scholarly journals Meeting the needs of young Latino gay, bisexual, and other men who have sex with men (MSM) and transgender women living with HIV through the weCare intervention in the United State (U.S.)

2021 ◽  
pp. 209-232
Author(s):  
Jorge Alonzo ◽  
◽  
Lilli Mann-Jackson ◽  
Jesús García ◽  
Amanda E. Tanner ◽  
...  
Keyword(s):  
Social Media ◽  
Viral Suppression ◽  
The United States ◽  
Transgender Women ◽  
Lessons Learned ◽  
Hiv Care ◽  
Media Messages ◽  
Women Living With Hiv ◽  
Sex With Men ◽  
Living With Hiv

Young gay, bisexual, and other MSM (men who have sex with men) and transgender women in the United States (US) who are living with HIV, and particularly those who are Latino, have low rates of viral suppression. The weCare intervention uses social media to increase HIV care engagement. Method: We used community-based participatory research to develop the intervention as well as theory-based social media messages tailored to each participant’s unique context. We analyzed elements and characteristics of weCare, messages sent by the Cyber Health Educator (CHE), and lessons learned to meet the needs of Latino participants living with HIV. Results: We identified 6 core elements, 5 key characteristics, effective social media messages used in implementation, and 8 important lessons regarding relationships between the CHE and HIV clinics, the CHE and participants, and participants and the health system. Conclusions: Social media offers a promising platform to retain young Latino gay bisexual and other MSM and transgender women living with HIV in care and achieve viral suppression.

scholarly journals Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial

10.2196/24043 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e24043
Author(s):  
Kathryn Elizabeth Muessig ◽  
Jesse M Golinkoff ◽  
Lisa B Hightow-Weidman ◽  
Aimee E Rochelle ◽  
Marta I Mulawa ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Hiv Status ◽  
Mhealth Intervention ◽  
Sex With Men ◽  
The University ◽  
Living With Hiv ◽  
Hiv Negative

Background Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space. Objective Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradata (data collected as users interact with an mHealth intervention, eg, time spent using the intervention), mediates stigma- and HIV care–related outcomes. Finally, we will assess whether changes in intersectional stigma and improvements in HIV care continuum outcomes vary across different types of social networks formed within the intervention study arms. Methods We will enroll 1050 YBLMT aged 15 to 29 years affected by HIV across the United States. Using an HIV-status stratified, randomized trial design, participants will be randomly assigned to 1 of the 3 app-based conditions (information-only app-based control arm, a researcher-created network arm of HMP 2.0, or a peer-referred network arm of HMP 2.0). Behavioral assessments will occur at baseline, 3, 6, 9, and 12 months. For participants living with HIV, self-collected biomarkers (viral load) are scheduled for baseline, 6, and 12 months. For HIV-negative participants, up to 3 HIV self-testing kits will be available during the study period. Results Research activities began in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020. Conclusions Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States. Trial Registration ClinicalTrials.gov NCT03678181; https://clinicaltrials.gov/ct2/show/study/NCT03678181. International Registered Report Identifier (IRRID) DERR1-10.2196/24043

scholarly journals Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Kathryn Elizabeth Muessig ◽  
Jesse M Golinkoff ◽  
Lisa B Hightow-Weidman ◽  
Aimee E Rochelle ◽  
Marta I Mulawa ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Hiv Status ◽  
Mhealth Intervention ◽  
Sex With Men ◽  
The University ◽  
Living With Hiv ◽  
Hiv Negative

BACKGROUND Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space. OBJECTIVE Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradata (data collected as users interact with an mHealth intervention, eg, time spent using the intervention), mediates stigma- and HIV care–related outcomes. Finally, we will assess whether changes in intersectional stigma and improvements in HIV care continuum outcomes vary across different types of social networks formed within the intervention study arms. METHODS We will enroll 1050 YBLMT aged 15 to 29 years affected by HIV across the United States. Using an HIV-status stratified, randomized trial design, participants will be randomly assigned to 1 of the 3 app-based conditions (information-only app-based control arm, a researcher-created network arm of HMP 2.0, or a peer-referred network arm of HMP 2.0). Behavioral assessments will occur at baseline, 3, 6, 9, and 12 months. For participants living with HIV, self-collected biomarkers (viral load) are scheduled for baseline, 6, and 12 months. For HIV-negative participants, up to 3 HIV self-testing kits will be available during the study period. RESULTS Research activities began in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020. CONCLUSIONS Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States. CLINICALTRIAL ClinicalTrials.gov NCT03678181; https://clinicaltrials.gov/ct2/show/study/NCT03678181. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24043

scholarly journals The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV

2019 ◽  
Vol 18 ◽  
pp. 232595821986732
Author(s):  
Parya Saberi ◽  
Torsten B. Neilands ◽  
Michelle A. Lally ◽  
Sybil G. Hosek ◽  
Lisa Hightow-Weidman
Keyword(s):  
Social Media ◽  
Anal Intercourse ◽  
Transgender Women ◽  
Sex Partners ◽  
Sexually Transmitted ◽  
Women Living With Hiv ◽  
Social Media Site ◽  
Site Use ◽  
Sex With Men ◽  
Living With Hiv

