A Spotlight on our Ending the Epidemic Research |
In this e-newsletter we spotlight a sample of Ending the Epidemic (EtHE) research conducted by the Division of Prevention Science |
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In this issue
- Director's Message
- Ending the Epidemic Research
- VIDEO - HIV Service Provision During COVID-19. Community Experiences
- VIDEO - CAPS/PRC at AIDS 2020
- Announcements
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Marguerita Lightfoot, PhD - Director's Message |
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As Director of UCSF Center for AIDS Prevention Studies (CAPS) and Prevention Research Center (PRC), I am excited about this newsletter, which features research projects funded by the National Institutes of Health (NIH) that support the Ending the HIV Epidemic: A Plan for America.
NIH’s $11 million in funding to community collaborative research projects throughout the nation will help to reduce new HIV diagnoses in the United States by at least 90% by 2030. This initiative prioritizes collaborations with partners in local communities to determine how best to leverage existing, highly effective tools to diagnose, prevent and treat HIV in priority areas targeted by the Ending the HIV Epidemic (EtHE) initiative, which includes 50 counties and cities with the highest rates of HIV and seven states with high rates of HIV in rural areas.
Projects submitted by CAPS/PRC faculty, as well as those from UCSF CFAR investigators, received input from our Community Advisory Board. Each project involved close collaboration between investigators and local implementing partners and community groups, supporting engagement that is critical to developing locally relevant interventions that meet a community’s unique needs, specifically in communities that face a disproportionate risk of HIV.
This newsletter highlights lessons learned and preliminary findings for some of EtHE projects. Please enjoy and click on available links to learn more about the researchers and their projects. Additionally, for a complete list of projects awarded nationally, click here.
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Ending the Epidemic Research |
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Adapting the Mpowerment Project to improve PrEP uptake, adherence, and persistence among young Black and Latino MSM in Texas.
CAPS, the Kind Clinic (Austin and San Antonio, TX), Vivent Health (Austin, TX) and AIDS Outreach Services (Ft. Worth, TX) collaboratively conducted four focus groups with 33 Black and Latino gay, bisexual, and other MSM, ages 20-36, with a variety of PrEP histories. Preliminarily, we learned that participants heard about PrEP from different sources and proactively accessed PrEP. PrEP allowed them to feel in control of their sex lives without fear of HIV. Most reported inconsistent condom use while on PrEP and taking PrEP may not be a linear process. Participants reported stopping and restarting PrEP due to side effects, not having sex, mental health issues, housing instability, or moving out of state. Participants appreciated the ease of obtaining PrEP at non-judgmental and stigma-free places like those in the collaborative. Participants expressed a common belief among YBLMSM that accessing PrEP is cumbersome and costly and stressed that efforts to facilitate PrEP access needs to include community representation and inclusivity. Intersectional barriers to PrEP such as cost, fear, limited access to health services, stigma, transportation, language (if monolingual Spanish), and being undocumented also need attention. Participation in the focus groups was an empowering and rare experience. They recommended content, structure, and processes for new PrEP promotion activities that can be conducted by Mpowerment Projects at community clinics and other organizations. CAPS Research Team - Susan Kegeles, Greg Rebchook, Scott Tebbetts, Robert Williams and Andres Mairoana.
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Optimizing Novel Strategies to Increase Virologic Suppression Rates Among Unstably Housed Patients Living With HIV
Homelessness and unstable housing are major barriers to ending the HIV epidemic. Matt Hickey, Liz Imbert, Monica Gandhi, and colleagues are conducting an implementation evaluation and discrete choice experiment to understand care preferences for this patient population and how these preferences have shifted in the era of COVID-19. Their research has focused on the POP-UP clinic at SFZGH Ward 86, a low-barrier care model for people living with HIV and experiencing homelessness. In an initial discrete choice experiment, patients preferred the flexibility of drop-in appointments from providers who knew them as opposed to urgent care drop in visits with an unknown provider (Conte, JAIDS 2020). Within the POP-UP drop-in care model, 60% attained HIV viral suppression within six months of enrollment, and there has been no decline in care engagement or viral suppression within this supportive clinic model during COVID-19. Another ongoing discrete choice experiment seeks to quantify patient preferences for telehealth during and after the COVID-19 pandemic. Understanding patient priorities for specific intervention components identified in this study will be used to help inform program adaptation and identify intervention components that can be useful in other settings.
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RAPID: Evaluating Gaps and Improving Linkage and ART Initiation in the Bay Area
Rapid initiation of HIV treatment is a key pillar ("Treat") of the Ending the Epidemic initiative and one of the central strategies of Getting to Zero efforts in the San Francisco Bay Area. Al Liu and collaborators aim to identify gaps in monitoring and implementing rapid linkage and treatment initiation in people newly diagnosed with HIV across San Francisco and Alameda counties by developing a common set of RAPID metrics to track outcomes in RAPID programs across the counties, and by conducting stakeholder engagement with local providers, navigators, and administrators to elicit barriers and facilitators to successful implementation of RAPID using the Consolidated Framework for Implementation Research. Across both counties, people experiencing homelessness and unstable housing face significant delays in linkage to care and treatment initiation. High clinical staff turnover and lack of real-time clinical consultation on evenings and weekends, and disruptions to clinical care due to COVID-19 are additional barriers to effective RAPID implementation. Facilitators to RAPID implementation include shared RAPID protocols, single points of contact, and provider detailing and education. We have identified several novel implementation strategies to address key barriers to early linkage and ART initiation, including a region wide Tele-RAPID protocol and training materials to facilitate RAPID linkage and ART initiation during clinic closures, a real-time clinical consultation team available evenings and weekends, and a “Data to RAPID” initiative integrating clinic and surveillance data to bolster quality improvement efforts and track RAPID indicators.
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HIV Service Provision During COVID-19. Community Experiences
A Center for AIDS Prevention Studies / UCSF Prevention Research Center Virtual Town Hall.
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CAPS/PRC at AIDS 2020
California HIV/AIDS Policy Research Centers investigators at UCSF CAPS, Dr. Emily Arnold, Associate Professor, and Shannon Fuller, Qualitative Analyst, presented a case study from California. Findings from their rapid response study, which examined access to HIV prevention and care services for immigrant community members impacted by shifting immigration policy in the US following the 2016 election are discussed.
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UCSF is responding to the outbreak of the respiratory illness COVID-19. This website provides regularly updated information for the UCSF community. https://coronavirus.ucsf.edu/
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Are you working to prevent HIV in your community?
We are home to 101 prevention scientists, researchers and staff who conduct high impact HIV prevention science. We also provide Technical Assistance in the use of HIV science.
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- Consult with one of our researchers
- Review program materials
- Targeted review of grant proposals and surveys
- Assistance in facilitating research and community partnerships
- Consultations on intervention curricula
- Review assessments and measurement tools
- Share stories of those living with HIV through the Positive Project
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The mission of Center for AIDS Prevention Studies is to end the HIV epidemic and associated health and social disparities by conducting high impact HIV prevention science and building capacity among researchers and communities to effectively address HIV. Project #: 2P30MH062246
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The mission of the UCSF Prevention Research Center is to maintain an interdependent network of community, academic, and public health partners to design and implement prevention research aimed at answering significant and innovative HIV research questions and promoting the wide use of practices proven to promote health for those infected and affected by HIV. Project #: 5U48DP004998
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