Project Style (Strength Through Youth Living Empowered)


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  • Project Style (Strength Through Youth Living Empowered)

    1. 1. Project STYLE ( S trength T hrough Y outh L ivin’ E mpowered) Lisa Hightow, MD, MPH UNC Chapel Hill
    2. 2. Background <ul><li>Early 2003 recognized an outbreak of HIV infection on North Carolina college campuses </li></ul><ul><li>Retrospective review of all state HIV surveillance records of men aged 18-30 diagnosed from 2000-April 2005 </li></ul>
    3. 3. 1403 Men Aged 18-30 Newly Diagnosed with HIV in North Carolina, 2000-April 2005 1197 Cases (85%) 157 College Students 13% 1040 Non College Students 87% 206 Cases previous positives or not available for review
    4. 4. Cases of HIV infection among non-college men aged 18-30
    5. 5. Cases of HIV infection among college and non-college men aged 18-30
    6. 6. 157 HIV-Infected College Students 133 African American (84.7%) 6 Female sex partners (4.5%) 79 Male sex partners (59.4%) 44 Male and female sex partners (33.1%)
    7. 7. Factors Associated with College <ul><li>College students more likely…… </li></ul><ul><ul><ul><ul><ul><li>OR 95%CI </li></ul></ul></ul></ul></ul><ul><li>African American 3.19 1.99-5.15 </li></ul><ul><li>Diagnosed with recent infection 3.17 1.84-5.44 </li></ul><ul><li>Both male and female sex partners 3.03 2.01-4.57 </li></ul><ul><li>Report anonymous sex 1.52 1.06-2.19 </li></ul><ul><li>Meet sex partners in: </li></ul><ul><li>Gay bars/clubs 2.01 1.37-2.96 </li></ul><ul><li>Internet 5.76 3.81-8.70 </li></ul><ul><li>College campus 16.79 7.39-38.90 </li></ul>
    8. 8. Project Goals <ul><li>Goal 1: Increase identification, testing and enrollment in enhanced HIV services for young MSM of color at risk for or infected with HIV in North Carolina </li></ul><ul><li>Goal 2: Improve linkage to and retention in care for HIV+ clients </li></ul><ul><li>Goal 3: Provide quality care and prevention messages for young sero-positive MSM of color </li></ul>
    9. 9. Project STYLE Team <ul><li>UNC Chapel Hill </li></ul><ul><ul><li>Lisa Hightow, MD, MPH: Co-PI, clinic physician </li></ul></ul><ul><ul><li>Peter Leone, MD: Co-PI </li></ul></ul><ul><ul><li>Justin Smith: Project Coordinator </li></ul></ul><ul><ul><li>Andre Brown: Research Assistant </li></ul></ul><ul><ul><li>Marcie Fisher-Borne, MSW, MPH: Research Assistant </li></ul></ul><ul><li>North Carolina Central University </li></ul><ul><ul><li>David Jolly, DrPH: co-investigator </li></ul></ul><ul><ul><li>Outreach worker: TBD </li></ul></ul><ul><li>Alliance of AIDS Services- Carolina </li></ul><ul><ul><li>Sebastian Battle: Outreach Worker </li></ul></ul>
    10. 10. Support Treatment HIV+ Care Advice Information
    11. 11. Connecting with Our Community <ul><li>On campus outreach </li></ul><ul><ul><ul><li>Contact established with seven colleges in the region </li></ul></ul></ul><ul><ul><ul><li>Program staff will work with each college to design programming </li></ul></ul></ul><ul><ul><ul><ul><li>Sponsoring social events </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Partnering with student organizations, including Greek letter organizations </li></ul></ul></ul></ul><ul><ul><ul><ul><li>HIV 101 presentation to academic classes and student organization </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Free, Confidential Rapid HIV Testing </li></ul></ul></ul></ul>
