Division of Infectious Diseases, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7030, USA.
AIDS Patient Care STDS. 2011 Jan;25(1):37-45. doi: 10.1089/apc.2010.0192. Epub 2010 Dec 16.
Young men who have sex with men (YMSM) of color are at particularly increased risk for HIV infection compared to white MSM. National data highlight the need to link YMSM of color to care to improve their overall health and stem further infections, yet, there is limited data on interventions and clinical outcomes focused on engaging and retaining youth, specifically HIV-infected YMSM of color in care. To address the medical care needs of this underserved population, in 2005, the Health Research and Services Administration (HRSA) created the YMSM of Color Initiative. Utilizing a social marketing campaign targeting youth and members of their sexual and social networks, testing and outreach on college campuses and within the broader community, and a tightly linked medical-social support network, we created STYLE (Strength Through Youth Livin' Empowered), a novel intervention that sought to diagnose, engage, and retain HIV-positive black and Latino YMSM in HIV primary care services. Over a 3-year period, 81 men were either newly diagnosed or reengaged in care. Overall, 63% of the cohort was retained in clinical care; defined as attending at least one medical visit every 4 months. Compared to the 3 years prior to STYLE, the odds ratio for whether or not someone attended a clinic visit was 2.58 (95% confidence interval [CI] 1.34-4.98) if enrolled in STYLE. We conclude that compared to a pre-STYLE cohort, STYLE was an effective intervention that increased HIV diagnoses, provided efficient and timely engagement in care for both those newly diagnosed and those who had fallen out of care and improved overall retention.
与白人男男性行为者(MSM)相比,有色人种的男男性行为者(YMSM)感染艾滋病毒的风险特别高。国家数据强调需要将有色人种的 YMSM 联系起来接受护理,以改善他们的整体健康状况,并阻止进一步的感染,但针对旨在吸引和留住青年,特别是感染艾滋病毒的有色人种 YMSM 参与和保留在护理中的干预措施和临床结果的数据有限。为了满足这一未得到充分服务的人群的医疗需求,2005 年,卫生研究和服务管理局(HRSA)创建了有色人种 YMSM 倡议。该倡议利用针对青年及其性和社交网络成员的社会营销活动、在大学校园和更广泛的社区进行检测和外展活动,以及紧密联系的医疗-社会支持网络,创建了一种名为 STYLE(通过青年赋权获得力量)的新型干预措施,旨在诊断、吸引和留住艾滋病毒阳性的黑人和拉丁裔 YMSM 参与艾滋病毒初级保健服务。在 3 年期间,有 81 名男性被新诊断或重新接受护理。总体而言,该队列中有 63%的人保留在临床护理中;定义为每 4 个月至少参加一次医疗就诊。与 STYLE 之前的 3 年相比,如果参加了 STYLE,那么某人参加诊所就诊的几率比为 2.58(95%置信区间 [CI] 1.34-4.98)。我们的结论是,与 STYLE 之前的队列相比,STYLE 是一种有效的干预措施,它增加了艾滋病毒的诊断,为新诊断的人和已经脱离护理的人提供了高效和及时的护理服务,并提高了整体保留率。