Seek, Test, and Retain. Linkages for Black HIV+, Substance-Using MSM
Condition: Substance Abuse; Sexual Behavior
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The study will seek and recruit substance-using Black Men who have Sex with Men (MSM) in New
      York City for Human Immunodeficiency Virus (HIV) testing and will link and retain those who
      are HIV infected in HIV primary care. The STAR study has two primary objectives: to evaluate
      the feasibility and effectiveness of Respondent Driven Sampling (RDS) in the substance using
      Black MSM population for identifying individuals who are HIV infected and not in care; and to
      assess the relative effectiveness of patient navigation and financial incentives in linkage
      and retention to HIV care.
    

Detailed description: 
      The HIV epidemic in the United States most severely affects men who have sex with men (MSM):
      61% of all new infections occur in this population. Black MSM bear a disproportionate burden,
      with prevalence of 28%, in contrast to 19% in MSM overall. Black MSM undergo HIV testing less
      frequently than other MSM; are less likely to be aware that they are HIV infected; are more
      likely to experience delays in entry into HIV care; and are less likely to be prescribed
      antiretroviral therapy (ART) when eligible. These disparities are pronounced in
      substance-using MSM, as substance users are at elevated risk of late diagnosis and delayed
      engagement in HIV care. The combination of pervasive stigma associated with MSM behavior and
      high rates of substance use hinders effective prevention efforts in this population, even as
      the prevalence of infection in Black MSM in some US cities approaches 50%. Reducing
      HIV-related disparities in MSM and among Black Americans are National HIV/AIDS Strategy
      priorities and are essential to the effort to control and prevent HIV/AIDS in the US.
    

Intervention name(s): Patient Navigation (PN) Intervention; Financial Incentives (FI) Intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Patient Navigation is defined as an individual relationship between a navigator and participant to promote retention in the continuum of HIV care . For this study, three experienced navigators will be hired. Their primary role will be to ensure that participants are linked to an HIV primary care provider, that they attend at least one scheduled visit within three months of receiving a confirmed HIV diagnosis, and that they are retained in care (as defined by attending three HIV visits within nine months of diagnosis). To promote linkage to HIV care, navigators will help participants identify material and other barriers to accessing care and will work with participants to overcome those barriers.; After confirmation that they have completed their first HIV primary care visit, Financial Incentive participants will receive a gift card. Additionally, the coordinator will flip a coin and give participants a bonus gift card if the coin flip comes up heads. Participants who attend the second HIV primary care visit will receive a gift card. Patients who attend a third HIV primary care visit will receive a gift card. Study staff will be responsible for confirming participants' attendance at appointments.
Other intervention name(s): PN Intervention; PN; FI Intervention; FI
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: MSM; HIV; Substance Abuse; Sexual Behavior