We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.

scholarly journals Qualitative Evaluation of Social Media and Mobile Technology Interventions Designed to Improve HIV Health Outcomes for Youth and Young Adults Living With HIV: A HRSA SPNS Initiative

2020 ◽  
Vol 21 (5) ◽  
pp. 693-704
Author(s):  
Ronald A. Brooks ◽  
Omar Nieto ◽  
Dallas Swendeman ◽  
Janet Myers ◽  
Ricardo Mendoza Lepe ◽  
...  
Keyword(s):  
Social Media ◽  
Young Adults ◽  
Mobile Technology ◽  
Viral Suppression ◽  
Medical Information ◽  
Qualitative Evaluation ◽  
The United States ◽  
Hiv Care ◽  
Youth And Young Adults ◽  
Living With Hiv

Youth and young adults living with HIV (YYALH) are less likely to be engaged in HIV care, adhere to their medications, and achieve viral suppression compared to older adult populations. In the United States, the majority of YYALH belong to racial/ethnic, sexual, and gender minority groups. HIV care interventions are needed that specifically target YYALH and that exploit the use of social media and mobile technology (SMMT) platforms, where youth and young adults have a ubiquitous presence. We conducted a qualitative evaluation of SMMT interventions included in a Health Resources and Services Administration Special Projects of National Significance initiative designed to improve medical care engagement, retention, and medication adherence to achieve viral suppression among YYALH. However, in this study, only young adults living with HIV (YALH) ages 18 to 34 years participated. A total of 48 YALH were interviewed. The data were analyzed using thematic analysis and revealed three main themes supporting the usefulness of the SMMT interventions, which included (1) acceptability of SMMT interventions in managing HIV care with subthemes of medical information accessibility, reminders, and self-efficacy; (2) feelings of support and personal connection afforded by SMMT interventions; and (3) SMMT interventions help to alleviate negative feelings about status and mitigate HIV-related stigma. A few participants identified problems with using their respective intervention, primarily related to the functionality of the technologies. Overall, findings from our qualitative evaluation suggest that SMMT-based interventions have the potential to increase engagement and retention in care, support YALH in adhering to medication, and help them adjust to their diagnosis.

scholarly journals 3242 Stressful experiences and adherence to HIV care among Black Women Living with HIV: A qualitative analysis

2019 ◽  
Vol 3 (s1) ◽  
pp. 74-74
Author(s):  
Crystal Chapman Lambert ◽  
Chastity McDavid ◽  
Tammi F. Thomas ◽  
Kiko King ◽  
Andres Azuero ◽  
...  
Keyword(s):  
Social Support ◽  
Black Women ◽  
Physical Abuse ◽  
Traumatic Events ◽  
The United States ◽  
Stressful Events ◽  
Hiv Care ◽  
Care Clinic ◽  
Women Living With Hiv ◽  
Living With Hiv

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

scholarly journals Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States

AIDS ◽  
2019 ◽  
Vol 33 (8) ◽  
pp. 1379-1384 ◽  
Author(s):  
Anna M. Leddy ◽  
Janet M. Turan ◽  
Mallory O. Johnson ◽  
Torsten B. Neilands ◽  
Mirjam-Colette Kempf ◽  
...  
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
The United States ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Care And Treatment ◽  
Living With Hiv

scholarly journals 884. Title: Factors Associated with Lack of Viral Suppression Among Women Living with HIV in the United States: An Integrative Review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S533-S534
Author(s):  
Titilola Labisi ◽  
Nada Fadul ◽  
Jason Coleman ◽  
Anthony Podany ◽  
Keyonna King
Keyword(s):  
United States ◽  
Substance Use ◽  
Health Insurance ◽  
Viral Suppression ◽  
Common Factors ◽  
The United States ◽  
Related Factors ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Living With Hiv

Abstract Background Women account for 19% of new HIV cases in the United States (US). Transgender women are 49 times more likely than other groups to be diagnosed with HIV. HIV is one of the top ten causes of death among women between 25 to 44 years. Adherence to antiretroviral therapy (ART) and consequent viral suppression (VS) are keys to preventing sexual transmission, risk of drug resistance, and improving health outcomes. Hence, it is essential to identify factors behind VS in women living with HIV (WLWH). Methods This review identified and synthesized peer-reviewed studies describing reasons for lack of VS among WLWH in the US. : Using the PRISMA model, we searched CINAHL, PubMed, Embase, Scopus, and PsycINFO, then selected US studies published from 2010 to April 2021. Studies that included men, non-adults, ongoing studies, and foreign studies were excluded. 1,359 studies were assessed and screened for duplicate and eligibility. PRISMA Model Results 15 studies were eligible for review; 8 included all WLWH, 5 focused on pregnant WLWH, 1 included only African American WLWH and 1 included only transgender WLWH. Based on study participants and findings, results were divided into pregnancy and non-pregnancy-related factors. Pregnancy-related factors: Early ART initiation and group prenatal care improved care retention and VS. WLWH in cities were more likely to be virally suppressed at delivery than those in rural regions. Intimate partner violence (IPV) was associated with poor ART adherence and time to achieve stable VS. Also, being postpartum was associated with high viral load regardless of ART. Non-pregnancy-related factors: The most reported common factors were substance use and IPV. Other factors included social determinants of health, age, race, health insurance, income, number of pills, and regimen. Transgender-specific factors were stress, race, age, relationship, transphobic experiences, gender satisfaction, and adherence to hormone therapy. Conclusion Substance use, income, mental health, health insurance, race, and ART regimen were the most common factors associated with VS in WLWH. There was paucity of data on transgender-specific VS factors. More research is needed to explore VS and treatment adherence amongWLWH, especially transgender women. Disclosures All Authors: No reported disclosures

