Exploring Syndemic Factors associated with HIV and STI Testing Preferences Among Students at an HBCU in Alabama

探索阿拉巴马州 HBCU 学生中与 HIV 和 STI 检测偏好相关的流行病因素

• 批准号: 10814063
• 负责人: Renee A. Heffron
• 金额: $ 22.28万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-03-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10814063
• 关键词: 19 year old; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adolescent; Adolescent and Young Adult; Advocate; Affect; Age; Alabama; Area; Award; Black American; Black race; Caring; Chlamydia; Collaborations; Communities; Data; Diagnosis; Disparity; Disparity population; Drops; Drug usage; Enrollment; Epidemic; Feedback; Geography; Goals; Gonorrhea; HIV; HIV Infections; HIV diagnosis; HIV risk; Health Personnel; Health Services; Health education; Historically Black Colleges and Universities; Hot Spot; Human Papillomavirus; Human immunodeficiency virus test; Imprisonment; Incidence; Infection; Interview; Medical History; Mental Health; Mental Health Services; Mental disorders; Modality; Nature; Outpatients; Persons; Pilot Projects; Population; Prevention; Process; Provider; Punishment; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recording of previous events; Reporting; Research Personnel; Risk; Role; Schools; Services; Severities; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Simplexvirus; Spottings; Students; Surveys; Syphilis; Testing; Trichomonas Infections; United States; Unsafe Sex; Vulnerable Populations; Work; Youth; acceptability and feasibility; adolescent health outcomes; aged; college; condoms; epidemic preparedness; evidence base; follow-up; home test; implementation evaluation; implementation framework; implementation outcomes; improved; infection burden; infection rate; novel; preference; programs; recruit; screening; service organization; sexual risk behavior; social health determinants; syndemic; testing services; testing uptake; theories; transmission process; university student; uptake

PROJECT SUMMARY Black adolescents and young adults (AYAs) are disproportionately affected by the HIV epidemic. In Alabama (AL), a state identified in the Ending the HIV Epidemic (EHE) initiative for America as a geographic hot spot, over 30% of new HIV infections occur in people aged 13 to 24 with over 80% of these infections occurring in Black AYAs. In addition to high HIV incidence rates among this population, sexually transmitted infection (STI) rates are also high in the South with Black AYAs disproportionately impacted. Given the largely asymptomatic nature of both HIV and STIs, testing is necessary for diagnoses; however only 9% of adolescents have ever been tested for HIV and yearly STI testing rates for this population are around 9%. Utilizing a syndemic theory approach requires the consideration of other co-existing epidemics among this population, such as mental illness, drug usage, and the social determinants of health (SDH) and how they may synergistically increase HIV and STI acquisition risk. To improve HIV diagnosis in an EHE priority area we propose to evaluate various HIV and STI testing modalities (i.e., facility based versus at home testing). We will assess the feasibility, acceptability, and testing modality preferences for student populations at a Historically Black College and University (HBCU), Stillman College, in Tuscaloosa, AL. The RE-AIM and CFIR implementation science frameworks will be utilized in addition to a syndemics theory framework to better understand the role of syndemics in testing modality preferences and follow through. In Aim 1, we will collect process data from Five Spot, the HIV and STI testing provider and our community partner, to evaluate the uptake, distribution, and use of various STI and HIV testing modalities. Five Spot will offer HIV and STI testing options to students attending Stillman while collecting data on testing uptake and follow-up care (e.g., number of students tested, STI and HIV testing modality used, number of students testing positive for any STI and/or HIV, testing and/or treatment/linkage to care or prevention). In Aim 2, we will use a quantitative, online survey with 135 students attending Stillman College to assess preferences for STI and HIV testing modalities (i.e., facility-based versus at home testing, secondary distribution to partners), sexual risk behaviors, STI and HIV testing history, past medical history, implementation outcomes informed by RE-AIM, and syndemic factors that may impact testing uptake and testing preferences, such as mental illness, drug usage, and SDH. In Aim 3, we will conduct qualitative in-depth interviews with key stakeholders and students attending Stillman College to explore barriers and facilitators to uptake and/or follow through of HIV/STI testing and treatment and identify additional needed services. The stakeholder interviews will focus on sustainability, opportunities for expansion, and unmet needs. We will solicit feedback from our Community Advisory Board comprised of key stakeholders including AYAs, youth advocates, healthcare workers, and school administration throughout the study period to inform and adapt our project to the needs of the local community in AL.

项目总结