PS11-003 Minority AIDS Research Initiative

描述（由申请人提供）：大都会亚特兰大社区青少年快速检测倡议（MACARTI）与护理和咨询试验的联系是一个多学科的建议，响应美国国家艾滋病毒/艾滋病战略，旨在增加检测和联系到艾滋病毒阳性的青少年和18-25岁的年轻人的护理。考虑到亚特兰大大都会统计区年轻人中新的艾滋病毒感染的发生率和流行率，这项建议特别具有现实意义。我们假设，在非传统场所实施60秒快速艾滋病毒检测是传统检测形式的可行和可接受的替代方案，将有助于增加高危人群的预防和早期检测。在与庞塞家庭和青年艾滋病毒诊所的重点小组以及人种学研究进行磋商后，我们将决定哪些地点适合进行检测。作为第二个目标，我们将采用一种新的干预模式，目的是从检测时开始，将动机性访谈技术与强化病例管理支持相结合，加强与艾滋病毒感染青年护理的联系。我们将比较我们目前的转诊系统，其首次就诊的平均时间为9周，留存率为60%，而新模式的目标是将首次就诊的平均时间减少到2周，并将留存率提高到至少80%。我们还将研究两组之间的第二次就诊时间和6个月后的护理持久性。以及与晚期免疫抑制和治疗延迟相关的变量差异。我们需要新的方法来治疗艾滋病毒感染的青少年和年轻人，并减少青年人之间的健康差距，我们预计MACARTI试验将成为这方面的一个有用的策略。 公共卫生相关性：有必要在青少年和年轻人中扩大艾滋病毒筛查，因为他们是艾滋病继续蔓延的年龄组。公共卫生官员明确表示，提供者需要针对高危人群。需要专门为青少年人口设计的新方法，以提高检测的可接受性和护理的连续性。

DESCRIPTION (provided by applicant): The Metropolitan Atlanta Community Adolescent Rapid Testing Initiative (MACARTI) with Linkage to Care and Counseling Trial is a multidisciplinary proposal which responds to the United States National Strategy for HIV/AIDS and aims to increase testing and linkage into care of HIV-positive adolescents and young adults 18-25 years of age. This proposal is particularly relevant given the incidence and prevalence of new HIV infections among young adults in the Atlanta Metropolitan Statistical Area. We hypothesize that implementing sixty second rapid HIV testing in non-traditional venues is a feasible and acceptable alternative to traditional forms of testing and will help increase prevention and early detection in an at-risk population. Following consultation with focus groups from the Ponce Family and Youth HIV clinic as well as ethnographic studies, we will decide which venues are suitable for testing. As a second objective we will apply a new model of intervention aiming to increase linkage into care of HIV- infected youth using a combination of motivational interview techniques with intensive case management support starting at the time of testing. We will compare our current referral system that has an average time to first medical visit of 9 weeks and a retention rate of 60%to the new model, which aims to decrease the average time to first medical visit to 2 weeks and increase the retention rate to at least 80%.We will also look at time to second visit and permanence in care after 6 months between the two arms, and differences in variables that are associated with advanced immunosuppression and delay of treatment. Novel ways of approaching HIV-infected adolescents and young adults as well as decreasing health disparities among youth are needed and we anticipate the MACARTI trial to be a useful strategy in this regard. PUBLIC HEALTH RELEVANCE: Project Narrative Expansion of HIV screening among adolescents and young adults is necessary since they constitute an age group in which the disease continues to expand. Public Health officials have made clear that providers need to target high-risk populations. New approaches specifically designed for the adolescent population are required to increase acceptability of testing and continuity of care.