Providing Unique Support for Health (PUSH) Study
Condition: HIV-1-infection
Study type: Interventional

Summary: 
      Project Narrative This 5-city proposal seeks to address HIV disparities among young (ages
      15-24) Black and/or Latinx men who have sex with men (YBLMSM) and transgender women (YBLTW)
      in a multilevel intervention to identify, engage and retain, high-risk HIV-uninfected and
      HIV-infected urban YBMSM/TW in the HIV prevention and treatment cascade. The mobile-enhanced
      engagement intervention (MEI) is driven by the expressed and self-determined needs of each
      HIV infected and uninfected participant and includes care navigation, engagement, treatment
      and adherence. MEI also includes a supplemental Screening, Brief Intervention, and Referral
      for Treatment (SBIRT), to support YBLMSM/TW who face barriers accessing substance use
      treatment. By building upon existing case management services and flexibility to be adapted
      across ages and maturity and for prevention services, this intervention has the ability to
      transform networks, HIV and prevention care in YBLMSM/TW in cities with very high primary and
      secondary HIV transmission.
    

Detailed description: 
      Project Summary The U.S. National HIV/AIDS Strategy 2020 calls for increasing access to care
      and improving outcomes of people living with HIV and targeting biomedical prevention efforts
      (including access to pre-exposure prophylaxis [PrEP]) where HIV is most heavily concentrated.
      Baltimore, MD; Washington, DC; Philadelphia, PA (BWP); and Tampa and St. Petersburg, FL. are
      disproportionately burdened by high rates of new cases of HIV infection, with
      disproportionate rates in young Black and/or Latinx men who have sex with men (YBLMSM) and
      transgender women (YBLTW) aged 15-24. High incidence underscores the need for increased
      identification, linkage and initiation in HIV and preventive care for YBLMSM. Grants focused
      on high rates directly address NIH research priorities to reduce health disparities in the
      incidence of HIV, in antiretroviral therapy (ART) outcomes or in high HIV prevalent or
      high-risk areas.

      This innovative proposal seeks to test, treat and retain YBLMSM/TW living in BWP along the
      prevention and treatment continuum using the following aims:

      Aim 1. Identify and recruit young (ages 15-24) Black and/or Latinx men who have sex with men
      (YBLMSM) in 3 urban cities who are (1) HIV-infected, not virally suppressed; and (2)
      high-risk HIV-uninfected YBLMSM, including gender variant and questioning men, using
      respondent driven sampling (RDS) with targeted seed identification. Assigned female sex at
      birth participants may be eligible to screen and participate in this aim to assist in
      recruiting YBLMSM/TW; Aim 2. Compare the efficacy of two study arms (mobile-enhanced
      engagement intervention (MEI) vs. standard of care (SOC)) to achieve sustained retention
      (measured by ≥ 4 follow up visits per 18-months) and engagement in HIV care (measured by
      durable viral suppression (HIV VL < 20 copies/ml) and substance treatment among 240
      HIV-infected YBLMSM who are not virally suppressed and recruited from RDS; and Aim 3. Modify
      and implement mobile-enhanced intervention for 225 high-risk HIV-uninfected YBLMSM, recruited
      from RDS to promote linkage, retention and engagement of pre-exposure prophylaxis (PrEP) and
      substance treatment uptake over 18-months, comparing younger (15-19) and older (20-24)
      participants.
    

Intervention name(s): Mobile-enhanced Engagement Intervention
Intervention type(s): Behavioral
Intervention description(s): Mobile phone based enhanced case management intervention for HIV positive & HIV negative young Black men who have sex with men.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Mobile-enhanced engagement interventions (MEI) to support 1) HIV viral suppression among HIV-positive, not virally suppressed participants; 2) HIV-PrEP uptake among high-risk HIV-negative participants; and 3) engagement in substance abuse treatment for HIV-positive and HIV-negative participants.
Masking: Single (Care Provider)
Primary purpose: Health Services Research
Keywords: HIV young Black men who have sex with men substance use