Project nGage: Results of a Randomized Controlled Trial of a Dyadic Network Support Intervention to Retain Young Black Men Who Have Sex With Men in HIV Care

Abstract

HIV-positive young Black MSM (YBMSM) experience poor outcomes along the HIV Care Continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n=45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also received four mini-booster sessions. Control participants (n=53) received treatment as usual. Surveys and medical records at baseline, 3-, and 12-months post-intervention assessed visit history (3 or more visits over 12 months; primary outcome), and sociodemographic, network, social-psychological, and behavioral factors. At baseline, there were no differences in age (M=23.8 years), time since diagnosis (M≤2 years), clinic visits in the previous 12 months (M=4.1), and medication adherence (68.6%≥90% adherence). In multivariate logistic regression analysis, intervention participants were 3.01 times more likely to have had at least 3 provider visits (95% CI: 1.0–7.3) than were control participants over 12 months. Project nGage demonstrates preliminary efficacy in improving retention in care among YBMSM. Results suggest that engaging supportive network members may improve key HIV Care Continuum outcomes.

Social Networks Moderate the Syndemic Effect of Psychosocial and Structural Factors on HIV Risk Among Young Black Transgender Women and Men who have Sex with Men

“…(101) Consistent with this trend, social network interventions engaging family members have been associated with better engagement in care among YBTM living with HIV. (20) In our sample, 59% of respondents reported having at least one family member in their social network. These findings support the need for family-based network approaches to HIV prevention among YBTM.…”

“…(3,(8)(9)(10)(11)(12)(13)(14)(15)(16) In addition, a growing body of evidence suggests that social network factors (i.e., the number of people in a social network and the characteristics of different network members) may significantly influence vulnerability to HIV infection among YBTM. (17)(18)(19)(20) Research on how social network characteristics moderate the relationship between psychosocial and structural factors and HIV transmission-related behaviors and HIV serostatus among YBTM is limited.…”

The social network context of HIV stigma: Population-based, sociocentric network study in rural Uganda

“…First, the clustering of negative attitudes towards HIV may suggest that changing attitudes toward HIV may require intervention not only at the level of the individual but also at the level of the network. Such an intervention may (for example) ask a person to recruit members of his or her social network peers to participate in an intervention together, or encourage peer-to-peer communication to create cascades in the diffusion of attitudes (Bouris et al, 2017;Morgan et al, 2018;Schneider et al, 2012;Valente, 2012). Second, our findings suggest that stigma reduction interventions should encourage community members to engage with PLH.…”

Protocol Development for HMU! (HIV Prevention for Methamphetamine Users), a Study of Peer Navigation and Text Messaging to Promote Pre-Exposure Prophylaxis Adherence and Persistence Among People Who Use Methamphetamine: Qualitative Focus Group and Interview Study

“…In the focus groups and interviews, we shared educational materials that had been previously developed during formative work done with Project NEON to increase PrEP education and uptake among MSM and TGP who use methamphetamine [ 19 ]; we then asked participants for feedback about the card images and content. Participants liked the nonjudgmental phrasing “we aren’t here to judge your drug use” but recommended replacing “your drug use” with “you.” Some, but not all, participants thought that the inclusion of the word “tweaker” was stigmatizing; however, there was consensus that the word “partying” would be a preferable word choice and widely understood among the LGBTQ+ community to refer to methamphetamine use.…”