An HIV Retention in Care Intervention for Black MSM in Baltimore with a Job Readiness Component

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Project Summary Retention in high-quality HIV care is critical for the health of people living with HIV (PLWH) as well as for reducing HIV transmission. One estimate of the HIV Continuum of Care for Black men how have sex with men (BMSM) in the US found that only 24% of BMSM are retained in care (RIC), 20% are on antiretroviral therapy, and 16% are virally suppressed. The structural factors that put men at increased risk for HIV, such as poverty, unemployment, and incarceration, also act as barriers to HIV care. The proposed project will develop and pilot test a retention in HIV care intervention for BMSM living in Baltimore that incorporates a job readiness component: Aim 1: Formative research for intervention development in practice settings One-to-one interviews with BMSM living with HIV will explore factors that facilitate engagement in care, unmet needs, and job readiness. Focus group discussions with key stakeholders will explore barriers and facilitators to implementing RIC interventions and the integration of job readiness into RIC programs. Aim 2: Develop and component test a RIC curriculum for BMSM with a job readiness component that is guided by Self-Determination Theory and an implementation science framework. Aim 3: Conduct a pilot RCT to assess feasibility and preliminary outcomes. A RCT with 50 BMSM living with HIV who are not virally suppressed will use mixed methods to assess acceptability, implementation, and limited efficacy. The primary outcome of interest will be viral suppression. The proposed behavioral-medical intervention will be guided by Self-Determination Theory. In addition, the intervention will be developed using an implementation science framework, the Damschroer's Consolidated Framework for Implementation Research, in order to promote sustainability and dissemination. This research reduces disparities in treatment outcomes in a severely underserved population of PLWH and will provide rigorous training and study in implementation science. This work is novel in that it: focuses on an underserved population, incorporates job readiness into HIV retention in care, and is guided by Self- Determination Theory. This research career development award will provide training to the recipient in the following three areas: implementation science, intervention development, and experimental design. This training will allow the recipient to achieve her career goal of conducting independent research to develop, test, and study the implementation of HIV prevention programs for underserved populations.