Structural Intervention to Promote HIV Care in Black Sexual Minority Men

University Of Chicago, Chicago IL

Investigators

Abstract

PROJECT SUMMARY The goals of this research project are to use the ADAPT-ITT framework to adapt elements of an existing career readiness interventions tailored to young SMM and trans women of color at-risk for HIV infection (Work2Prevent) to the needs of young Black SMM (YBSMM), ages 18-29, living with HIV. Once adapted, a pilot study of the intervention (Work2Prevent Plus; W2P+) will be conducted with 40 YBSMM to determine intervention feasibility, acceptability, and efficacy for improving care engagement. To ensure W2P+ can serve the needs of HIV-positive YBSMM, the research team will engage in a formative phase of adaptation, wherein quantitative and qualitative data will be collected from employers. A sample of potential employers (n=50) will complete a survey focused on challenges related to hiring and retaining individuals with a range of minority identities. A second sample (n = 20) of potential employers will complete an interview with project staff, where they will respond to vignettes focused on successes and challenges a hiring manager could encounter when trying to hire and retain employees who are YBSMM living with HIV. These data will inform the adaptation of W2P+. Next, a series of focus groups will be conducted with members of the population (n = 40) to identify what they most need in a career readiness intervention. More specifically, this phase will use the ADAPT-ITT framework to ensure the adapted intervention addresses the range of concerns associated with employment for YBSMM irrespective of HIV status. Next, the research team will conduct a theater test with 8 YBSMM aged 18-29 years old and 10 stakeholders serving YBSMM, wherein stakeholders will observe the administration of content from the existing interventions to identify which content should be retained, adapted, or replaced. Next, 3 to 5 experts on employment and treatment barriers will be asked for additional feedback for intervention revision. The feedback will be used for additional revision of W2P+. Finally, a computerized readability test will ensure that language used in the revised intervention manual and activities is accessible to a 6th grade reading level. After the intervention manual and delivery procedures with the ADAPT-ITT model are finalized, 40 YBSMM, ages 18-29, will be enrolled in a single arm pilot trial, with follow- up assessments at 6 and 12 months. The primary research outcomes for the pilot study are feasibility and acceptability. Additional outcomes include hours worked per week, job seeking self-efficacy, and proportion of missed HIV care visits. Further, we will use implementation science measures to identify the best approach for delivering the intervention in a CBO setting. Primary implementation outcomes are relative advantage of the intervention and implementation climate. Secondary outcome is readiness for implementation.