Dexter Voisin - US grants

[unreadable] DESCRIPTION (provided by applicant): Objectives: A disproportionate number of urban African American youth are engaging in HIV sexual risk behaviors. Accumulating evidence suggests that among youth, factors such as family and community violence exposure, psychological distress, low school achievement and negative peer group associations are related to HIV sexual risk behaviors. However, to date, no research has examined the interrelationships among these variables with regards to Urban African American youth and their disproportionate rates of HIV infection. Guided by a developmental framework, this exploratory study investigates whether higher levels of psychological distress, lower school achievement, and increased negative peer group association mediates the relationship between family and community violence exposure and increased HIV sexual risk behaviors. [unreadable] [unreadable] Design: Using audio-computer assisted self-interviewing technology, data on socio-demographics, violence exposure, psychological distress, school achievement, peer associations, and sexual behaviors will be collected from 300 African American youth in the 9th and 10th grades, attending a high school on Chicago's Southside. Structural equation modeling (SEM) would examine the relationships among variables. [unreadable] [unreadable] Conclusions: The findings from this study hold promise for increasing our understanding of the interrelationship among key factors associated with risky sexual behaviors among urban African American youth. Such knowledge is critical to designing HIV prevention programs that are culture-specific, in order to curtail the increasing spread of infection. [unreadable] [unreadable]

DESCRIPTION (provided by applicant): This goal of this project is to refine and pilot test a flexible Network Supported Engagement in Care (NSEC) intervention that recruits and motivates one or more organic social support network members of recently HIV diagnosed young black men who have sex with men (YBMSM) to improve engagement in HIV primary care. While data exist for young black men on factors related to HIV acquisition and antiretroviral adherence, there is a lack of empirically tested interventions on a key intermediate step in the treatment cascade: retention in care. Several existing strategies seek to address challenges to retention in care, including peer support groups, case management programs, multi-modal peer outreach, and peer health navigation. These efforts all share a common ingredient - newly created network members - a traditional public health intervention approach. What is often missing in these strategies is a coordinated attempt to harness organic social support networks that naturally exist. Our use of organic refers to an endogenous existing network; and can be contrasted to newly generated support persons such as assigned peer navigators or lay health workers. The concept of organic social support as a powerful force in the health of HIV infected persons is well documented; but has been underutilized to retain YBMSM newly diagnosed with HIV in care. Living with HIV requires persistent, deep and ongoing social support; support often only available from existing confidants - friends, partners, kin and other individuals - with whom one might share personal information with and be influenced by. Flexibility of NSEC ensures that a support confidant (SC) is selected based upon factors such as providing a supportive function (e.g., emotional support) as opposed to their status (e.g., mother). Such SCs are likely important not only to retention in care, but also to sustained health maintenance, risk reduction behavior maintenance and long-term adherence to antiretrovirals (ARVs). We have developed a theoretically and conceptually grounded NSEC brief intervention that 1) utilizes social support network visualization and network theory to help YBMSM safely identify a SC to engage in retention in care activities; 2) uses an Information-Motivation-Behavioral Skills (IMB) Model targeted at the SC to activate and maintain HIV-specific social support within the dyad; and 3) uses a linked HIV-specific social support conceptual model to then drive appointment adherence among the index YBMSM. Our primary aims are to: 1) Refine intervention protocol, materials and assessments by 1) coordinating intervention components that activate the SC through individual and dyadic sessions; and 2) systemizing social support of the index via interactive mini-booster cell-phone/text sessions directed at both members of the dyad; and 2) Pilot test the feasibility and initial efficacy (lower missed visit proportion (MVP) of the NSEC intervention versus standard linkage to care at 3- and 12- months post randomization among a sample of 94 YBMSM, ages 16-29. Secondary outcomes to be assessed include dyadic closeness, self- efficacy and social support, antiretroviral adherence and HIV viral load. PUBLIC HEALTH RELEVANCE: The goal of this project is to refine and test an intervention to keep newly HIV infected young black men in HIV primary care. We do this by recruiting, informing and motivating naturally existing social support network members to help these young men keep their HIV care appointments. Keeping HIV care appointments is associated with prolonged life and good health.

PROJECT SUMMARY THIRD COAST CFAR SCIENTIFIC WORKING GROUP : END HIV The END HIV Scientific Working Group (SWG) of the TC CFAR will catalyze research to slow the HIV epidemic among young men who have sex with men (YMSM). The primary goals are to enable transdisciplinary research teams to generate novel projects, submit at least 2 multi-investigator applications to NIH each year, and advance the TC CFAR's national leadership in this critical area of HIV research. Improving TC CFAR strategic planning processes and productivity are also important goals, along with advancing translational HIV science. The goals of catalyzing innovative funded research in YMSM, and enhancing CFAR processes/productivity, will be reached through three specific aims. Aim 1: To engage with, and educate, the community as well as researchers across a broad range of HIV research disciplines, to identify and prioritize new research intended to improve HIV prevention, strengthen the cascade of care to virus suppression, and increase participation in relevant treatment/cure research for at-risk/infected YMSM. Aim 2: To support key TC CFAR stakeholders in developing research by facilitating access to resources of each TC CFAR Core, advising each Core how to optimize its resource offerings to help the SWG, and pushing TC CFAR planning for continuous improvement that will accelerate cross- disciplinary, translational research aimed at ending HIV among YMSM (including changing or adding to this SWG). Aim 3: To start and sustain teams that generate ideas and data supporting applications for Developmental Core awards, administrative supplements from the CFAR HIV Continuum of Care Working Group, and multi-investigator NIH grant applications. These efforts will be prioritized to address needs determined through partnering of aim 1, and be facilitated by aim 2.