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Demonstration Sites |
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Dr. Angulique Outlaw
Assistant Professor Department of Pediatrics
Wayne State University
Horizons Project
4201 St. Antoine UHC, 6E.16
Detroit, MI 48201
Phone: (313) 745-3218
Fax: (313) 745-4004 aoutlaw@med.wayne.edu
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http://peds.med.wayne.edu/divisions.htm
The goal of Brothers Saving Brothers (BSB) is to conduct field and Internet
outreach to encourage African American YMSM to know their status (i.e., HIV
counseling and testing, and returning for test results) and to encourage HIV
infected African American YMSM to enroll and remain in medical care.
Motivational interviewing (MI) is provided in addition to field outreach to
encourage HIV counseling and testing (HIV C&T), and returning for test
results. Our Internet outreach has two phases. In Phase I, YMSM completed an
Internet survey that inquired about possible barriers to HIV C&T. In Phase
II, MI is provided in addition to online outreach to encourage HIV C&T and
returning for results. All newly diagnosed HIV infected YMSM in this project
receive MI to encourage enrollment and engagement in medical care. Our primary
outcome hypothesis is that African American YMSM who receive peer outreach plus
MI (in the field and via the Internet) will be more ready to know their HIV
status compared to those who receive peer outreach only. The utility of the
completed evaluations will be the addition of innovative ways to encourage
African American YMSM to know their HIV status.
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[click here to see Site Presentation given at January 2005 Grantee Meeting]
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Intervention
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Traditional peer outreach versus traditional peer outreach plus motivational
interviewing
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Comprehensive continuum of care based on a continuous relationship model and
elements of social network theory, with community and Internet outreach
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MI during outreach to use CTR and during post-testing to engage in care
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Inter-disciplinary care using MI to promote retention in care and risk
reduction
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Healthy Choices MI support group intervention, Brother-to-Brother prevention
group intervention
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Agency outreach to capture HIV+ identified elsewhere, outreach and home visits
for those lost to care
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Peer advocacy and recreation services
Outputs
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150 YMSM reached per year via 1,500 community outreach contacts, with one-half
using MI
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100 YMSM reached per year via Internet outreach, with one-half using MI
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52 YMSM use CTR in first year, with all clients who receive CTR receiving MI
with regard to post-testing
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All HIV+ receive MI regarding enrolling in care, with 100%-80% HIV+ to receive
MI regarding staying in care
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18 support groups held, 60 youth to receive case management, 80 youth to
receive advocacy services
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All lost-to-care receive attempted contact
Short Term Outcomes
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Increase knowledge of HIV risks, readiness to know serostatus, knowledge of
individual serostatus
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Increase in number of clients who use CTR, enroll in care and arrive at first
primary care appt
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Increased attendance at quarterly primary care visits, adherence to treatment
regimens, self-efficacy and social support, readiness to change negative
behaviors, and re-enrollment of lost-to-cares
Long Term Outcomes
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Decrease in unmet health care needs and HIV transmission related to not knowing
serostatus
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Improve health and well-being of HIV+
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Reduction in high risk sexual and substance using behaviors
Proposed Local Evaluation Strategy
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Compare peer outreach to peer outreach plus motivational interviewing to assess
the effect on readiness to accept diagnosis, receipt of HIV CTR, and return for
test results; also linkage into care
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Randomized controlled trial with pre-post test comparisons: randomization to
traditional versus traditional plus motivational interviewing to assess if
intervention results in the pursuit of HIV CTR
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For field recruitment, field outreach three days per week
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Baseline, three, and six month follow-up
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For field: ni=50 (total N=100), for Internet: ni=75 (total N=150)
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