HIV Self-Testing in African American Young MSM: A Formative Translational Study

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 DESCRIPTION (provided by applicant): Innovative technology and programs require a period of translation research following the clinical trial phase to improve the fit between the innovation's core components and client/consumer characteristics and needs. The proposed R21 is the first stage in a series of translation studies designed to enhance community HIV testing and linkage-to-care (LTC) among young African American men who have sex with men (MSM; ages17-24), by improving implementation fidelity and, ultimately, increasing dissemination of a self- implemented HIV testing program (OraQuick- SIT). The proposed R21 study will examine the impact of "program-client" fit on SIT testing-fidelity and intentions to use OraQuick LTC referral sites. This formative work addresses a key issue in HIV prevention: identifying HIV positive persons and linking them to care. African American young MSM who reside in economically disadvantaged urban areas are at high risk for HIV and substantial segments of this population remain untested. Moreover, prior work indicates that there are significant barriers to clinic-based HIV testing in this population. The OraQuick-SIT program offers promise in reducing the number of untested at-risk persons, and in linking HIV-positive consumers to treatment. As a self- implemented program, the OraQuick-SIT requires consumers to execute 3 core components: (a) specimen collection and testing, (b) interpretation of results, and (c) a linkage-to-care referral system. Fidelity (i.e., correctly implementing program components) in self-implementation is critical to successful SIT outcomes. However, little is known about how well African American MSM youth implement SIT. Based on prior work, the degree of cognitive and socio-cultural fit between SIT program features and consumers are posited to influence implementation fidelity. In addition, we will develop quantitative measures of key fit-related concepts that will be utilized in the next stage of research. The proposed R21 will add to the science of translation by expanding our knowledge of the antecedents of self-implementation fidelity. Further, the proposed R21 provides an initial step in a four stage program of study designed to examine consumer SIT-fidelity, community adoption and dissemination of SITs, sustainability of SIT dissemination programs, and the impact of SITs on HIV testing and linkage-to-care rates. The overarching goal of this series of studies is to increase HIV testing and linkage-to-care aimed at reducing HIV transmission, morbidity, and mortality.