This primary aims of this proposed Phase 2 research study are to: 1) refine and pilot test the feasibility and acceptability of a peer-delivered intervention called the Bridge Program for HIV-positive adults who are hospitalized for HIV/AIDS related health consequences; 2) identify barriers and facilitators to implementation of the proposed intervention; 3) estimate intervention parameters (e.g., effect size, study population variance, attrition rates, and response rates); and 4) examine the preliminary impact of the BRIDGE Program on outpatient treatment attendance, qualities of connection with outpatient medical providers, rates of re- hospitalization, HIV illness and medication knowledge, and use of additional services immediately post intervention and at 4 month follow-up. With the introduction of antiretroviral therapy in 1996, living with HIV became a possibility, although those afflicted were faced with a new set of hurdles, including accepting a stigmatizing illness for which there was no cure, complex treatment regimens, and constant involvement with a medical system. Additionally, those living with HIV, particularly adults of color with few economic resources, experienced significant barriers to accessing treatment. Accordingly, infectious disease doctors began to report missed medical appointments and inconsistent medication adherence, especially within urban communities of color. Peer-led interventions are one promising option to increase treatment adherence and engagement in care. However, while such programs have been utilized to address multiple illnesses and conditions, most are focused upon HIV prevention, and not outpatient service usage. Moreover, the few peer-led programs that do target treatment engagement do not occur within inpatient settings with already established discharge planning procedures. A sample of 40 HIV-positive adults who are hospitalized for HIV/AIDS related health consequences will be recruited from Mount Sinai Hospital, an urban New York City medical center. Participants will be randomly assigned to the BRIDGE Program or standard care at discharge, and assessed at baseline, post-test, and 4- month follow-up. Findings of the proposed study could provide critical information concerning the effectiveness of peer-led interventions upon treatment adherence and engagement in outpatient care, and ultimately be used to inform a larger effectiveness study. The proposed study will contribute to the public health knowledge base by providing critical information concerning the effect of the BRIDGE Program for HIV positive adults on attendance at appointments, connections with providers, knowledge of HIV illness and medications, and re-hospitalization rates. ? ? ? ?
