Stigma and Online Counseling to Increase HIV/STI Testing
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/11/2018 |
| Start Date: | December 2016 |
| End Date: | May 2021 |
| Contact: | Moira Kalichman, MSW |
| Email: | moira.kalichman@uconn.edu |
| Phone: | 860-486-8702 |
Novel Stigma/Structural Interventions for HIV/STI Testing
The alarmingly high rates of HIV/STI (sexually transmitted infections) observed among Black
men who have sex with men (BMSM) necessitate a new model for engaging BMSM. New approaches
include addressing stigma related concerns and structural barriers in order to increase
HIV/STI testing uptake. This research includes a 2 x 2 factorial design to test an
intervention that is aimed at increasing HIV/STI testing uptake among BMSM; this design
includes testing HIV/STI stigma focused counseling, and online HIV/STI test counseling with
at-home, self-administered HIV and STI test kits.
men who have sex with men (BMSM) necessitate a new model for engaging BMSM. New approaches
include addressing stigma related concerns and structural barriers in order to increase
HIV/STI testing uptake. This research includes a 2 x 2 factorial design to test an
intervention that is aimed at increasing HIV/STI testing uptake among BMSM; this design
includes testing HIV/STI stigma focused counseling, and online HIV/STI test counseling with
at-home, self-administered HIV and STI test kits.
This research is aimed at conducting structural and stigma-focused interventions to increase
HIV and STI testing uptake among Black men who have sex with men (BMSM). The research is
focused on this population due to the alarmingly high rates of HIV/STI (sexually transmitted
infections) among BMSM- this group has experienced elevated rates of HIV incidence and
prevalence since the beginning of the US epidemic, and current estimates demonstrate that
although BMSM make up only 0.2% of the population they make up 22% of new HIV infections. The
investigator have documented a 5.1% annual HIV incidence and a 35% HIV prevalence among BMSM.
Health care models are failing to engage BMSM at all points of the HIV care continuum
including the seek and test components. The CDC recommends that individuals at substantial
risk for HIV be tested for HIV/STI every three to six months; however, this goal is not being
achieved and, therefore, a new approach to engaging BMSM is needed. To address these
shortcomings and based on preliminary studies, the investigators are conducting a 2 x 2
factorial design study to evaluate a model that is aimed at increasing HIV/STI testing uptake
among BMSM. The investigators will test a stigma-focused intervention as stigma is a known
deterrent to HIV/STI testing, yet little has been done to address this factor; and, the
investigators will evaluate HIV/STI test counseling delivered online (in conjunction with
at-home HIV/STI test kits) as this delivery of testing may remove key barriers to reaching
BMSM in need of HIV/STI related care services. Specific Aim 1: Assess HIV/STI testing uptake
at scheduled HIV/STI test counseling appointments during the 12 month follow-up period. 500
BMSM will be randomly assigned to one of four conditions: (a) receive CDC-based risk
reduction counseling and scheduled for in-office HIV/STI test counseling appointments, (b)
receive HIV stigma-enhanced intervention and scheduled for in-office HIV/STI test counseling
appointments, (c) receive CDC-based risk reduction counseling and scheduled for online, via
video calling, HIV/STI test counseling appointments, or (d) receive HIV stigma-enhanced
intervention and scheduled for online, via video calling, HIV/STI test counseling
appointments. Specific Aim 2: Evaluate mediating (key theoretical stigma variables) factors
collected via assessments at 3, 6, and 12 month follow-ups. Specific Aim 3: Conduct an
economic evaluation to determine the costs of the office-based and online-based HIV/STI test
delivery formats from both a community-based payer perspective and a comprehensive societal
perspective that includes all costs. This project has the potential to exert a sustained and
powerful impact not only on approaches to engaging BMSM, but to improving HIV/STI testing
uptake which will likely improve multiple health outcomes among BMSM. If effective, this
approach to improving HIV/STI testing uptake would be available for dissemination immediately
and would fit within resource limited settings such as community based organizations and
health departments.
HIV and STI testing uptake among Black men who have sex with men (BMSM). The research is
focused on this population due to the alarmingly high rates of HIV/STI (sexually transmitted
infections) among BMSM- this group has experienced elevated rates of HIV incidence and
prevalence since the beginning of the US epidemic, and current estimates demonstrate that
although BMSM make up only 0.2% of the population they make up 22% of new HIV infections. The
investigator have documented a 5.1% annual HIV incidence and a 35% HIV prevalence among BMSM.
Health care models are failing to engage BMSM at all points of the HIV care continuum
including the seek and test components. The CDC recommends that individuals at substantial
risk for HIV be tested for HIV/STI every three to six months; however, this goal is not being
achieved and, therefore, a new approach to engaging BMSM is needed. To address these
shortcomings and based on preliminary studies, the investigators are conducting a 2 x 2
factorial design study to evaluate a model that is aimed at increasing HIV/STI testing uptake
among BMSM. The investigators will test a stigma-focused intervention as stigma is a known
deterrent to HIV/STI testing, yet little has been done to address this factor; and, the
investigators will evaluate HIV/STI test counseling delivered online (in conjunction with
at-home HIV/STI test kits) as this delivery of testing may remove key barriers to reaching
BMSM in need of HIV/STI related care services. Specific Aim 1: Assess HIV/STI testing uptake
at scheduled HIV/STI test counseling appointments during the 12 month follow-up period. 500
BMSM will be randomly assigned to one of four conditions: (a) receive CDC-based risk
reduction counseling and scheduled for in-office HIV/STI test counseling appointments, (b)
receive HIV stigma-enhanced intervention and scheduled for in-office HIV/STI test counseling
appointments, (c) receive CDC-based risk reduction counseling and scheduled for online, via
video calling, HIV/STI test counseling appointments, or (d) receive HIV stigma-enhanced
intervention and scheduled for online, via video calling, HIV/STI test counseling
appointments. Specific Aim 2: Evaluate mediating (key theoretical stigma variables) factors
collected via assessments at 3, 6, and 12 month follow-ups. Specific Aim 3: Conduct an
economic evaluation to determine the costs of the office-based and online-based HIV/STI test
delivery formats from both a community-based payer perspective and a comprehensive societal
perspective that includes all costs. This project has the potential to exert a sustained and
powerful impact not only on approaches to engaging BMSM, but to improving HIV/STI testing
uptake which will likely improve multiple health outcomes among BMSM. If effective, this
approach to improving HIV/STI testing uptake would be available for dissemination immediately
and would fit within resource limited settings such as community based organizations and
health departments.
Inclusion Criteria:
- Men who have sex with men
- Transgender women who have sex with men
- 18 years of age and older
- Reside in Atlanta metro area.
- Other criteria may apply
Exclusion Criteria:
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