Among the numerous health disparities disproportionately burdening people of color, HIV/AIDS is among the highest. In the African American community the HIV/AIDS epidemic is one of the most urgent public health issues. In order to address the health disparity in HIV/AIDS, detection of HIV in the African American community is crucial. The benefits for early detection of HIV include potentially prolonged duration and quality of life for those living with the virus. HIV testing has also been proposed as a HIV preventive strategy. Detection of HIV has a number of potential preventive benefits, including reduced transmission risk behaviors by those infected9 and reduced viral load by those taking antiretroviral medications, whereby potentially reducing transmission. The proposed study makes a significant public health impact by developing and pilot testing an innovative strategy to increase the number of high-risk adolescents receiving HIV screening. In response to PA-09-146 (Pilot and Feasibility Studies in Preparation for Drug Abuse Prevention Trials [r34]), we propose a pilot study to examine the acceptability and feasibility of a peer-driven, HIV-testing campaign. Peer education and outreach strategies have been successful at reducing sexual risk behavior and increasing the use of health resources in adolescents and other at-risk groups, including adults residing in census tracts where STI rates are high. A potential vehicle for outreach to adolescents is socially interactive technologies (e.g., text messages). The proposed study makes a scientific impact in examining the effectiveness of messaging diffused through the social network of adolescents. A total of 100 current patients at an urban adolescent health clinic serving predominately African Americans will be recruited to disseminate at least 5 text messages to friends they believe are sexually active. Youth will be provided with a brief guide to help them develop their messages. The youth generated text messages will encourage their friends to visit the clinic and get tested.
The specific aims of this project are to:
Aim 1 : Develop protocols and a theory-informed message guide for a peer-driven text message intervention for adolescents recruited from an adolescent health clinic.
Aim 2 : Examine the acceptability and feasibility of sending text messages related to obtaining HIV/STI testing. We will obtain participant feedback and examine the recruitment rate, number of youth failing to meet inclusion criteria, number of youth verified to have sent text messages, and number of text messages sent. We will also obtain feedback from the clinic providers regarding impact on patient and services flow, provider reactions, and impact on clinical visit.
Aim 3 : Preliminarily examine the efficacy of a youth generated messaging intervention to increase the: 1) number of high-risk youth seeking services and 2) clinic volume as measured by: a) number of new patients at clinic, b) increase in rate of new patient appointments, and c) number of STI tests conducted. If successful, the proposed study will significantly contribute to the field of HI prevention by examining the acceptability, feasibility and potential impact of an innovative strategy for delivering messages to high-risk youth, which encourage connection with the healthcare system and screening for HIV. This trial will fill a critical need to improve the sexual health outcomes of high-risk African American youth and lay the groundwork for a subsequent R01 proposal with a larger sample and that would include control sites.

Public Health Relevance

Adolescents exhibit high rates of STI/HIV, which have implications for a myriad of other sexual health issues, including reproductive health. Further, African American youth are disproportionately impacted by HIV. The proposed study will significantly contribute to the field of HIV/STI prevention by examining the impact of an innovative strategy for delivering telehealth messages to high-risk youth that encourage connection with the healthcare system and screening for HIV. This trial will fill a critical need t improve the sexual health outcomes of high-risk youth.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Planning Grant (R34)
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Special Emphasis Panel (ZRG1-AARR-G (02))
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Lloyd, Jacqueline
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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