ID and Testing Via Friendship Networks

The proposed pilot study will utilize a cross-sectional research design to recruit
Hispanic/Latina and African American young women to undergo HIV screening. The research
design will consist of a friendship-based, female network recruitment approach that
incorporates a dual method of incentives for index recruiters and network members as a
strategy for identifying new HIV infections in the target population. Among sexually
experienced young women (many of whom who reside in communities with a high prevalence of
STIs and HIV), 50 who self-identify as HIV positive, 50 who self-identify as HIV negative
(based on receiving a negative HIV test within 12 months prior to study consent), and 50
whose HIV status is self-reported as unknown (who have no history of prior HIV testing or
who had HIV screening more than 12 months prior to date of study consent) will be recruited.
These women will serve as index recruiters to recruit two or more (on average four) female
friendship network members to undergo HIV screening. The index recruiters will be recruited
through three participating ATN sites utilizing the existing infrastructure within the AMTUs
and their community and clinical partnerships. Index participants that agree to take part in
this research will be asked to self-disclose their HIV status, to complete a risk assessment
and indicate their willingness to recruit their close female friends to undergo HIV
screening. In addition, index recruiters who self-identify as HIV negative and those who do
not know their HIV status will be invited to undergo HIV screening.

Index recruiters will be given up to four months to recruit members of their friendship
network. At the end of this recruitment period or after successful recruitment of two or
more friendship network members, whichever comes first, all index recruiters will be asked
to complete a brief questionnaire that describes factors that both facilitated and hindered
their ability to recruit the friendship network members. Sexually experienced friendship
network members who agree to participate in the study will also complete a risk assessment
regardless of whether or not they agree to undergo HIV screening. Participation in this
study will be strictly on a voluntary basis.

Inclusion Criteria for INDEX RECRUITERS:

- Born female;

- Aged 13-24 years at the time of consent;

- African American or Hispanic/Latina ethnicity or mixed-race/ethnicity, which must
include African American race and/or Hispanic/Latina ethnicity;

- A history of sexual intercourse with at least one male sexual partner;

- Any HIV status as follows: (1) HIV positive; (2) HIV negative defined as receiving a
negative HIV test result < 12 months prior to the date of study consent); or (3) HIV
status unknown defined as either no history of HIV testing or receipt of negative HIV
test results more than 12 months prior to the date of study consent);

- History of vaginal and/or anal sexual intercourse with a male;

- Willing to complete a HIV risk assessment; and

- Willing to recruit two or more friendship network members to discuss and eventually
undergo HIV screening;

- Ability to understand written and spoken English; and

- Willing to provide written informed consent/assent.

Inclusion Criteria for FRIENDSHIP NETWORK MEMBERS:

- Born female;

- Aged > 13 years at the time of consent;

- A history of sexual intercourse with at least one male sexual partner;

- Willing to complete an HIV risk assessment;

- Willing to discuss and consider HIV screening;

- Self-report that the most recent HIV test result was negative, or has no prior
history of HIV testing;

- Ability to understand written and spoken English; and

- Willing to provide written informed consent/assent.

Exclusion Criteria for INDEX RECRUITERS:

- Psychiatric disorder (untreated) associated with thought disorder, hallucinations,
acute substance use withdrawal. Stabilized patients receiving appropriate psychiatric
care will not be excluded if informed consent can be reasonably assumed;

- Visibly distraught and/or visibly emotionally unstable (e.g., depressive mood;
exhibiting manic, suicidal, or violent behavior);

- Active drug or alcohol use or dependence that, in the opinion of the site personnel,
would interfere with ability to give true informed consent and to adhere to the study
requirements; and

- Acutely ill at the time of enrollment.

Exclusion Criteria for FRIENDSHIP NETWORK MEMBERS:

- Self-report an HIV positive test result;

- Psychiatric disorder (untreated) associated with thought disorder, hallucinations,
acute substance use withdrawal. Stabilized patients receiving appropriate psychiatric
care will not be excluded if informed consent can be reasonably assumed;

- Visibly distraught and/or visibly emotionally unstable (e.g., depressive mood;
exhibiting manic, suicidal, or violent behavior);

- Active drug or alcohol use or dependence that, in the opinion of the site personnel,
would interfere with ability to give true informed consent and to adhere to the study
requirements;

- Acutely ill at the time of enrollment.