Unrepresented Investigators 3 Studies Acute Infection: Smaller - - PowerPoint PPT Presentation

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Dec 12, 2023 206 likes •360 views

Unrepresented Investigators 3 Studies Acute Infection: Smaller viral reservoirs (N=72) HIV+ Youth: HIV Care Continuum (N=220) Viral suppression endpoint HIV- Youth: HIV Prevention Continuum (N=1500) Repeat testing, Linkage &

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Unrepresented Investigators

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3 Studies

①Acute Infection: Smaller viral reservoirs (N=72) ②HIV+ Youth: HIV Care Continuum (N=220)

Viral suppression endpoint

③HIV- Youth: HIV Prevention Continuum (N=1500) Repeat testing, Linkage &

Retention to Svcs., Adherence (PrEP, PEP, Condoms, STI Tx.)

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Cross-Cutting Themes

Same interventions tailored to HIV+ & HIV- youth
Technology-focused
Evidence-based practices (EBP), not manualized EBI
Cost-feasibility data of the CDC recommended

interventions: repeat testing & sustained follow- up; care linkage

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Laboratory Tests Repeated Every Four Months

HIV 4th Gen Alere Ag/Ab Combo
Cepheid Xpert HIV-1 Quant Assay
Cepheid Xpert CT/NG Assay
Syphilis RDT
RDT for amphetamine, meth,
Crack/cocaine, opiates, marijuana
Breathalayzer for alcohol
Oraquick HCV (site specific)

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Screen GLBTY-HY w/ RDT for HIV, STI, Substance Use; N=4500 Study 1 Acute HIV Infection; n=36+

(+36 established)

Study 2 RCT for HIV+ Youth; n=220 Study 3 RCT for HIV- Negative Youth; n=1500

1500 High Risk Youth

Overview

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Standard Care Conditions

CDC Recommendations UCLA Adaptations HIV testing every 3 months HIV testing every 4 months Repeat HIV testing Repeat 4th generation HIV test, plus STI and substance use RDT Linkage & Retention to Care Link & Retain to Care & Prevention Reminders Automated Messaging & Monitoring (AMM)

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Acutely Infected Youth

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Stepped-Care for Youth Living with HIV

AMM + Repeated Assessments every 4 months over 24 months (n=220) Virally Suppressed? (VL<200) Level 2: AMM + Peer Support Level 3: AMM + Peer Support + Coaching

No No

Virally Suppressed? (VL<200) yes yes Virally Suppressed? (VL<200) No

yes

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RCT for HIV-Negative Youth for HIV Prevention Continuum

GBTY-HY N=1500 AMM (n=900) AMM + Peer Support (n=200) AMM + eNavigator (n=200) AMM + Peer Support + eNavigator (n=200)

Assessments 4 Months 8 Months 12 Months 16 Months 20 Months 24 Months } 17 weekly SMS/mobile-web surveys

Acute HIV Symptoms
Adherence, Risk Beh. & Contexts

Repeat HIV, STI, Substance use RDT

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Automated Messaging & Monitoring (AMM)

Daily Informational, Motivational, & Referral Text-Messages
Tailored to age (<=17, >=18) & risk profiles (HIV-status, Gender)
Youth Advisory Boards inform adaptation from source libraries:
“UCARE4LIFE” - HRSA developed for HIV Care Continuum
“Project Tech Support” - NIDA RCT, Reback PI
>600 theory-based messages for gay/bisexual meth using men
“Text-me, Girl!” – HRSA SPNS Project, Reback PI
270 theory-based messages for Trans Women
Weekly 7-question survey via mobile-web or SMS
Immediate follow-up for nonresponse, or acute HIV symptoms
Intensive Longitudinal Data -> Risk beh., housing & food insec.,

adh.

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Peer Support on Social Media

Adapt from Harnessing Online Peer Education (HOPE) and others
Sean Young (ATN Co-I, PI on HOPE pilots & RCTs)
Consultation and Training from
Social networking site for LGBTQ youth ages 13-24 and allies
Open-source online discussion platform:
Mobile-web, private groups, likes, emojis, avatars, badges, media, etc.

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Community Partners

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