HRSA
awarded grants under its Special
Projects of National Significance
program to the applicants listed
below.
Men
of Color Health Awareness Project,
Inc
25 Franklin Street
Rochester, NY 14604
The
purpose of this project is to
modify and adapt comprehensive,
theory based, and culturally appropriate
prevention intervention programs
for use with HIV-infected YCMSM,
establish an effective outreach
program which identifies infected
YCMSM and links them into care,
and increase counseling and testing
of this population. This project
will adapt the Many Men, Many
Voices (3MV) curriculum for the
younger target audience they will
be enrolling and validate associated
instruments; they also propose
a randomized trial of the intervention.
Finally, they will intensify outreach
and co-locate services and expand
other services to enhance
outreach. The local evaluation
will be conducted by a University
of Rochester School of Nursing
research team.
Intervention
- Intensified
outreach via provider presentations,
case finding and high-risk education
in community settings, presence
at community events, monthly
newsletter, website, speakers
bureau, and peer-led support
group
- Co-location
of CTR and referral services
with intensified outreach and
MOCHA office activities Enhanced
CTR and referrals for services
via a care collaborative
- Primary
care and case management via
the care collaborative
- Individualized
prevention counseling with HIV+
using revised Rochester
- STD/HIV
Behavioral Counseling (RoSHBeC)
model
- Small
group level prevention intervention
with HIV+ and peers using adapted
3MV curriculum
Outputs
- A
revised RoSHBeC model and a
revised 3MV curriculum
- A
clearly established network
with identified responsibilities
and sufficient links and capacity
to provide culturally competent
comprehensive care to HIV+
- Two
focus groups and four pilot
test groups involving 48 persons
to adapt 3MV
Short
Term Outcomes
- Increase
awareness in the community of
purpose and goals of MOCHA and
the care collaborative
- Increase
use of website
- Increase
availability of culturally competent
care and support services
- Increase
knowledge of individual serostatus
and early identification of
HIV+ clients and enrollment
into care systems at earlier
disease stages
- Increase
the number of providers who
are competent with the revised
RoSHBeC model and 3MV curriculum
- Increase
the number clients involved
in behavior change via RoSHBeC
counseling and 3MV groups
Long
Term Outcomes
- Increase
understanding among YMSM of
factors that influence risk
behavior
- Decrease
risk taking behaviors among
YMSM
Proposed
Local Evaluation Strategy
- Focus
groups to assess and adapt (if
needed) individual- and group-level
curricula
- Evaluation
of process data/fidelity to
the intervention focusing on
process, utilization, and programmatic
- Randomized
controlled trial “feasibility
pilot test” comparing ni=16
(N=32) YCMSM at their office,
recruited with fliers, HIV prevention
intervention, and the general
healthy/career development group;
each has twohour weekly MMMV
group sessions for six weeks
- Evaluations
for this pilot at pretest, Week
6, and Month 3
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Dept
of Health Services, County of
LA
HIV Epidemiology Program Evaluation
Center, LA Department of Health
Services
600 South Commonwealth Ave., Suite
1920
Los Angeles, CA 90005-4001
The
Los Angeles County HIV Epidemiology
Program (LACHEP) will offer expanded,
active, community-based outreach
to HIV counseling and testing,
followed by referral and linkage
into care at one of two clinics:
AltaMed and Drew University Oasis
Clinic. The program will offer
Latino and African American YMSM
intensive integrated case management
(ICM) sessions at local clinics.
A randomized controlled study
of the intervention will be used,
as well as qualitative and quantitative
methods to follow clients and
evaluate the program.
