Transcript Slide 1

Community
Report-Back
May, 2005
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Goals of the study
• To reduce sexual and drug use practices that could
transmit HIV
• To increase access to and use of HIV primary
health care
• To increase access and adherence to HIV
treatments
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INSPIRE
Study Description
 Each site attempted to recruited about 250 HIV+ IDUs with opposite sex
partners and a history of IDU in the past year.
 Eligible participants completed a baseline survey on ACASI and provided blood
samples for CD4 and viral load testing.
 Participants who came to initial intervention visit were randomly assigned to
one of two program conditions.
 Participants attended 8-10 intervention visits.
 Participants returned for follow-up ACASI survey at 3, 6, and 12 months post
intervention.
 Participants provided blood samples for lab testing at 6 and 12 months.
 Some participants returned for qualitative de-brief interview post-study.
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Total Number of Participants
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Baltimore
313
Miami
298
New York
271
Bay Area
279
Total
1161
Bay Area
Participant Characteristics (N = 279)
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Gender:
Male
Female
Transgender
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58%
34%
9%
Race/Ethnicity
African American 65%
API/AN
7%
Latino
18%
White
10%
Age:

Education:
Less than H.S
H.S. diploma
Some college+
Ever incarcerated:
In last 6 months:
Sexual orientation:
M
Straight
45%
35%
42 years old (mean) Bi
Gay
16%
(Range: 24-58)
32%
35%
33%
71%
73%
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W
72%
23%
2%
T
20%
20%
48%
Overview of PMI & VDI
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Peer Mentor Intervention:
–
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Video Discussion Intervention:
–
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Seven group sessions, two individual sessions, and
one Peer Volunteer Activity at a community agency
8 group sessions based on watching and discussing
videos on a range of topics including criminal justice
system, overdose, disclosure of HIV to children
History
TO
1997-1999
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1999-2005
Peer Mentoring Intervention Summary
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Session I
Group Workshop
Introduction to Peer Mentoring
Session II
Group Workshop
Health Care Decision-Making, Disclosing HIV Status to Providers
Session III
Individual Meeting
Your Relationship to HIV Care, HIV Medications and Adherence
Session IV
Group Workshop
Peer Mentoring: Talking to Peers
Session V
Group Workshop
Introduction to Harm Reduction, Sex, Drugs and HIV Risk
Session VI
Group Workshop
Disclosing Status to Partners, HIV Responsibility
Session VII
Individual Meeting
Barriers to Protecting Partners, Strategies to Overcome Barriers
Session VIII
Group Workshop
Male and Female Condom Demo Condom Use Skills-Building,
Negotiating Condom Use
Session IX
Individual Activity
Peer Volunteer Activity: Participation in an AIDS Service
Organization
Session X
Group Workshop
Debrief from Peer Volunteer Activity, Intervention Review, Plans for
the Future
Session 1 - Introduction to Program
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Identity as HIV+ people
Group Composition
Years since HIV Diagnosis (mean = 8 years):
–
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Less than 3 years
12%
Sessions 2 & 3: Health Care Utilization,
Adherence & Relationship with Providers
10
Primary Healthcare Visits in the Past 6 months
%
None
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One to Three
30
Four or more
49
Total
100
Currently on HIV medication = 47%
Not on meds but CD4 less than 200 = 9%
100% Adherence: Yesterday
= 81%
Past 7 days = 67%
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Session 4:
Communication Skills & Peer Mentoring
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Session 5: Harm Reduction for
