and (7) have no cognitive impairment and no medical history of serious complications, such as myocardial infarction, congestive heart failure, coronary artery bypass graft, or cerebral vascular accident. It is documented that the highest incidence of HIV is among emerging adults (ie, up to 34 years old) [ 46 ], as chronic illness is becoming diagnosed at earlier stages of life (eg, 18 to 30 years old) with the highest prevalence at age 50 years and older [ 47 ]. Our sample age range is appropriate given the changing age demographic of chronic illness and will provide a thorough overview spanning 3 generations.…”

Section: Methodsmentioning

confidence: 99%

Cardiovascular Disease Prevention Education Using a Virtual Environment in Sexual-Minority Men of Color With HIV: Protocol for a Sequential, Mixed Method, Waitlist Randomized Controlled Trial

Ramos¹,

Johnson²,

Melkus³

et al. 2022

JMIR Res Protoc

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Background It is estimated that 70% of all deaths each year in the United States are due to chronic conditions. Cardiovascular disease (CVD), a chronic condition, is the leading cause of death in ethnic and racial minority males. It has been identified as the second most common cause of death in persons with HIV. By the year 2030, it is estimated that 78% of persons with HIV will be diagnosed with CVD. Objective We propose the first technology-based virtual environment intervention to address behavioral, modifiable risk factors associated with cardiovascular and metabolic comorbidities in sexual-minority men of color with HIV. Methods This study will be guided using social cognitive theory and the Technology Acceptance Model. A sequential, mixed method, waitlist controlled randomized control feasibility trial will be conducted. Aim 1 is to qualitatively explore perceptions of cardiovascular risk in 15 participants. Aim 2 is to conduct a waitlist controlled comparison to test if a virtual environment is feasible and acceptable for CVD prevention, based on web-based, self-assessed, behavioral, and psychosocial outcomes in 80 sexual-minority men of color with HIV. Results The study was approved by the New York University Institutional Review Board in 2019, University of Texas Health Science Center at Houston in 2020, and by the Yale University Institutional Review Board in February 2022. As of April 2022, aim 1 data collection is 87% completed. We expect to complete data collection for aim 1 by April 30, 2022. Recruitment for aim 2 will begin mid-May 2022. Conclusions This study will be the first online virtual environment intervention for CVD prevention in sexual-minority men of color with HIV. We anticipate that the intervention will be beneficial for CVD prevention education and building peer social supports, resulting in change or modification over time in risk behaviors for CVD. Trial Registration ClinicalTrials.gov NCT05242952; https://clinicaltrials.gov/ct2/show/NCT05242952 International Registered Report Identifier (IRRID) PRR1-10.2196/38348

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“…The AMTUs chose HIV testing strategies with input from their local community partners (coalitions) with an understanding of local needs and resources . The testing strategies followed 1 of 3 general approaches: universal screening in community-based and clinical settings, which attract large numbers of youths (eg, school-based health centers and hospital emergency departments); targeted testing at community-based events (such as pop-up youth-focused parties) at community venues where young people socialize and through mobile testing vans; and combination testing approaches that used universal screening and targeted testing strategies.…”

Section: Methodsmentioning

confidence: 99%

Evaluating Testing Strategies for Identifying Youths With HIV Infection and Linking Youths to Biomedical and Other Prevention Services

et al. 2017

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IMPORTANCE Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. OBJECTIVE To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results. DESIGN, SETTING, AND PARTICIPANTS Testing strategies were evaluated using an observational design during a 9-month period (June 1, 2015, through February 28, 2016). Testing strategies were implemented by 12 adolescent medicine HIV primary care programs and included targeted testing, universal testing, or a combination. Data were collected from local youth at high risk of HIV infection and, specifically, sexual minority males of color. MAIN OUTCOMES AND MEASURES Proportion of sexual minority males and sexual minority males of color tested, proportion of previously undiagnosed HIV-positive youths identified, and rates of linkage to prevention services. RESULTS A total of 3301 youths underwent HIV testing. Overall, 35 (3.6%) of those who underwent universal testing in primary care clinical settings, such as emergency departments and community health centers, were sexual minority males (35 [3.6%] were males of color) compared with 236 (46.7%) (201 [39.8%] were males of color) who were tested through targeted testing and 693 (37.8%) (503 [27.4%] were males of color) through combination efforts. Identification of new HIV-positive cases varied by strategy: 1 (0.1%) via universal testing, 39 (2.1%) through combination testing, and 16 (3.2%) through targeted testing. However, when targeted tests were separated from universal testing results for sites using a combined strategy, the rate of newly identified HIV-positive cases identified through universal testing decreased to 1 (0.1%). Rates of new HIV-positive cases identified through targeted testing increased to 49 (6.3%). Youths who tested through targeted testing (416 [85.1%]) were more likely to link successfully to local HIV prevention services, including preexposure prophylaxis, compared with those who underwent universal testing (328 [34.1%]). CONCLUSIONS AND RELEVANCE The findings suggest that community-based targeted approaches to HIV testing are more effective than universal screening for reaching young sexual minority males (especially males of color), identifying previously undiagnosed HIV-positive youths, and linking HIV-negative youths to relevant prevention services. Targeted, community-based HIV testing strategies hold promise as a scalable and effective means to identify high-risk youths who are unaware of their HIV status.

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Creating systems change to support goals for HIV continuum of care: The role of community coalitions to reduce structural barriers for adolescents and young adults

Cited by 13 publications

References 45 publications

HIV Continuum of Care for Youth in the United States

HIV Continuum of Care for Youth in the United States

Cardiovascular Disease Prevention Education Using a Virtual Environment in Sexual-Minority Men of Color With HIV: Protocol for a Sequential, Mixed Method, Waitlist Randomized Controlled Trial

Evaluating Testing Strategies for Identifying Youths With HIV Infection and Linking Youths to Biomedical and Other Prevention Services

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