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Implementation of a Socio-structural Demonstration Project to Improve HIV Outcomes Among Young Black Men in the Deep South

  • Russell BrewerEmail author
  • Chris Daunis
  • Sabira Ebaady
  • Leo Wilton
  • Sarah Chrestman
  • Snigdha Mukherjee
  • Mary Moore
  • Renee Corrigan
  • John Schneider
Article

Abstract

Background

We describe the background, rationale, intervention components, and formative results of a demonstration project aimed to ameliorate five socio-structural barriers to HIV services for young Black men aged 18–29 living with and at risk for HIV in Louisiana.

Methods

The interventions and activities consisted of (1) five person-centered approaches to enhance linkage to HIV services and improve socio-economic outcomes; (2) the implementation of systematic mystery shopping tests to document instances of housing discrimination; (3) the development and implementation of a multi-prong communications campaign to increase knowledge about the signs of housing discrimination and community resources among young Black men who have sex with men (YBMSM); (4) the integration of HIV/STI services and lesbian, gay, bisexual, and trans (LGBT)–inclusive events on Historically Black Colleges and Universities (HBCUs); and (5) the development of a safe space for YBMSM. A multi-method approach was used to evaluate the outcomes of the different interventions.

Results

The majority (62%) of participants living with HIV were linked to HIV care and 49% had achieved viral suppression. More than 40% of participants were employed during the project. Thirty-seven percent (37%) of the mystery shopping tests showed definite or possible signs of housing discrimination. The housing campaign’s duration was limited with unknown long-term impact among YBMSM. Fifteen cases of syphilis were identified during two HBCU events. A safe space was specifically created for YBMSM at a community-based organization.

Conclusion

Multi-component holistic health interventions are needed to improve HIV outcomes and curb the high HIV rates among young Black men, particularly YBMSM in the United States and the Deep South.

Keywords

Black men who have sex with men (BMSM) Social and structural factors HIV prevention South Young Black men 

Notes

Acknowledgments

The authors thank the participants, interventionists, CAB members, and integrated sector partners.

Contributors

R. Brewer generated the initial concept and served as Principal Investigator of the study. All authors contributed to writing each of the manuscript sections.

Funding Information

This project was supported with funds from the Office of Minority Health (Grant no. 6 CPIMP141066-03-01). R. Brewer’s time was also supported by a grant from National Institute of Mental Health (NIMH) (R25MH067127) for the Visiting Professor Program at the University of California, San Francisco; Centers for Disease Control and Prevention (CDC) 5U01PS005122-03; and National Institute on Drug Abuse (NIDA) (3P30DA027828-08S1).

Compliance with Ethical Standards

Conflict of Interest

Dr. Russell Brewer currently serves as advisory to Gilead’s Implementation Science Group and ViiV Healthcare’s Accelerate Initiative.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board approval was obtained for the study.

Informed Consent

Informed consent was obtained from individuals receiving the person-centered interventions.

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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Louisiana Public Health InstituteNew OrleansUSA
  3. 3.State University of New York at Binghamton, Human Development DepartmentUniversity Downtown CenterBinghamtonUSA
  4. 4.Faculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
  5. 5.Foundation for Advancement of International Medical Education and ResearchPhiladelphiaUSA
  6. 6.Dillard UniversityNew OrleansUSA
  7. 7.Greater New Orleans Fair Housing Action CenterNew OrleansUSA

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