Young Black men who have sex with men (YBMSM) have had among the highest recent increases in HIV incidence in the US and Baltimore. The efficacy of control strategies such as pre-exposure prophylaxis (PrEP) is well established, but implementation of these strategies have been limited by available resources and the inability to identify and access those at greatest risk for acquisition. To interrupt HIV transmission it is essential to identify sexual networks with on-going transmission. Once identified, chains of transmission can be interrupted in these networks using a targeted PrEP control strategy to reduce the susceptibility of those at risk. The goal of the proposed research plan is to identify access points for YBMSM within HIV transmission networks and enable the development of a PrEP control strategy to halt transmission within these networks. The applicant is an adolescent medicine and HIV provider with doctoral level training in public health. He is trained as a qualitative researcher and has focused his research on understanding HIV disparities affecting YBMSM. However, as this disparity persists, he has recognized the need to shift his research focus from descriptive studies aimed at understanding the disparity to the effective implementation of strategies aimed at addressing the disparity. Together with his mentors he has developed a training plan to address the additional skills he will for this shift. This training plan includes 1) attaining network analysis skills focused on HIV transmission dynamics in sexual networks, 2) developing field research skills including sampling in venue and internet-based settings, 3) developing mixed methods skills to inform effective implementation design, and 4) attaining knowledge and skills in community-centered implementation of evidence-based prevention strategies. The research plan is designed to identify sex partner meeting venues with ongoing HIV transmission and to explore the barriers and facilitators to accessing and achieving PrEP uptake in YBMSM within these venues Specific Aim 1 is to graph venue affiliation networks linking sex partner meeting venues reported by new MSM HIV cases in Baltimore.
Specific Aim 2 is to describe the network structure and compositional characteristics of the venue affiliation networks identified in Aim 1 and, using prospective HIV testing data, to determine the association between network structure, compositional characteristics and HIV incidence and prevalence. Informed by data from the prior aims, Specific Aim 3 is to explore barriers and facilitator to accessing and achieving PrEP uptake in YBMSM in high incidence venue networks in order to interrupt HIV transmission. Through this award, the applicant will become a physician scientist skilled in mixed methods and network analysis, experienced in field research on the ground and online, and skilled in engaging communities in the application of evidence-based prevention. Together with his clinical and public health perspective on the HIV disparities affecting YBMSM, this training will uniquely position him to implement effective strategies to eliminate these disparities and improve the health of patients and their communities.
Young Black gay, bisexual and other men who have sex with men (YBMSM) suffer significant racial disparities in HIV incidence in the U.S. despite advances in treatment and prevention. The purpose of this study is to identify high risk sex partner meeting venues connected by ongoing HIV transmission networks among users. Findings will provide access points for YBMSM at risk for infection. Using these data, the study will explore facilitators and barriers to accessing and achieving PrEP uptake among YBMSM who attend these venues with the goal of using PrEP to halt transmission within these networks.
| Rhodes, Scott D; Tanner, Amanda E; Mann-Jackson, Lilli et al. (2018) Community-Engaged Research as an Approach to Expedite Advances in HIV Prevention, Care, and Treatment: A Call to Action. AIDS Educ Prev 30:243-253 |
