142nd APHA Annual Meeting and Exposition

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309494
"Is Silk open tonight?": Lessons learned from Project Silk, an HIV prevention demonstration project for young African American MSM and transgender people

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 11:00 AM - 11:15 AM

Mackey Reuel Friedman, PhD, MPH , Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Sarah Krier, PhD, MPH , Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Nayck Feliz, MA , Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Brian Adams, MPH , Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Michael Brookins , Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Suzanne Kinsky, MPH , Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
Anthony Silvestre, PhD , Dept. of Infectious Diseases and Microbiology, Graduate School of Public Health, Pittsburgh, PA
BACKGROUND: Project Silk is a CDC-funded HIV prevention services demonstration project targeting African-American young MSM and transgender people, ages 13-29, in Pittsburgh.  Utilizing a community-based participatory practice model, Project Silk combines structural and behavioral high-impact prevention to provide a safe recreational space, open four evenings/week; HIV CTRS on- and off-site; nested HIV care linkage/re-engagement; and ancillary social services across 19 domains.

METHODS: Quantitative data for safe space utilization, HIV CTRS, linkage to care, and ancillary service provision outcomes were collected via CDC reporting mechanisms in year 1 (2013).  Qualitative data assessing barriers/challenges were collected by an independent process evaluator who recorded 32 meetings and interviews with staff, stakeholders, and participants, and coded these data for themes.

RESULTS: 323 unique participants utilized the Project Silk safe space (median age=17).  28.4% (n=213) of total estimated County target population accessed the space (mid-year mean=8.0 visits/person), achieving community-level diffusion.  55.7% of participants reported ancillary service needs, with employment (29.7%) and housing (25.1%) most requested.  6.3% of target population members receiving HIV CTRS (n=64) were newly diagnosed as HIV-positive; 20.3% reported previously testing HIV-positive.  93.8% of HIV-positive participants were linked/re-engaged in HIV care services.  Three key programmatic challenges emerged: violence between participants; peer worker difficulties managing personal and professional spheres; and HIV-related stigma among participants.

CONCLUSION: Targeted HIV prevention, testing, and linkage/re-engagement in high-prevalence populations can be effectively provided in dedicated recreational safe spaces offering comprehensive social services.  We will discuss strategies addressing interpersonal violence, peer worker boundary-setting, and HIV-related stigma to maximize programmatic effectiveness.

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the first-year findings of a combination, high-impact HIV prevention model for young African American MSM and transgender people. Discuss lessons learned from a demonstration project using innovative approaches to target a high-prevalence risk group.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted HIV prevention and care research, prevention, and policy planning for 18 years, with a specialization in hard-to-reach populations, including young African American MSM and transgender people.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.