MSM

 

Texas PrEP Implementation Study

Investigators: Susan Kegeles, Greg Rebchook, Robert Williams, Scott Tebbetts, Andres Maiorana 

Texas has high rates of HIV infection despite the availability of PrEP. Young Black and Latino men who have sex with men (YBLMSM) are less likely than young white MSM to take PrEP, adhere to PrEP, and continue PrEP use over time. This study involves collaboration with two CBOs providing PrEP and an organization running two PrEP clinics. The three organizations are using Core Elements of the Mpowerment Project (MP), an evidence-based, community-level intervention to facilitate the empowerment of young MSM and reduce HIV risk. This project is assessing the feasibility of using Plan-Do-Study-Act (PDSA) cycles to develop PrEP enhanced MP activities and assessing the implementation outcomes.  

Preliminary research findings:

  • The study may have served as a catalyst for organizations to provide enhanced PrEP promotion activities
  • MP methods can be used to support PrEP uptake, adherence, and persistence among YBLMSM (more work needed to reach monolingual Spanish-speaking men)
  • The community partners have stressed the importance of being extra patient and gentle with them and clients during COVID pandemic
  • PDSAs seemed to be a feasible implementation strategy
  • While very challenging, because of the COVID pandemic, the last 2+ years have also been a time of considerable institutional innovation, flexibility, and dynamic growth
  • Other challenges have included staff turnover, the  merger of one of the organizations with a larger one that caused changes in organizational culture, integrating project activities with other services, including clinical ones, and incorporating PreP adherence and persistence activities
  • This project created an opportunity for three organizations to learn from and support each other during periodic meetings to discuss activities and exchange ideas
  • Administrative challenges related to billing/invoicing sometimes stymied implementation


Listen to a podcast on queer sex (MPACT DFW).

Visit the Mpowerment Project site.
 

 
We Are Family: Testing, Linkage and Engagement in Care among African American Gay, Bisexual, and Trans youth in the House Ball Community 

Investigators: Emily Arnold (PI), Parya Saberi, Susan Kegeles, Torsten Neilands, Lance Pollack, Michael Benjamin (CAL-PEP), Felicia Bridges (CAL-PEP), and Gloria Lockett (CAL-PEP) 

This 4-year study was supported by the California HIV/AIDS Research Program (CHRP) to develop and test intervention activities that build upon forms of social support already occurring among young people involved in the house ball and gay family communities, specifically related to HIV prevention and care. This is a collaboration between UCSF, CAL-PEP, and members of the house ball and gay family communities. 

Research finding: Many Bay Area houses and gay families already share HIV prevention information and support to help one another connect to services if necessary. Building on family connections provides a natural forum to bring up the most recent prevention and treatment advances, such as home testing and PrEP/PEP, and U=U.

We Are Family CA HIV/AIDS Research Program.

 

 

The Bruthas Project: Sexual Health Promotion Counseling Sessions 

Investigators: Emily Arnold (PI), Gloria Lockett (Community PI) 

Black men who have sex with men and women (BMSMW) are at high risk for acquiring and transmitting HIV, but few interventions exist to address their prevention needs. To address this, we developed the Bruthas Project, a series
of four individualized sexual health promotion counseling sessions designed to build upon HIV counseling and testing (HIV-CT). 

Research finding: In this randomized controlled trial of the Bruthas intervention, we compared participants who received culturally tailored HIV testing and counseling plus four individualized counseling sessions to those who received only the culturally tailored HIV testing and counseling. BOTH groups reduced their number of sex partners and episodes of condom-less intercourse. BMSMW are responsive to HIV prevention and testing efforts when they are provided in a culturally responsive and respectful manner. 

Bruthas Project Randomized Controlled Trial

 

 

Using Evidence Informed Interventions to Improve Health Outcomes for People Living with HIV Initiative (E2i) Evaluation Center

Investigators: Janet Myers (PI), Greg Rebchook (Co-PI), Starley Shade, Kim Koester, Carol Dawson-Rose, Beth Bourdeau

The purpose of E2i was to address disparities in access to and retention in effective care and treatment for people with HIV served by Ryan White HIV/AIDS Program (RWHAP). E2i funded 26 RWHAP sites implementing 11 evidence-informed interventions in four focus areas, including Black men who have sex with men (BMSM). Sites differed in the services offered (clinical and non-clinical), the larger context (university hospitals, federally qualified health centers, community-based organizations), and location throughout the U.S. (rural and urban settings).

Research finding. Interventions in the BMSM focus area included 1) Tailored Motivational Interviewing (TMI), Project Connect, and TXTXT. BMSM interventions reached 278 BMSM. TMI and TXTXT showed a significant increase in participants’ engagement in HIV care. TMI also demonstrated significant increases in ART prescription, retention in care, and viral suppression. Participation in TMI also had a dosage effect, with increased exposure to the intervention predicting greater increases in retention, and was found to be cost effective relative to viral suppression.
 

 

The LetSync Project: Creating a mHealth Tool for Enhancing HIV Care Engagement in the Dyadic Context

Investigator: Judy You Rong Tan

The primary relationship provides an important context for understanding HIV care engagement, but little is known regarding how the primary relationship helps Black or African American MSM engage in care and treatment. Mobile health (mHealth) holds potential for facilitating relationship factors conducive to HIV care engagement among Black men who are in a primary romantic relationship with another man. The goal of the LetSync Project is to develop a couples-focused mHealth tool that facilitates synchronization (“let’s sync”) of HIV care engagement among Black or African American men in couples.  

 

 

Partner Violence, And COVID-19 On HIV Care Engagement Among Young Black Sexual Minority Men With HIV In The US South

Investigators: Erik Storholm (SDSU), Susan Kegeles (UCSF), Wilson Vincent (TU).

Among sexual minority men, young Black sexual minority men are the most disproportionately impacted by new HIV infections. Intimate partner violence (IPV) is one of the most understudied factors that may exacerbate these disparities. Both IPV and substance use leading to IPV may help explain poorer CC engagement among YBSMM+ and are likely to be exacerbated by the COVID-19 pandemic, which is having devastating health and economic impacts. This study uses structural equation modeling to explore the associations between substance use and IPV and their impact on HIV care engagement, viral suppression, condomless anal sex, and to determine if distinct forms of resilience (global resiliency, coping skills, and social support) buffer associations between these relationships among YBSMM+ in the U.S. South. This study will shed new light on the associations between substance use, IPV and CC outcomes and risk and subsequently aid in developing a resiliency and advocacy-based intervention that potentially reduces the impact of substance use and IPV on CC engagement and retention among YBSMM+.