Sexual and Drug Risk
Number of Sexual Partners
%
13
0
8.3
1
40.2
2
14.5
3
13.0
4+
24.0
Total
100.0
Mean
5
Range
0 – 188
Drug Risk Behaviors with HIV-/? in the
Past 3 Months
%
14
Injected
85
Lending Used Needles
8.3
Sharing Cooker, Cotton or Rinse Water
22.8
Unprotected Vaginal and/or Anal Sex with
HIV-/? by Respondent’s Gender
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Men
33% (52/156)
Women
37% (33/90)
Transgender
36% (8/22)
Sessions 6-8: HIV Disclosure &
Responsibility
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Condom Use Consistency with Main
HIV-/? Partner by Respondent’s Gender
Male
17
Female
Transgender
n
%
n
%
n
%
Consistent
16
35
14
44
3
43
Inconsistent
4
9
7
22
1
14
Non-User
26
57
11
34
3
43
Total
46
100.0
32
100.0
7
100.0
Condom Use Consistency with Non-Main HIV/? Partner by Respondent’s Gender
Male
18
Female
Transgender
n
%
n
%
n
%
Consistent
14
18
8
24
2
18
Inconsistent
23
29
10
30
4
36
Non-User
43
54
15
46
5
46
Total
80
100.0
33
100.0
11
100.0
Session 9: Peer Volunteer Activity
Goals:
 Provide an opportunity to act as peer
volunteer in a community setting
 Increase utilization of community resources
Logistics:
 Created MOUs with community service
providers
 Established volunteer activities for study
participants at each site
 Participants signed-up for their preferred site
and activity during 8th session
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PVA Partner Sites
SF:
East Bay:
TARC
NIA Project
Action Point 2
Lyon Martin
Urban Health Study
APAN (Redwood City)
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WORLD
HEPPAC
Tranquilium
Highland Hospital, C2 Clinic
Session 10: Graduation
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Community Partners
The Center for AIDS Services
La Clinica de la Raza
HEPPAC
NEED
Bay Area Consortium for Quality Health
Care: EIP Program
APEB
Neighborhood House of North Richmond
WORLD
Berkeley Free Clinic
Tranquilium
African American AIDS Support Service
14th Street Clinic
AIDS Housing and Information Project
Oasis Clinic
Alameda County Office of AIDS
EBAC
Alameda Public Health Dept.
CAL-PEP
Ark of Refuge
Highland Hospital, Adult Immunology Clinic
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National Partners – INSPIRE
Intervention for Seropositive Injectors: Research & Evaluation
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Centers for Disease Control & Prevention (CDC)
David Purcell, Yuko Mizuno, Richard Garfein, Scott Santibanez,
Ann O’Leary, Craig Borkowf, Cindy Lyles.
Health Resources & Services Administration (HRSA)
Lois Eldred, Kathleen Handley.
New York Academy of Medicine
Mary Latka, David Vlahov, Julia Arnsten, Bob Gern, Mark Gourevich
University of Miami
Lisa Metsch, Jay Wilkinson, Eduardo Valverde, Clyde McCoy, Rob Malow
John Hopkins School of Public Health
Carl Latkin, Amy Knowlton, Susan Sherman, Phillip Coffin
Bay Area Team - UCSF
Cynthia Gomez,
Kelly Knight,
Carol Dawson-Rose,
Starley Shade,
Paula Lum,
Catherine Lyons,
Sonja Mackenzie,
Caryn Pelegrino,
Debra Allen,
Barbara Garcia,
Jeff Moore,
Dinah Usog,
Gilda Mendez,
Erin Rowley,
Greg Austin,
Reggie Payne,
Charles Pearson,
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Principal Investigator
Co-Investigator & Project Director
Co-Investigator & Clinical Coordinator
Statistician
Medical Director
Clinical consultant
Evaluation Coordinator; Project Coordinator
Recruitment/PVA Coordinator; Project Coordinator
Recruitment Team & Tracker
Interventionist
Interventionist
Phlebotomist & Assessment Team
Phlebotomist
Project Assistant, Assessment Team Coordinator
Assessment Team
Assessment Team
Qualitative Interviewer
Recruiters: Senobia Ellis; Maria Pedrosa, Natalie Isaac, Duaniel Menifee, Askia Muhammad, Hazel
Betsy, Shawnna Demmons, Andrew Reynolds, Michael Northcutt
How to reach us
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CAPS www.caps.ucsf.edu
Caryn Pelegrino:
Tel: 415-597-8118; [email protected]
Kelly Knight:
Tel: 415-597- 4651; [email protected]
Cynthia Gomez:
Tel: 415-597-9267; [email protected]