Optimizing HIV counseling testing and referral through an adaptive drug use intervention

Sponsor: University of Michigan

Location(s): United States


Young men who have sex with men (YMSM ages 15-25) account for the largest proportion of incident HIV cases in the Detroit Metro Area (DMA), with incidence doubling since 2000, particularly among YMSM living in socioeconomically disadvantaged communities and who are racial/ethnic minorities. The Centers for Disease Control and Prevention (CDC) have recommended that HIV and STI testing be repeated frequently (3-6 month intervals) for high-risk YMSM (i.e., having multiple or anonymous partners with whom they have condomless anal intercourse (CAI) and who report engaging in illicit drug use). Testing rates for YMSM remain low in the DMA. In three prior studies with YMSM living in the DMA, a large proportion of YMSM (15%-36%) have never tested for HIV. Among testers, over 65% had not tested in the prior year. Furthermore, their viral load suppression among youth was lowest across all age groups, with less than half of all HIV+ youth achieving viral suppression. Therefore, consistent with this RFA, we propose to increase successful engagement (i.e., repeat HIV-testing behaviors among HIV-negative YMSM and linkage and retention in care among incident HIV+ cases) in HIV prevention and care services for high-risk YMSM in the DMA.