    12. 12. Connecting with Our Community <ul><li>Off campus outreach: </li></ul><ul><ul><li>Gay-identified nightclubs </li></ul></ul><ul><ul><li>Urban nightclubs (non-gay identified) </li></ul></ul><ul><ul><li>Concerts </li></ul></ul><ul><ul><li>Churches </li></ul></ul><ul><ul><li>Step Shows </li></ul></ul><ul><ul><li>“ Balls” </li></ul></ul><ul><ul><li>Internet sites (i.e. </li></ul></ul><ul><ul><li>Sex parties </li></ul></ul>
    13. 13. Outreach Photos
    14. 17. S.T.Y.L.E. Survey Highlights Findings from a Survey of Young Men of Color
    15. 18. About the Survey <ul><li>Designed to explore knowledge, attitudes and behavior with respect to HIV testing </li></ul><ul><li>Administered as pen and paper survey </li></ul><ul><li>Participants were given $20 Wal Mart Gift Card as incentive for completion </li></ul>
    16. 19. About the Survey <ul><li>40 men recruited at two venues </li></ul><ul><ul><li>John Legend Concert </li></ul></ul><ul><ul><ul><li>Popular Neo-Soul Singer </li></ul></ul></ul><ul><ul><li>Capital Corral (CC’s) </li></ul></ul><ul><ul><ul><li>Thursday Hip-Hop Night </li></ul></ul></ul><ul><ul><ul><ul><li>Only night that draws primarily African American Men in the Triangle </li></ul></ul></ul></ul>
    17. 20. Demographics- Race/Ethnicity
    18. 21. Demographics- Education
    19. 22. Sexual Identity
    20. 23. Number of Sexual Partners
    21. 24. Effective Strategies <ul><li>Question: What are ways that your school could improve its efforts to educate and test students for HIV? </li></ul><ul><ul><li>88% responded that integrating HIV information into courses would be effective </li></ul></ul><ul><ul><li>85% responded that having more student groups talking about HIV would be effective </li></ul></ul><ul><ul><li>85% responded that specific programs for men of color would be effective </li></ul></ul><ul><ul><li>77% reported that more HIV testing venues would be effective in this regard </li></ul></ul>
    22. 25. Motivation for Getting Tested
    23. 26. Factors Considered in Choosing to Test <ul><li>Nearly 62% of respondents said that cost of the test was either not important at all or slightly important </li></ul><ul><li>82% responded that confidentiality was very important </li></ul><ul><ul><li>52% of the respondents cited confidentiality as the single most important factor </li></ul></ul><ul><ul><li>54% responded that turn around time for results was very important </li></ul></ul>
    24. 27. Where do people test?
    25. 28. Barriers to Testing at Student Health <ul><li>Confidentiality </li></ul><ul><ul><li>Students often work there </li></ul></ul><ul><li>Cost </li></ul><ul><li>Appointment/testing times </li></ul><ul><li>Location </li></ul><ul><ul><li>One student health facility located directly across from the cafeteria </li></ul></ul>
    26. 29. STYLE testing events <ul><li>Apple Chill – April 2005 </li></ul><ul><li>Location : Downtown Chapel Hill Street Festival </li></ul><ul><li>Turnout : 75 </li></ul><ul><li>Festifall – October 2005 </li></ul><ul><li>Location : Downtown Chapel Hill Street Festival </li></ul><ul><li>Turnout : 137 </li></ul><ul><li>World AIDS Day – December 2005 </li></ul><ul><li>Location : UNC Center for Healthy Student Behaviors </li></ul><ul><li>Turnout : 228 </li></ul><ul><li>NC State – February 2006 </li></ul><ul><li>Location : NC State University Student Center </li></ul><ul><li>Turnout : 110 </li></ul><ul><li>Pre-Spring Break Testing – March 2006 </li></ul><ul><li>Location : UNC Center for Healthy Student Behaviors </li></ul><ul><li>Turnout : 151 </li></ul><ul><li>Apple Chill – April 2006 </li></ul><ul><li>Location : Downtown Chapel Hill Street Festival </li></ul><ul><li>Turnout : 156 </li></ul><ul><li>Latino Health Fair – April 2006 </li></ul><ul><li>Location : Latino Health Fair, local Chapel Hill Catholic Church </li></ul><ul><li>Turnout : 48 </li></ul><ul><li>Livingstone College – April 2006 </li></ul><ul><li>Location : Livingstone College, Salisbury, NC </li></ul><ul><li>Turnout : 107 </li></ul><ul><li>Totals : 1021 individuals tested, 4 positive results </li></ul>