Intervention
- Active
and passive community outreach,
with mobile and clinic-based
CTR, using incentives for post-testing
- One-hour
integrated case management (ICM)
sessions at two sites –
one African American identified
and the other Latino identified,
with biweekly peer support groups
for clients, partner counseling
and referral services, and transition
to standard case management
after two years
- Weekly
intervention visits at first,
then bi-weekly, then monthly
second year
Outputs
- 2,000
people reached during outreach
use CTR; 100-200 HIV+ identified
via active outreach; 100 HIV+
identified via passive outreach:
100 African Americans and 100
Latinos linked to ICM—90
African Americans and Latinos
linked to standard case management
(as control)
- 90
African Americans and 90 Latinos
complete 42 ICM sessions, average
ICM caseload of 25-35 clients
- All
clients receive medical care
quarterly, 1,000 additional
services visits
- Client
receives 30 prevention messages
during ICM, with 100 ICM clients
transitioned to standard case
management
Short
Term Outcomes
- Increased
knowledge of HIV, HIV threat,
and personal serostatus
- Increased
use of HIV services, with decreased
unmet need among HIV+ who are
not getting care
- 75%
kept appointment rate; 50% decrease
in viral loads; 50% increase
in CD4 counts; 50% increase
in condom use; 50% decrease
in high risk behaviors; 50%
increase in voluntary disclosure
to of serostatus to partners;
50% increase in asking about
partner serostatus
- Increased
rapport with ICM regarding prevention
Long
Term Outcomes
- Increased
use of HIV care services by
previously undiagnosed HIV+.
- HIV
care seen by clients as of higher
quality and more culturally
competent
- Decreased
morbidity and mortality related
to HIV among HIV+
- Increased
use of ongoing local continuum
of care by HIV+
Proposed
Local Evaluation Strategy
- Randomized,
controlled design with two groups:
African American and Hispanic
(ni=90); control group of n=90
African American and Hispanic
in traditional case management
programs
- Stratified
blocked randomization (two sites,
race/ethnicity-specific)
- Data
collection: repeated measures,
structured face-to-face interviews,
adopt validated tools where
possible
- Qualitative
component with providers
- Baseline
and twice yearly follow-up face
to face interviews over 36 months
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University
of North Carolina at Chapel Hill
Department of Medicine/Division
of Infectious Diseases (ID)
130 Mason Farm Road, CB #7030
Chapel Hill, NC 27599-7030
A
collaborative between UNC and
community-based prevention and
case management agencies will
conduct and evaluate a social
marketing campaign on college
campuses, promote access to HIV
treatment and care among newly
diagnosed African American HIV-infected
college students at a consortium
of colleges. They will assess
the prevalence of acute HIV infections
through a serosurvey, and compare
outcomes between campuses exposed
and not exposed to the intervention.
UNC will partner with North Carolina
Central University,
a historic Black university, and
the Alliance of AIDS Services,
a community-based AIDS service
organization.
Intervention
- Elicitation
research to develop a prevention
intervention
- Outreach
by CBO and campus organization
staff to inform about HIV and
promote CTR
- Media
campaign on campuses and in
local community
- Social
marketing partnerships with
campus groups and local businesses,
freshman orientation education;
CTR at student health centers
and in the community
- Cultural
competency training of CTR staff
and use of RNA testing by CTR
staff
- Health
department Disease Intervention
Specialists to locate HIV+ not
in care and promote partner
testing
- Provision
of primary and specialty care
via UNC ID clinic
- Prevention
for positives program at UNC
ID via new protocol follow-up
by DIS and local case managers
to locate HIV+ lost to care
Outputs
- Six
focus groups will be held to
develop prevention intervention
- Greater
than 85/90% of HIV+ located
and linked to care
Short
Term Outcomes
- Increase
penetration and receipt of prevention
messages
- Increase
use of CTR and knowledge of
individual serostatus
- Decrease
risk behaviors by HIV+ and within
larger community
- Increase
identification of HIV+ earlier
in course of disease and increase
access and retention in care
- Improve
quality of primary care and
prevention services
Long
Term Outcomes
- Improve
health outcomes and enhanced
quality of life for HIV+ patients
- Decrease
morbidity and mortality among
HIV+ and decrease HIV transmission
within community
Proposed
Local Evaluation Strategy
- Compare
individual at the participating
campuses and those at similar
non-participating campuses
- Focus
groups and key informant interviews
with peers, members of advisory
board and staff
- Interviews
pre-test and also end of Years
2 and 5
- Convenience
sampling to assess n=100 general
population and n=50 members
of target population
- Seroprevalence
study on intervention and control
campuses in pooled batches to
identify RNA+ samples versus
antibody testing, to assess
acute infection
- Linkages
into care at UNC ID clinic will
be tracked over time, but tools
and method based on existing
project evaluation (demographic,
clinical, behavioral, utilization)
at UNC ID clinic
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AIDS
Project East Bay
1755 Broadway, Second Floor
Oakland, CA 94612
AIDS
Project East Bay collaborates
with the Sexual Minority Alliance
of Alameda County (SMAAC) and
Alameda County Medical Center
(ACMC) in this project. New and
adapted programs, within an existing
network of programs, will comprise
a youth-directed, community-based
outreach based through a variety
of approaches. The local evaluation
design includes a prospective,
repeated measures design, which
also compares enrollees with a
control group of those receiving
other East Bay AIDS Center (EBAC)
services. Local evaluation of
outreach and testing activities
is through process evaluation
and comparison of previous periods
in a historical cohort approach.
