The HIV epidemic in the United States is becoming increasingly concentrated among young, Black men who have sex with men (YBMSM). Increasing the frequency of HIV tests in this important risk group could make a significant impact on the incidence of new infections, and one promising strategy for enabling more frequent testing is home collection of dried blood spots (DBS) for centralized HIV testing. This approach removes many of the structural and psychosocial barriers keeping YBMSM from testing frequently for HIV, allows for identification of early infections by detection of HIV RNA and antibodies, and enables prompt engagement in care for anyone diagnosed.
The specific aims of this research proposal are to: (1) use survey data to determine which YBMSM are most likely to utilize DBS for home testing, (2) explore barriers to this strategy through qualitative interviews with a sample of YBMSM, and (3) assess the acceptability and feasibility of quarterly home DBS collection, centralized testing, and reporting of results by phone or secure website, in a pilot study. The proposed research will support the long-term career and short-term training goals of the candidate for this career development award, Dr. Christopher Hurt. He is an Assistant Professor in the Division of Infectious Diseases (ID) at the University of North Carolina at Chapel Hill (UNC) who is seeking to achieve career independence as an investigator in public health-oriented HIV research, with a focus on understanding the structural, biological, and behavioral factors influencing HIV transmission among young, Black men who have sex with men (YBMSM) in the United States. To accomplish that goal, Dr. Hurt needs mentored guidance in career development and specific training in the science of health behavior. Through intensive short-courses, seminars, formal coursework, and experiential learning, Dr. Hurt will: (1) learn the theoretical underpinnings of health behavior, (2) become proficient in quantitative and qualitative methods for behavioral assessment, (3) develop skills needed to design and conduct clinical studies of behavior and behavioral change, (4) advance his understanding of molecular diagnostics in HIV, and (5) extend his training in the responsible conduct of human subjects research. Two established ID faculty members with public health training, Drs. Lisa Hightow- Weidman and William Miller, will provide primary mentorship for the candidate, with contributions from expert faculty in qualitative research (Dr. Clare Barrington), molecular diagnostics (Dr. Susan Fiscus), and biostatistics (Dr. Mark Weaver) at UNC, and in behavioral science (Dr. Alex Carballo-Dieguez) at Columbia University. The research plan has the support of the candidate's chairman, who will provide the resources and protected time necessary for completion of this career development award.
The HIV epidemic in the United States is becoming increasingly concentrated among young, Black men who have sex with men (YBMSM). Since YBMSM test for HIV less often than other MSM, increasing the frequency of testing may be an important step toward minimizing the spread of HIV in this population. The proposed research will evaluate whether centralized testing of self-collected dried blood spots, with reporting of results by phone or secure website, is an acceptable and feasible means of increasing test frequency among YBMSM.
