Metropolitan Atlanta community adolescent rapid testing initiative (MACARTI) with linkage to care and counseling trial

Issues: HIV disproportionately affects African-American and Hispanic young people in the Southern United States. Georgia ranks 6th highest for HIV diagnoses nationally; novel HIV testing and care approaches for minority youth in Georgia are warranted. The Metropolitan Atlanta Community Adolescent Rapid Testing Initiative (MACARTI) uses non-traditional venue rapid testing, case management and motivational interviewing to improve HIV detection, linkage and retention in care for disproportionately affected minority youth in Atlanta. Description: The MACARTI trial has 2 phases: 1) venue identification based on focus groups with HIV-positive and at-risk youth, ethnographic studies and enrollment of the control arm (patients' referred for routine HIV care); 2) outreach to identify newly-diagnosed patients in non-traditional venues and enrollment of the intervention arm. Lessons Learned: Enrollment is ongoing for Phase 1; 28 subjects have participated in the focus groups. They were: 96% African-American, 69% male, 67% horizontally infected, with a median age of 21 years. The majority reported that they had: prostituted themselves to obtain food, drugs or lodging (83%); participated in sex parties (57%); liked venue testing (54%); felt that 1 minute testing was a better strategy than other rapid testing (82%). Participants' also provided a local venues list where youth gather to meet and/or to have sex. Phase 2 will start enrolling after review of Phase 1 venues. Recommendation: By including youth-specific feedback, we anticipate that MACARTI will increase identification of infected youth, decrease the first physician visit time to 2 weeks (currently 6 weeks) and improve retention rate to 80% (currently 60%).