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This randomized phase III trial compares topical or ablative treatment with active monitoring in preventing anal cancer in patients with human immunodeficiency virus (HIV) and high-grade squamous intraepithelial lesions (HSIL). Anal HSIL is tissue in the anal canal that has been damaged by infection with human papillomavirus (HPV) and is at risk for turning into anal cancer. It is not yet known if treating HSIL is more effective than active monitoring in preventing patients from developing anal cancer.

The Generation study is the first long-term, five year study to examine the health and well-being across three generations of lesbians, gay men, and bisexuals (LGB). Investigators in the Generations study will use both qualitative and quantitative methods, asking about LGB people’s sense of identity and identification with the LGB community, stressors and challenges they experience, resilience and sources of strength, and health and well-being. An innovative quantitative survey procedure will identify Black, Latino, and White LGB individuals in the United States. Respondents will participate in the study over a 5-year period to detect changes in the social environment as people age. The qualitative portion of the study will collect narrative life histories of Black, Latino, White, and Asian LGB individuals living in urban and non-urban regions of New York, California, and Arizona.

The purpose of this K24 application is to support the continuation and proposed expansions of Dr. Mallory Johnson's programs of Mentoring and patient-oriented research (POR) in social and behavioral approaches to optimizing engagement in HIV Care among drug-using populations. the candidate proposes new Mentoring, new research, and additional Training to build competency in Drug abuse research, HCV and liver disease, and advanced research methodologies. the proposed plan for Mentoring expands his current Mentoring program in new directions, including an innovative grand Mentoring program, new sources of mentees, development of online team-based Mentoring tools, and scholarship in best practices of Mentoring. These plans emphasize the importance of addressing challenges to successful transition to independence during periods of budgetary constraint through the leveraging and strategic use of data, Infrastructure, and expertise available through existing NIH-funded research networks, Training programs, and Funding mechanisms. Three aims for new research are proposed, which will provide data for future interventions to improve health Care Empowerment and Clinical outcomes for populations at risk for suboptimal engagement in HIV Care, including HIV-infected substance users (men, women, and transgender women) and HIV/HCV co-infected women. These POR activities will be conducted within the Infrastructure of the Women's Interagency Health Study (WIHS), the CFAR Network of Integrated Clinical Systems (CNICS) and a cohort of transgender women led by one of the candidate's mentees. the overriding theme of the new POR is to investigate the challenges of engagement in Care and uptake, persistence, and adherence, to antiretroviral therapy (ART) among populations at greatest risk for poor treatment outcomes. These POR activities will involve active participation by mentees and will Complement their development plans and transitions to independence. All of the new aims will be framed in the Model of Health Care Empowerment and will provide preliminary data for subsequent observational and interventional studies of engagement in Care. Through the efficient leveraging of existing resources, collaborations, data, and affiliations with NIH-funded networks, the overarching goal of this application is to support the development of early career Investigators, new mentors, and to provide opportunities for my own training/competency-building, and to catalyze new projects in the area of engagement in HIV Care among at- risk populations.

NIMH re-funds CAPS for another five years & CAPS 30th Anniversary!

Welcome to our 2nd quarterly e-newsletter! This issue highlights new research projects from CAPS VII,the CAPS 30th Anniversary Celebration, and NIMH re-funding for another 5 years. Updates include our newly funded research, updated fact sheet on stigma, the launch of the new CAPS/PRC website, awards, and new staff! In this issue:

1. CAPS 30th Anniversary
2. NIMH re-funds CAPS for 5 years
3. New California Projects
4. New International Projects
5. Featured: Updated fact sheet on stigma and HIV prevention
6. New website launch
7. Announcements

HIV prevalence and incidence rates have reached catastrophic levels among Young black Men who have sex with Men (YBMSM), ages 18-29. The goal of this project is to determine the efficacy of a Multilevel, theory- based Intervention, calld United Black Element (UBE), in reducing YBMSM's sexual risk behavior and increasing the frequency of HIV testing. Although based on the Mpowerment Project, a cost-effective HIV Prevention Intervention that has been shown to be efficacious in reducing the rate of unprotected sex among Young MSM, UBE has been extensively adapted to the socioeconomic, cultural, and social context of YBMSM's lives. Through the Development of an empowered, mobilized YBMSM community, UBE creates positive social norms around HIV Prevention that are diffused throughout diverse social networks. We began work to launch and begin testing the efficacy of UBE in Dallas and Houston, TX with CDC funding; Dallas was randomized to the Intervention condition. Large cities were chosen since that is where the majority of YBMSM reside, and testing a community mobilization approach in such a setting is critical in considering how to translate it to practice. It took longer than anticipated to fully implement UBE because of community capacity issues, but UBE is now fully implemented and is reaching into diverse social networks of Dallas YBMSM. The CDC funding that supported the Intervention and baseline assessments has ended, and the Texas State Health Department is now funding UBE at a local organization with which we are collaborating. In the proposed mixed methods project, we have an extraordinary opportunity to study the impact of this Intervention without having to start up or cover the costs of the Intervention. Thus, the aims of this mixed methods project are to: 1) Analyze public health data and conduct 3 additional annual cross-sectional Surveys of YBMSM in Dallas and Houston using venue-based sampling to determine the efficacy of UBE in: (a) reducing unprotected anal sex; (b) increasing recent HIV testing; (c) modifying psychosocial mediating variables that may be causally related to HIV risk reduction; and (d) changing psychosocial factors related to positive mental health and wellbeing; 2) Determine how community changes occur during implementation of UBE by examining when changes in the psychosocial mediating variables, sexual risk behavior and HIV testing take place and if changes in sexual risk behavior and testing continue to improve, remain the same, or decrease over time; 3) Explore how UBE penetrates diverse YBMSM subcommunities in Dallas, and how this Multilevel Intervention impacts individual, interpersonal, and social level factors related t risk behavior and testing. Using ethnography, we will follow a longitudinal cohort while the Intervention is being fully implemented. 4) Examine the potential integration of biomedical HIV Prevention methods into UBE through administering and analyzing quantitative data from the survey and qualitative data from the interviews.