A faculty member of the University
of California San Francisco will
participate in the local site
evaluation.
Intervention
- Outreach,
counseling, testing, and referral
(CTR), and linkages into community-based
programs
- Screen
at ACMC (eventually developing
rapid testing mobile van)
- Cohort
design, with repeated measures
- Historical
comparison group
- Target
population: African American
Outputs
- Youth
centered outreach n=7,500 high-risk
young African American
- Rapid
testing to n=450
- Link
into care n=35
- Link
to community involvement, prevention
with positives, and self-empowerment
for n=50
- Then
enroll in Mpowerment and/or
TLC
- Repeated
measures design. ni=3,050 (total
N=6100); control group is those
receiving other EBAC; crosssectional
for rest
Short
Term Outcomes
- Increased
awareness of HIV risks and benefits
of HIV counseling/testing among
African American MSM
- Increased
knowledge of serostatus among
high risk MSMs
- Increased
engagement and retention of
HIV+ into care
- Decreased
risk behaviors by HIV+ in care
- Reduced
risk behaviors among African
American MSM
Long
Term Outcomes
- Improve
health and wellbeing, and quality
and length of life of HIV+ MSM
Proposed
Local Evaluation Strategy
- Outreach
and testing to general population;
process evaluation. Compare
with historical data
- Intervention
participants vs. stages of change
- Focus
groups in first six months with
members of target population
- Cohort
design
- Process
evaluation
- Outcome
evaluation: primary outcomes
include: improved clinical outcomes,
adherence to treatment and appointments,
improved CD4 and viral load
measurements, improved safer
sex behavior
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Harris
County Public Health and Environmental
Services
Harris County Public Health and
Environmental Services Department
2223 West Loop South
Houston, TX 77027
The
purpose of this project to be
conducted through the Harris County
Public Health and Environmental
Services Department, is to engage
HIV seropositive YCMSM into care,
link them into appropriate services,
and facilitate retention in care
using existing locally defined
categories of RWCA services. A
new approach to case management
will be evaluated which coordinates
a variety of relevant services
into one Client Management Team
(CMT)—a wide-ranging and
intensive service which provides
outreach, medical care coordination,
service linkage, peer counseling,
health education, and other services
to engage and retain high risk
youth in care. Evaluation includes
use of existing client data, and
comparison with previously enrolled
clients.
Intervention
- Consolidated
case management based on combination
of existing services.
- A
multidisciplinary team will
provide case management, outreach,
peer counseling, medical care
coordination, and health education
risk reduction using a Client
Management Team (CMT) approach
- Outreach
is not for testing individuals
at large, but rather outreach
to existing or newly diagnosed
HIV+ YCMSM
- During
outreach clients come for services
every week in 4-8 hours.
- Counseling
and testing as needed, and individual
sessions on education, services,
etc.
