Local, National, and Global HIV/AIDS Research & Resources | Summer 2019
doctor talking to patient in office
HIV Care Engagement for Black Men, Latinx, Youth, and Global Populations
Staying in HIV care can be challenging, even for motivated patients, and their needs may change over time. Learn about our care engagement research, including STYLE, an intervention to improve care for young Black men; an innovative telehealth and texting intervention for youth; an intervention for increasing retention and care among black men living with HIV; and more.
In This Issue

  1. Local projects
  2. Domestic projects
  3. International projects
  4. National HIV Testing Day: Research and Resources Booklet and Video
  5. Announcements
  6. Technical Assistance
Local projects

AIDS Project of the East Bay ( APEB ) and the UCSF Prevention Research Center ( PRC) partnered to adapt, implement, and evaluate STYLE, an evidence-informed intervention to improve engagement in care for young African American gay, bisexual, and other men who have sex with men, in Oakland CA (named M+). The website provides a guide for implementing HIV testing, referral, care, and support. Tools and information from the M+ project and from the original STYLE study conducted by University of North Carolina are available available online at style.ucsf.edu .

Anti-immigrant policies and rhetoric have led to a high demand for HIV-related legal services among immigrant populations in California. Health care and social service providers, attorneys, and legal/policy experts participated in qualitative interviews to understand maintenance of HIV care and prevention for immigrant populations and define medical–legal partnership best practices. Shannon Fuller, Wayne Steward, Omar Martinez, and Emily Arnold analyzed the role of medical–legal partnerships (MLPs) and document best practices. Participants reported immigrant clients’ increased need for legal services. 
 
In the United States, nearly a third of persons diagnosed with HIV are diagnosed late, meaning that they are diagnosed with AIDS at the same time as or within one year of their HIV diagnosis. Late diagnosis is associated with greater HIV transmission, morbidity, and mortality. Will Vincent and colleagues are interviewing 20 late-diagnosed individuals and 20 individuals who are not late-diagnosed to elucidate reasons for late testing and to uncover potential strategies for increasing early HIV detection, the initial step in the HIV continuum of care. We are working in partnership with the Alameda County Public Health Department to examine factors that fuel late HIV diagnosis within a multilevel framework. 

Ending the HIV epidemic requires that we achieve viral suppression and reduce HIV transmissibility for groups that are disproportionately affected, such as Black men who have sex with men (BMSM). As such, retention in HIV care is key. However, critical barriers to retention in care for HIV+ BMSM (+BMSM) have not been sufficiently addressed. Will Vincent and colleagues aim to develop an intervention that is strategic such that it combines in-person approaches with two-way text messaging while finding +BMSM who have left HIV care where they are likely to present (e.g., public health clinics, community-based organizations, emergency rooms).

John Sauceda and colleagues are conducting a two-year mixed-method study to promote HIV care engagement among Latinx people living with HIV (PLWH) in Los Angeles. Together with  Bienestar , a Latino/a-focused community-based organization that provides services across Los Angeles, they will use the Index of Engagement in HIV Care tool to estimate the level of HIV care engagement at the Bienestar HIV clinic and community-led strategies for facilitating and solving problems around HIV care engagement will be identified. 

John Sauceda is conducting a sequential multiple assignment randomized trial to optimize evidence-based treatments for depression and mHealth technology for the promotion of HIV care engagement. The trial will recruit Spanish and English-speaking Latinx patients at the SALUD Clinic at Ward 86 at Zuckerberg San Francisco General Hospital. Efficacious treatments for depression will be leveraged to build an adaptive treatment strategy to reduce depression while promoting HIV care engagement. 

Youth and young adults living with HIV (YLWH) face a range of challenges in their engagement in HIV care and adherence to antiretroviral therapy, such as untreated mental health and substance use issues. Angie Wootton, Parya Saberi, and colleagues present a telehealth counselling and text messaging method aiming to support and enhance HIV care engagement among YLWH in the San Francisco Bay area. The counseling series, which is held via video conferencing and includes a text messaging component, provides education, motivational enhancement and problem-solving around HIV care, mental health, substance use, and other life challenges. The study is currently underway and the research protocol, including details about the intervention’s structure and content, are published in this paper.
Domestic projects

Level of care engagement is not reflected in patients’ medical visits, but in their experience and interaction with providers and the care site. Through a collaborative process of consensus-building with patients, providers, and research experts, using iterative online Delphi surveys and in-person focus groups, Mallory Johnson, Katerina Christopoulos, and colleagues created a patient-centered Index of Engagement in HIV Care that considers patient experience and interaction with providers and the care site. The collaboration and development of the self-report care engagement index have resulted in examination of HIV care disengagement, patient-provider relationships and improvement of HIV care engagement, and an explanatory model of engagement in HIV care comparing retained and less, well-retained patients. Publications from the project include:

International projects
Self-test strategies and linkage incentives to improve ART and PrEP uptake in men in Kenya

A newly awarded NIMH R01 study by Carol Camlin will test a combination intervention to improve the HIV prevention and care cascades in a population of mobile men (fishermen in Kenya) through a cluster randomized controlled trial. The study will recruit and train highly socially-connected men to distribute HIV self-tests and provide linkage support to men in their close social networks. The research question is whether a social network-based approach, along with small financial incentives (transport vouchers) and biomedical technologies (HIV self-testing), can increase men's self-testing, linkage to and uptake of ART and PrEP after self-testing, and virologic suppression and PrEP adherence.

In Brazil, at least one third of trans women are living with HIV. Even though treatment is free in public clinics, an estimated 40% of transgender people living with HIV in S ã o Paulo are not in care. Sheri Lippman, Jae Sevelius, and investigators at The Center for Research on Human Rights and LGBT+ Health (NUDHES), Santa Casa School of Medicine in Brazil, developed the Trans Amigas project. The project aims to engage transgender women living with HIV in São Paulo in medical care by pairing them with peer navigators: other transgender women living with HIV who are successfully staying in HIV care and who can assist participants with overcoming their own barriers to care with a gender affirming approach. Acceptability and feasibility results from this pilot randomized trial are expected in late 2019 and will inform a future multi-site trial.

National HIV/AIDS Awareness Day - 
Research and Resources

This brochure list CAPS/PRC research and helpful resources for:

HIV Testing Day - June 27
Announcements
The 10th IAS Conference on HIV Science took place from July 21-24 at Mexico City, Mexico!

The 23rd International AIDS Conference (AIDS 2020) will take place July 6-10, 2020 in Oakland and San Francisco. AIDS 2020 is the world’s largest gathering on HIV and AIDS and serves as a forum at the intersection of science, advocacy, and human rights. The next local planning meeting is on Friday, August 23, 2019 from 10-12 pm.
CAPS Community Town Hall presented Meaningful Involvement of People Living with HIV/AIDS (MIPA) with Naina Khanna of Positive Women's Network - USA on June 25, 2019 at UCSF Mission Hall.

Welcome to our new DPS staff! Veronica Jimenez (PrEP Coordinator for Parya Saberi) and Christina Camp (Research Assistant for Parya Saberi)
The mission of Center for AIDS Prevention Studies is to end the HIV epidemic and associated health and social disparities by conducting high impact HIV prevention science and building capacity among researchers and communities to effectively address HIV.  Project #: 2P30MH062246

The mission of the UCSF Prevention Research Center is to maintain an interdependent network of community, academic, and public health partners to design and implement prevention research aimed at answering significant and innovative HIV research questions and promoting the wide use of practices proven to promote health for those infected and affected by HIV.  Project #: 5U48DP004998 
University of California San Francisco