black men's care, and intervention to re-engage hiv+ black men in care

Conditions: HIV/AIDS

Summary: the proposed study aims to develop an intervention that is strategic in that it will 1) be a focused on an approach that combines an in-person session with post-session, two-way text messaging to continue the intervention and reinforce the gains from the in-person session and 2) ultimately find hiv+ black men who have sex with men who have left hiv care where they are likely to present (e.g., city and county health clinics, community-based organizations, emergency rooms).

the overarching goal of this application is to develop and conduct a preliminary test of a "portable" intervention, "black men's care" (bmc), to re-engage in hiv care hiv+ black men who have sex with men who have left hiv care (+bmsm-lc) that is flexible with respect to where it can be conducted. the aims of the study are: aim 1-to conduct formative research to develop bmc content and optimize its delivery; aim 2-to develop bmc, a theory-based, combination in-person and text messaging (mhealth) intervention for +bmsm-lc; and aim 3-to evaluate the acceptability, feasibility, and preliminary outcomes of bmc in preparation for submitting an r01 proposal to finalize and conduct an efficacy trial of bmc. aims 1 and 2 will comprise the formative phase of the proposed study. aim 1 will consist of semi-structured interviews with 2 staff members at each of 3 city and county health clinics, 3 community-based organizations, and 3 emergency rooms to identify effective settings for intervention. aim 2 will consist of semi-structured interviews with 10 +bmsm-lc and 10 hiv+ black men who have sex with men who remain in care to develop intervention content. findings from these semi-structured interviews and aim 1 will be used to develop a preliminary intervention protocol that will be refined across 2 sets of 3 sequential, single-subject iterations of the intervention sampled by age (n=3 for ages 18 to 29 years, n =3 for ages 30 and up). for aim 3, a pilot study of 18 +bmsm-lc purposively sampled by age will assess acceptability, feasibility, and preliminary outcomes of bmc for re-engaging +bmsm-lc in care. the research and career development activities of this k23 proposal will allow the pi to achieve the goal of becoming an independent, r01-funded investigator. the pi will gain a broad range of critical skills (e.g., intervention development; qualitative research methods; trial design, safety monitoring, and process and outcome evaluation) and experiences to address the health needs of vulnerable populations at greatest risk of morbidity and mortality.

Eligibility criteria:
inclusion criteria: * staff (interviews): administrators and frontline workers who have worked in their respective positions for at least 6 months and have a caseload that includes +bmsm or a position at an organization that serves +bmsm. these staff members will be recruited from the san francisco bay area. * hiv-positive black male patients (interviews): 1) hiv+, 2) self-identified as men who have sex with men, 3) 18 years or older, 4) have left hiv care, as indicated by less than 2 appointment in the past year and no scheduled appointments in the next 6 months or are engaged in care, as indicated by at least 2 appointment at least 90 days apart in the last year, and 5) live in or near the san francisco bay area * hiv-positive black male patients (pilot study): 1) hiv+, 2) self-identified as men who have sex with men, 3) 18 years or older, 4) have left hiv care, as indicated by less than 2 appointment in the past year and no scheduled appointments in the next 6 months, 5) live in or near the san francisco bay area, and 6) must also be available for the pre-intervention survey; the bmc in-person session, 12 weeks of sms, and post-intervention survey upon completion of the intervention; and 3-month follow-up after the intervention exclusion criteria: * non-native english speaker