Outputs
- Enroll
10 to 15 HIV+ by 8/05; enroll
85 by end of project
- A
minimum of 50 to 80% of newly-identified
HIV+ clients will enter primary
care and/or case management
- A
minimum of 50/60/90% of HIV+
clients will use primary care
during 6 month period per year
Short
Term Outcomes
- Increase
proportion of HIV+ who know
their serostatus
- Increase
knowledge of HIV risk reduction
and practice of safer sex
- Increase
proportion of HIV+ that are
identified, linked to care,
and remain in care
- Increase
client use of primary care and
support services
- Improved
or maintained CD4 counts
- Improved
or maintained viral loads
- Increase
knowledge of care system and
how to use it
- Increase
adherence to treatment regimens
Long
Term Outcomes
- Reduce
new HIV cases among YCMSM
- Slow
and stabilize disease progression
in HIV+
Proposed
Local Evaluation Strategy
- Comparison
group of those in system not
enrolled in the program. ni=85;
nc=30
- Client
assessments from case management
requirements (e.g., assessment
form within ten working days
of assessment and linked to
service within 30 days). Centralized
Patient Data Management System
(CPCDMS) to collect data, with
one face to face interview visit
q30 days and at least one visit
to natural environment every
90 days
- Comparison
group is those clients enrolled
into CPCDMS within two years
of project start and those enrolled
by other agencies meeting the
inclusion criteria
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Bronx
AIDS Services, Inc.
540 East Fordham Road
Bronx, NY 10458
The
Bronx Boogie Down Project is a
collaboration of Bronx AIDS Services,
Inc. (BAS) and the Adolescent
AIDS Program of the Children’s
Hospital at Montefiore Medical
Center (AAP). The project strives
to improve outreach, care and
prevention services to engage
seropositive YCMSM in the region
and help them stay in care. The
project strives to use social
and geographic mapping, performed
by community ethnographer-organizers
(CEOs), to identify high-risk
areas for this target population,
and then develop new methods of
outreach to improve access to
services and establish use of
popular opinion leaders. Once
outreach has taken place, the
program expects to enroll 15 to
20 YCMSM of color to medical care
per year and achieve risk reduction
and retention in care among participants.
The local evaluation includes
mapping and focus groups with
the target population followed
by content analysis using Ethnograph,
and process evaluation.
Intervention
- Ethnographic
investigation, followed by outreach
in mobile van with counseling
and testing, then entry and
retention into care with assistance
of case management model
- Training
of CEOs who will examine and
map social and sexual networks
- Community
organizing and individualized
interviewing by CEOs that convey
HIV information and identify
HIV+ not in care
- Outreach
to agencies that serve YMSM
- Standard
and CTR and linking of HIV+
to care and accompanying HIV+
to appointments
- Case
management and support services
management with prevention counseling
by case manager and/or support
services manager Rapid testing
of partners of HIV+
Outputs
- 10
CEOs trained and CEO interviews
- 100
MSM and maps four Bronx communities
- 80-100
HIV+ linked to care, 10 partners
of HIV+ receive rapid testing
- Connection
for seropositive into care via
a case management model for
n=15 to 20 YCMSM annually
Short
Term Outcomes
- Increased
use of CTR services.
- Increased
knowledge of personal serostatus
- Increased
use of services by HIV+
- Increased
adherence of HIV+ to treatment
plans and medications
- 60%
of HIV+ who receive behavioral
counseling will reduce one risky
behavior
Long
Term Outcomes
- Improved
health status of HIV+.
- Reduced
HIV infection within the community
- Proposed
Local Evaluation Strategy
- Primarily
qualitative and ethnographic
endeavor using social network
evaluation, with mapping of
target population and mapping
YCMSM
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Wayne
State University
540 East Canfield, Room 1128,
Scott Hall
Detroit, MI 48201
This
project strives to conduct innovative
field and Internet outreach to
encourage YCMSM to find out their
HIV status and enroll, engage,
and maintain in care. The investigators
will use and evaluate a motivational
interviewing (MI) strategy, with
extensive MI training to field
workers, to encourage at-risk
YCMSM to be
counseled and tested for HIV.
Traditional peer-outreach will
be compared with traditional peer
outreach in combination with MI.
They will also conduct an evaluation
of internet-based outreach to
this population.
