Adopting and Demonstrating the Adaptation of Prevention Techniques (ADAPT), Harlem United Community AIDS Center
Condition: Sexually Transmitted Diseases; HIV Infections
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      This project will pilot test a step-by-step guide for community-based organizations to engage
      in evidence-based adaptation of interventions previously shown to be effective in research
      settings for use in real world applications. The main purpose of this program is to improve
      understanding of the processes needed for adapting evidence-based behavioral interventions to
      fit new conditions or populations and to pilot CDC-developed draft guidance for adaptation.
      The second purpose of the program is to increase the number of effective behavioral HIV
      prevention interventions for 18-24 year old sero-positive men of color who have sex with
      other men (MSM of color).
    

Detailed description: 
      The Adopting and Demonstrating the Adaptation of Prevention Techniques project (referred to
      as ADAPTATION throughout this protocol) responds to concerns from the field that existing
      interventions do not address the HIV prevention needs of diverse and often unstudied
      populations. This project will pilot test a step-by-step guide for community-based
      organizations to engage in evidence-based adaptation of interventions previously shown to be
      effective in research settings for use in real world applications. The main purpose of this
      program is to improve understanding of the processes needed for adapting evidence-based
      behavioral interventions to fit new conditions or populations and to pilot CDC-developed
      draft guidance for adaptation. The second purpose of the program is to increase the number of
      effective behavioral HIV prevention interventions for 18-24 year old sero-positive men of
      color who have sex with other men (MSM of color).

      Harlem United Community AIDS Center is one of five sites originally funded through Program
      Announcement 04064 and selected to receive a supplement to conduct adaptation activities.
      Under Program Announcement 04064, Harlem United, a community-based organization with over 16
      years of experience providing quality HIV services to the Harlem and South Bronx communities,
      was funded to implement a multi-faceted, HIV prevention program. The program combines rapid
      testing, access to care, and an evidenced-based, group-level behavioral intervention (i.e.,
      Healthy Relationships) for sero-positive, heterosexual men and women of color. Healthy
      Relationships is a five-session, small group-level intervention for persons living with
      HIV/AIDS that promotes the development of decision-making and problem-solving skills that
      enable participants to make informed and safe decisions about disclosure and behaviors.
      Preliminary evaluation efforts suggest that this service model is effective in reducing risk
      behaviors among the general population, but its appropriateness and effectiveness for
      specific sub-populations has yet to be fully demonstrated. The original research for Healthy
      Relationships was conducted in Atlanta, Georgia. Approximately half of the participants
      identified as gay and the study population had a mean age of 40 years. Harlem United will
      adapt the Healthy Relationships intervention for young sero-positive MSM of color between the
      ages of 18-24 who reside in Harlem, New York. Further adaptation also may include adding
      decision-making for disclosure with needle sharing partners.

      The goal of Harlem United's ADAPTATION project is to evaluate efforts to adapt and implement
      the Healthy Relationships intervention for young sero-positive MSM of color by: 1)
      documenting the resources and activities required to adapt and implement the Healthy
      Relationships intervention model for young sero-positive MSM of color; 2) optimizing service
      delivery; 3) measuring the effectiveness of the newly-adapted intervention; and 4) assessing
      CDC's guidance for adapting effective behavioral interventions for new populations.
    

Intervention name(s): Healthy Relationships
Intervention type(s): Behavioral
Intervention description(s): "Healthy Relationships," grounded in the social cognitive theory, is a five-session, group-level intervention originally designed for HIV-positive heterosexual individuals seeking skills-building and support around risk reduction, as well as disclosure of status and sexual preference. Through clip media and active role-plays, the intervention promotes the development of decision-making and problem-solving tools, empowering participants to make voluntary and informed decisions around disclosure and safer sex practices. This model was formally disseminated to AIDS Service Organizations as part of CDC's strategic plan - Advancing HIV Prevention, New Strategies for a Changing Epidemic - which focused on innovative strategies to recruit individuals into HIV testing, as well as a movement towards secondary prevention efforts.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: HIV; Adaptation; Behavioral interventions; Seropositive; MSM; HIV Seronegativity