Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 22, 2020
Date Accepted: Apr 8, 2021
Come As You Are: Nurse Case Management HIV prevention intervention for Youth Experiencing Homelessness Study Protocol
ABSTRACT
Background:
Youth Experiencing Homelessness (YEH) are more likely than housed youth to experience premature death, suicide, drug overdose, pregnancy, substance use, and mental illness. Yet while YEH are 6-12 times more likely to become infected with HIV than housed youth, with HIV prevalence as high as 16% many do not access the prevention services they need. Despite adversities, YEH are interested in health promotion programs, can be recruited and retained in interventions and research studies, and demonstrate improved outcomes when programs are tailored and relevant to them.
Objective:
The study aims to determine the efficacy of a Nurse Case Management HIV Prevention and Care Intervention titled Come As You Are (CAYA) among YEH compared to usual care among YEH aged 16-25 years.
Methods:
A two-armed randomized wait-list controlled trial is being implemented to test the efficacy of CAYA on HIV prevention behaviors. Participants (N=450) are being recruited and followed for 9-months after the intervention for a total study period of 12 months. CAYA combines nurse case management with a smartphone-based daily Ecological Momentary Assessment to develop participant driven HIV prevention behavioral goals that can be monitored in real-time. Youth in the city of Houston, Texas, are being recruited from drop-in centers, shelters, street outreach programs, youth-serving organizations, and clinics.
Results:
The Committee for the Protection of Human Subjects institutional Review Board approval was obtained in November, 2018. The first participant enrolled in November, 2019 and data collection will conclude in 2022. To date, 130 participants have consented to the study, 110 have enrolled, and 15 have completed the final follow up.
Conclusions:
A recent systematic review of interventions to prevent HIV among YEH highlighted the paucity of HIV prevention research with YEH and concluded that more research is necessary. Novel and scalable interventions that address the full continuum of behavioral and biomedical HIV prevention are needed. This study will determine whether a personalized and mobile HIV prevention approach can reduce risk for HIV among a hard-to-reach, transient population of high-risk youth. Clinical Trial: clinicaltrials.gov ID: NCT03910218
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