Intervention
- Traditional
peer outreach versus traditional
peer outreach plus motivational
interviewing
- Comprehensive
continuum of care based on a
continuous relationship model
and elements of social network
theory, with community and Internet
outreach
- MI
during outreach to use CTR and
during post-testing to engage
in care
- Inter-disciplinary
care using MI to promote retention
in care and risk reduction
- Healthy
Choices MI support group intervention,
Brother-to-Brother prevention
group intervention
- Agency
outreach to capture HIV+ identified
elsewhere, outreach and home
visits for those lost to care
- Peer
advocacy and recreation services
Outputs
- 150
YMSM reached per year via 1,500
community outreach contacts,
with one-half using MI
- 100
YMSM reached per year via Internet
outreach, with one-half using
MI
- 52
YMSM use CTR in first year,
with all clients who receive
CTR receiving MI with regard
to post-testing
- All
HIV+ receive MI regarding enrolling
in care, with 100%-80% HIV+
to receive MI regarding staying
in care
- 18
support groups held, 60 youth
to receive case management,
80 youth to receive advocacy
services
- All
lost-to-care receive attempted
contact
Short
Term Outcomes
- Increase
knowledge of HIV risks, readiness
to know serostatus, knowledge
of individual serostatus
- Increase
in number of clients who use
CTR, enroll in care and arrive
at first primary care appt
- Increased
attendance at quarterly primary
care visits, adherence to treatment
regimens, self-efficacy and
social support, readiness to
change negative behaviors, and
re-enrollment of lost-to-cares
Long
Term Outcomes
- Decrease
in unmet health care needs and
HIV transmission related to
not knowing serostatus
- Improve
health and well-being of HIV+
- Reduction
in high risk sexual and substance
using behaviors
Proposed
Local Evaluation Strategy
- Compare
peer outreach to peer outreach
plus motivational interviewing
to assess the effect on readiness
to accept diagnosis, receipt
of HIV CTR, and return for test
results; also linkage into care
- Randomized
controlled trial with pre-post
test comparisons: randomization
to traditional versus traditional
plus motivational interviewing
to assess if intervention results
in the pursuit of HIV CTR
- For
field recruitment, field outreach
three days per week
- Baseline,
three, and six month follow-up
- For
field: ni=50 (total N=100),
for Internet: ni=75 (total N=150)
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Working
for Togetherness
Youth Empowerment Center
Chicago Area Priority Access Project
3333 W. Arthington St., #108
Chicago, IL 60624
The
Chicago Area Priority Access (CAPA)
Project at Working For Togetherness
aims to decrease barriers within
the HIV/AIDS healthcare delivery
system for young African American
MSM (YAAMSM) and increase integration
of services for these young men.
The three primary goals of the
CAPA Project are to: 1) conduct
outreach to deliver HIV prevention
messages and increase early detection
of seropositive YAAMSM; 2) develop
an integrated, adolescent-specific
continuum of care network for
seropositive YAAMSM; and 3) create
and operate a Youth Empowerment
Center to increase youth self-efficacy
to enter and remain in culturally-
and developmentally-appropriate
HIV primary care.
Project
activities include maintaining
and enhancing the CAPA Project
Continuum of Care, housing and
implementing preventive interventions
for HIV-positive YAAMSM in the
Youth Empowerment Center, performing
local and multi-site evaluation
activities, and disseminating
project information and evaluation
findings at local and national
conferences.
The
CAPA Project evaluation is assessing
the effectiveness of “Mobile
Tech” outreach in helping
YAAMSM receive HIV prevention
services, learn their HIV status,
and access medical care. The project
will also adapt a CDC –
Effective Behavioral Intervention
to determine effectiveness in
reducing HIV risk behaviors among
these youth. The completed evaluation
is expected to deliver a protocol
to replicate Mobile Tech outreach,
provide research evidence on the
effectiveness of CDC-EBI for YAAMSM,
and offer a Collaborative Continuum
for Care Model for community-based
organizations and healthcare providers
to link HIV-positive youth to
care.
