2012 Innovative Grants

CAPS awarded these two Innovative Grants in February 2012:

Piloting HIV Self-Testing for High-Risk MSM
PI: Oliver Bacon, MD
Mentor: Susan Buchbinder, MD
Co-Investigator: Lynae Darbes, PhD

Abstract: Men who have sex with men (MSM) remain at high risk of acquiring and transmitting HIV infection, despite prevention efforts. Timely diagnosis of HIV infection allows linkage to care (including antiretroviral therapy) and risk-reduction counseling, thereby reducing morbidity and mortality to the individual and risk of onward transmission. Approximately 20% of HIV-infected MSM in the United States don’t know their serostatus, putting them at substantial risk of illness and of transmitting HIV to their sexual partners. HIV home-testing, using rapid oral test kits, could help to close this testing gap, but substantial questions remain regarding the acceptability and feasibility of such an approach.

The proposed pilot study aims to gather preliminary data on the feasibility and acceptability of HIV-self testing among two groups of high risk MSM in the San Francisco Bay Area: gay self-identified MSM in San Francisco, and African-American MSM in Alameda County who may or may not be gay self-identified. We plan to enroll 20 participants (10 in SF and 10 in Alameda County). After being trained and observed in the performance and interpretation of the OraQuick Advance® Rapid HIV1/2 oral test, participants will be given a supply of test kits and asked to test monthly for three months. Before and after the testing phase, they will complete a detailed behavioral questionnaire regarding their willingness to self-test, the effect of testing on their sexual risk behavior, and their preferences and experiences regarding training, results counseling, and linkage to care.

The goal of the current pilot project is to efficiently gather preliminary data on a number of important questions related to HIV self-testing that will be essential in designing a larger demonstration project on the feasibility and outcomes of HIV self-testing by high-risk MSM. These include the choice of target population for such an intervention, the feasibility of training the target population to self-test accurately, their needs and preferences regarding training, test-counseling, and linkage to care, their willingness to involve sexual partners in home-testing, and the potential effects of self-testing on risk behavior.

 

Measuring Treatment Engagement among HIV-Positive Transgender Women: A Critical First Step in Research to Optimize Health Outcomes among a Vulnerable Population
PI: Jeanne (Jae) Sevelius, PhD
Mentor: Mallory Johnson, PhD
Co-Investigator: Glenn Wagner, PhD

Abstract: The National AIDS Strategy calls for efforts to increase access to care and improve health outcomes for people living with HIV. Consonant with this mission is the priority of reducing HIV-related disparities for populations disproportionately impacted by the epidemic. Transgender women (persons born male but who do not identify as male) have higher rates of HIV infection, lower rates of HIV testing, and those who test HIV-seropositive are less likely to take antiretroviral therapy (ART). There is evidence that transgender women on ART are less adherent to their medications than other groups and report unique challenges interacting with care providers and integrating treatment into their lives. We are moving toward the development of an intervention based in a novel Model of Health Care Empowerment to increase HIV+ transgender women’s active and productive engagement in HIV medical care.

This CAPS Innovative Grant funding application addresses the critical and specific issue of measuring engagement in care. We propose to recruit, follow, and assess 12 HIV+ transgender women on ART to test the feasibility, acceptability, and potential value of two measures of engagement: (1) electronic medication event monitoring system (MEMS) medication adherence assessments and (2) calendar-based timeline follow-back (TLFB) HIV primary care appointment attendance. The proposed activities will provide necessary data and experience with measures that can potentially serve as primary outcomes in the planned NIH R01 submission. Collectively, this work has the potential to reverse the growing disparities of poor HIV-related outcomes for transgender women living with HIV.

Last modified: September 27, 2012