scholarly journals Perceived Barriers to HIV Care and Viral Suppression Comparing Newly Diagnosed Women Living with HIV in Rural Uganda with and without a History of Intimate Partner Violence

2021 ◽  
pp. 088626052110282
Author(s):  
Ijeoma Nwabuzor Ogbonnaya ◽  
Elizabeth Reed ◽  
Rhoda K. Wanyenze ◽  
Jennifer A. Wagman ◽  
Jay G. Silverman ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Viral Suppression ◽  
Intimate Partner ◽  
Hiv Care ◽  
Newly Diagnosed ◽  
Women Living With Hiv ◽  
History Of ◽  
To Come ◽  
Living With Hiv

Intimate partner violence (IPV) is associated with poor HIV care linkage and retention, medication adherence, and viral suppression. However, limited knowledge exists regarding potential mechanisms linking IPV to these outcomes. We aimed to (a) identify the top barriers to accessing HIV care experienced by women living with HIV (WLHIV) who report a history of IPV and have suppressed viral load (VL) versus unsuppressed VL and (b) understand how these barriers influence VL, comparing WLHIV with a history of IPV to WLHIV without a history of IPV. Study data come from newly diagnosed WLHIV in rural Uganda participating in the standard-of-care control arm of a randomized trial ( n = 152). Descriptive results ranking mean scores from highest to lowest showed that, among women with a history of IPV, irrespective of viral suppression status, paying for transportation to come to clinic, having to wait at the clinic for long periods of time, and finding a clinic within reasonable travel distance were the top three barriers to accessing HIV care. WLHIV with a history of IPV were significantly more likely to have unsuppressed VL versus suppressed VL if they reported higher levels of difficulty finding a clinic within reasonable travel distance (RRR = 1.7, 95% CI [1.1–2.7]), getting permission to take time off from work (RRR = 1.5, 95% CI [1.0–2.9]), and finding time to come to the clinic for an appointment (RRR = 1.6, 95% CI [1.0–2.6]). The same relationships were not present among WLHIV without a history of IPV, suggesting these barriers and their effect on VL may be uniquely related to IPV. Interventions should address IPV and HIV care continuum outcomes in tandem, targeting barriers to accessing HIV care likely associated with IPV. Additional research is necessary to better understand how IPV relates to HIV care barriers and VL.

scholarly journals Social determinants of health and care outcomes among people living with HIV in the United States

2021 ◽  
Author(s):  
Timothy W Menza ◽  
Lindsay K Hixson ◽  
Lauren Lipira ◽  
Linda Drach
Keyword(s):  
United States ◽  
Social Determinants ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Care ◽  
Economic Disadvantage ◽  
People Living With Hiv ◽  
Care Outcomes ◽  
Durable Viral Suppression ◽  
Living With Hiv

Abstract Background Fewer than 70% of people living with HIV (PLHIV) in the United States have achieved durable viral suppression. To end the HIV epidemic in the United States, clinicians, researchers, and public health practitioners must devise ways to remove barriers to effective HIV treatment. To identify PLHIV who experience challenges to accessing healthcare, we created a simple assessment of social determinants of health (SDOH) among PLHIV and examined the impact of cumulative social and economic disadvantage on key HIV care outcomes. Methods We used data from the 2015-2019 Medical Monitoring Project, a yearly cross-sectional survey of PLHIV in the United States (N=15,964). We created a ten-item index of SDOH and assessed differences in HIV care outcomes of missed medical appointments, medication adherence, and durable viral suppression by SDOH using this index using prevalence ratios with predicted marginal means. Results Eighty-three percent of PLHIV reported at least one SDOH indicator. Compared to PLHIV who experienced none of the SDOH indicators, people who experienced one, two, three, and four or more SDOH indicators, were 1.6, 2.1, 2.6 and 3.6 as likely to miss a medical appointment in the prior year; 11%, 17%, 20% and 31% less likely to report excellent adherence in the prior 30 days; and, 2%, 4%, 10% and 20% less likely to achieve durable viral suppression in the prior year, respectively. Conclusions Among PLHIV, cumulative exposure to social and economic disadvantage impacts care outcomes in a dose-dependent fashion. A simple index may identify PLHIV experiencing barriers to HIV care, adherence, and durable viral suppression in need of critical supportive services.

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