Unrepresented Investigators 3 Studies Acute Infection: Smaller - PowerPoint PPT Presentation

Unrepresented Investigators

3 Studies ① Acute Infection: Smaller viral reservoirs (N=72) ② HIV+ Youth: HIV Care Continuum (N=220) Viral suppression endpoint ③ HIV- Youth: HIV Prevention Continuum (N=1500) Repeat testing, Linkage & Retention to Svcs., Adherence (PrEP, PEP, Condoms, STI Tx.)

Cross-Cutting Themes • Same interventions tailored to HIV+ & HIV- youth • Technology-focused • Evidence-based practices (EBP), not manualized EBI • Cost-feasibility data of the CDC recommended interventions: repeat testing & sustained follow- up; care linkage

Laboratory Tests Repeated Every Four Months • HIV 4 th Gen Alere Ag/Ab Combo • Cepheid Xpert HIV-1 Quant Assay • Cepheid Xpert CT/NG Assay • Syphilis RDT • RDT for amphetamine, meth, Crack/cocaine, opiates, marijuana • • Breathalayzer for alcohol • Oraquick HCV (site specific)

Overview Screen GLBTY-HY w/ RDT for HIV, Study 3 Study 2 STI, Substance RCT for HIV- RCT for HIV+ Youth; Use; N=4500 Negative Youth; n=220 n=1500 1500 High Risk Youth Study 1 Acute HIV Infection; n=36+ (+36 established)

Standard Care Conditions CDC Recommendations UCLA Adaptations HIV testing every 3 months HIV testing every 4 months Repeat 4 th generation HIV test, Repeat HIV testing plus STI and substance use RDT Linkage & Retention to Care Link & Retain to Care & Prevention Reminders Automated Messaging & Monitoring (AMM)

Acutely Infected Youth

Stepped-Care for Youth Living with HIV AMM + Repeated Assessments every 4 months over 24 months (n=220) Virally Suppressed? yes (VL<200) No Level 2: AMM + Peer Support No Virally Suppressed? yes (VL<200) No Level 3: AMM + Peer Support + Coaching Virally Suppressed? No yes (VL<200)

RCT for HIV-Negative Youth for HIV Prevention Continuum GBTY-HY N=1500 AMM AMM + Peer Support AMM + eNavigator AMM + Peer Support + (n=900) (n=200) (n=200) eNavigator (n=200) Assessments 4 Months 24 Months } 8 Months 17 weekly SMS/mobile-web surveys - Acute HIV Symptoms 12 Months - Adherence, Risk Beh. & Contexts 16 Months Repeat HIV, STI, Substance use RDT 20 Months

Automated Messaging & Monitoring (AMM) • Daily Informational, Motivational, & Referral Text-Messages • Tailored to age (<=17, >=18) & risk profiles (HIV-status, Gender) • Youth Advisory Boards inform adaptation from source libraries: • “UCARE4LIFE” - HRSA developed for HIV Care Continuum • “Project Tech Support” - NIDA RCT, Reback PI • >600 theory-based messages for gay/bisexual meth using men • “Text-me, Girl!” – HRSA SPNS Project, Reback PI • 270 theory-based messages for Trans Women • Weekly 7-question survey via mobile-web or SMS • Immediate follow-up for nonresponse, or acute HIV symptoms • Intensive Longitudinal Data -> Risk beh., housing & food insec., adh.

Peer Support on Social Media • Adapt from Harnessing Online Peer Education (HOPE) and others • Sean Young (ATN Co-I, PI on HOPE pilots & RCTs) • Consultation and Training from • Social networking site for LGBTQ youth ages 13-24 and allies • Open-source online discussion platform: • Mobile-web, private groups, likes, emojis, avatars, badges, media, etc.

Community Partners

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