The Treatment Advocacy Program-Sinai: A Peer-Based HIV Prevention Intervention for Working with African American HIV-Infected Persons

Abstract

As HIV/AIDS continues to disproportionately affect African American communities, there is a growing need for empirically based, culturally appropriate, tailored interventions for this clientele. As part of a Health Resources and Services Administration (HRSA)/Special Projects of National Significance (SPNS) initiative to increase prevention amongst those living with HIV, we implemented the Treatment Advocacy Program Intervention at Mount Sinai Hospital in Chicago, IL, USA. The main goal of the intervention was to help patients increase their medication adherence and sexual safety skills. This paper describes the rationale for implementing this peer-based HIV-prevention intervention, discusses how the intervention was tailored to work within our low socio-economic status, urban patient population, and reviews the training and quality assurance activities needed to integrate the intervention into our primary care clinic. We review the intervention content in detail, including the structure of the multiple, one-on-one education sessions, and the core topics covered (medication adherence and sexual safety). Finally, we discuss the challenges in implementing this program, many of which arise from the chaotic social situations that our patients experience.

A longitudinal analysis of HIV treatment adherence among men who have sex with men: A cognitive escape perspective

“…Participants received a $25 stipend for each visit. The intervention consisted of peerdelivered, motivational interviewing-based interactive modules focusing on sexual safety and HIV treatment adherence (see Raja, McKirnan, & Glick, 2007).…”

Patterns of Treatment Use and Barriers to Care Among Hospitalized Adults with HIV

“…A growing number of these models rely extensively on peers in this study (PLWHA from the targeted community; Raja, McKirnan, & Glick, 2007) or near-peers (i.e., outreach workers, peer counselors; Berkley-Patton et al, 2009) who provide emotional support, education, and a variety of outreach services such as distributing educational materials, running support groups, teaching strategies to decrease alcohol and drug use, and modeling safe sex practices (e.g., Berkley-Patton et al, 2009;Messias, Moneyham, Vyavaharkar, Murdaugh, & Phillips, 2008;Molitor et al, 2005;Raja et al, 2007).…”

Prevention counseling for HIV-infected persons: What every clinician needs to know

“…The Protect and Respect program integrates multilevel prevention strategies under three broad components: a clinician-administered brief prevention counseling session during routine medical care; a health educator-administered group-level intervention; and a peer-led support group [30]. The peer-based model is also the principal component of the Treatment Advocacy Program-Sinai [31]. We await the full results of these interventions, but preliminary feedback from patients has been encouraging.…”

“…Studies in developing nations replicated such strong fertility desires among PLWHA, despite an understanding of the risks to their partners and their unborn children [25,33]. Because half of all US pregnancies are unplanned, preconception care and counseling should be a priority for all women throughout their reproductive years, including those who have not expressed fertility desires [31]. It is also imperative to test male partners for HIV infection and bring those who test positive into care, thereby potentially limiting the chain of transmission [6••].…”