Center for Translational Behavioral Science, College of Medicine, Florida State University, Tallahassee, FL, United States.
Department of Health, College of Osteopathic Medicine, Nova Southeastern University, Miami, FL, United States.
JMIR Res Protoc. 2024 Nov 20;13:e63191. doi: 10.2196/63191.
There is a high incidence of HIV among young sexual minority men in Florida. Many are unaware of their status due to low testing rates. Counseling, testing, and referral (CTR) services are essential for diagnosis and prevention of HIV and are integral to the Ending the HIV Epidemic (EHE) strategic plan. However, efforts to increase CTR among young sexual minority men have not been successful.
The Young Adult Centered Healthforce Training (YACHT) program promotes developmentally sensitive, culturally appropriate, and evidence-based CTR services for young sexual minority men. This study tests whether the YACHT program increases HIV testing among young sexual minority men and fidelity to evidence-based CTR among testing providers.
Agencies in Florida EHE counties that tested at least 24 young sexual minority men aged 18 to 29 years in 2021 will be invited to participate. The sites (N=42) will be randomized in blocks of 6 to participate in the YACHT program, following a stepped wedge design. Through YACHT, all sites will receive visits from mystery shoppers (MSs), who are trained to evaluate HIV testing services and complete postvisit quality monitoring assessments. Sites will be offered the opportunity to review their MS feedback and to receive tailored motivational interviewing training and evidence-based technical assistance to address areas of need identified through MS assessments. The study will evaluate whether YACHT leads to increased HIV testing by comparing numbers of young sexual minority men testing for HIV before versus after YACHT's implementation. The Exploration, Preparation, Implementation and Sustainment framework will help understand the barriers to and facilitators of the program's implementation and sustainment.
YACHT was funded in August 2022. Data collection began in June 2023. As of June 2024, 194 MS visits have taken place at 42 sites; 4 (67%) sites from the first block and 1 (33%) site from the second block have engaged with the study. At baseline, sites exhibited the lowest competencies in relationship context, counseling sessions, and safer sex education and the highest competency in privacy and confidentiality. Data collection will continue through May 2027, with results published by the end of 2027.
To address the high incidence of HIV among young sexual minority men in Florida, YACHT aims to support testing sites with tailored motivational interviewing training and technical assistance to address needs identified by MS assessments. The program seeks to improve delivery of evidence-based CTR services, thereby increasing HIV testing, counseling, and pre-exposure prophylaxis referrals and reducing HIV incidence among this population.
ClinicalTrials.gov NCT06015581; https://classic.clinicaltrials.gov/ct2/show/NCT06015581.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63191.
佛罗里达州年轻的性少数群体男性中 HIV 的发病率很高。由于检测率低，许多人不知道自己的状况。咨询、检测和转介（CTR）服务对于 HIV 的诊断和预防至关重要，也是终结艾滋病毒流行（EHE）战略计划的组成部分。然而，增加年轻性少数群体男性接受 CTR 的努力并未取得成功。
青年为中心的卫生人力培训（YACHT）计划为年轻的性少数群体男性提供了发展敏感、文化适宜和基于证据的 CTR 服务。本研究检验了 YACHT 计划是否增加了年轻的性少数群体男性的 HIV 检测，以及检测提供者对基于证据的 CTR 的遵守情况。
佛罗里达州 EHE 县的机构，只要在 2021 年至少对 24 名年龄在 18 至 29 岁的年轻性少数群体男性进行了检测，就将被邀请参与。这些站点（N=42）将以 6 个为一组随机分组，采用逐步楔形设计参与 YACHT 计划。通过 YACHT，所有站点都将接受神秘购物者（MS）的访问，这些购物者经过培训，可以评估 HIV 检测服务，并完成访问后的质量监测评估。站点将有机会查看他们的 MS 反馈，并接受有针对性的动机访谈培训和基于证据的技术援助，以解决通过 MS 评估确定的需求领域。该研究将通过比较 YACHT 实施前后接受 HIV 检测的年轻性少数群体男性的数量，来评估 YACHT 是否会导致 HIV 检测的增加。探索、准备、实施和维持框架将有助于了解该计划实施和维持的障碍和促进因素。
YACHT 于 2022 年 8 月获得资金。数据收集于 2023 年 6 月开始。截至 2024 年 6 月，在 42 个站点进行了 194 次 MS 访问；第一个块中的 4（67%）个站点和第二个块中的 1（33%）个站点参与了研究。在基线时，站点在关系背景、咨询环节和安全性行为教育方面表现出最低的能力，在隐私和保密性方面表现出最高的能力。数据收集将持续到 2027 年 5 月，结果将于 2027 年底公布。
为了解决佛罗里达州年轻的性少数群体男性中 HIV 的高发率，YACHT 旨在通过提供有针对性的动机访谈培训和技术援助，来支持检测站点满足 MS 评估确定的需求。该计划旨在改善提供基于证据的 CTR 服务，从而增加 HIV 检测、咨询和暴露前预防转介，并降低该人群的 HIV 发病率。
ClinicalTrials.gov NCT06015581；https://classic.clinicaltrials.gov/ct2/show/NCT06015581。
国际注册报告标识符（IRRID）：DERR1-10.2196/63191。