    27. 30. Testing Event Photos
    28. 31. World AIDS Day Event Compared with Student Health Testing 40% 60% 78% 11% - 11% Campus Demographics Male Female White Black Hispanic Other 23.8 22.6 Mean age 166 (43.8) 213 (56.2) 88 (38.6) 140 (61.4) Gender 254 (67.2) 65 (17.2) 16 (4.2) 44 (11.6) 103 (45.2) 82 (36.0) 15 (6.6) 28 (12.3) Race Student Health (n=378) WAD (n=228)
    29. 32. World AIDS Day Event Compared with Student Health Testing 0 (0.0) 2 (0.9) Positive Test Results MSM Yes 44 (11.6) 36 (15.7) Risk Behaviors 199 (52.5) 71 (31.1) Previously Tested Student Health (n=378) WAD (n=228)
    30. 33. Overall Satisfaction with WAD Event <ul><li>Of respondents to question about future testing preferences, (N=190) 96.3% would prefer to have the OraQuick test done compared to 3.7% who would prefer a conventional blood test </li></ul><ul><li>“ Ya’ll did a good job making this comfortable and not so awkward” </li></ul><ul><li>“ I thought it was great that the rapid test was offered for free, which means more people could come get tested.” </li></ul>
    31. 34. Conclusions <ul><li>Tested almost as many students during one time event as at student health all year </li></ul><ul><li>Tested more minority students and MSM during WAD event </li></ul><ul><li>Tested more previously untested students during WAD event </li></ul>
    32. 35. 2006-2007 College “Testing Tour” <ul><li>Supplemental funding from Gilead Foundation to do rapid testing on 10 North Carolina colleges </li></ul><ul><li>Combine testing with education, games, entertainment to increase participation </li></ul><ul><li>Located on campus but separate from student health </li></ul><ul><ul><li>Remove barriers for testing at student health expressed by students </li></ul></ul>
    33. 36. Advertising for testing tour <ul><li>Local media- newspapers, college newspapers </li></ul><ul><li>Urban radio spots </li></ul><ul><li>30 second commercial airing on local WB/ UPN stations </li></ul>
    34. 38. Unique aspects of STYLE testing events <ul><li>Free, rapid, oral testing </li></ul><ul><li>Group or individual pre-test counseling encouraging “friends” coming in for testing together </li></ul><ul><li>Graduate students as counselors- promotes youth-friendly environment </li></ul><ul><ul><li>Close enough in age to undergrads to be seen as understanding, but removed from undergraduate social circles- less confidentiality concerns </li></ul></ul><ul><li>Physician on-site for referral of all positive cases </li></ul><ul><li>Co-sponsorship with campus organizations promotes student buy-in </li></ul>
    35. 39. Acknowledgements <ul><li>Justin Smith </li></ul><ul><li>Peter Leone </li></ul><ul><li>Sebastian Battle </li></ul><ul><li>Andre Brown </li></ul><ul><li>Keith McAdam </li></ul><ul><li>Marcie Fisher-Borne </li></ul><ul><li>David Jolly </li></ul><ul><li>Andrew Kaplan </li></ul><ul><li>GW YES Center </li></ul><ul><li>Byrd Quinlivan </li></ul><ul><li>Better World Advertising </li></ul><ul><li>Laini Jarrett-Echols </li></ul><ul><li>Cindy Gay </li></ul><ul><li>Kristin Ito </li></ul><ul><li>Maureen Boland </li></ul><ul><li>Lizzie Torrone </li></ul><ul><li>Sandi McCoy </li></ul>