HIV - - CHIPTS - Center for HIV Identification, Prevention and Treatment Services

22Dec

The BARS Study: Building Agent Based Models of Racialized Justice System Study in Black MSM

Abstract: Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Despite the efficacy of several prevention interventions, reducing these disparities requires approaches that maximally engage these men’s social and sexual networks. Because of frequently transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice involved (CJI) BMSM who use substances represent an important target for intervention. Although effective behavioral and structural interventions exist that target CJI populations, their successful implementation for CJI BMSM networks and communities has not been demonstrated. Furthermore, research to determine intervention impact at these larger social units is costly and does not readily lend itself to the randomized control trial approach. This proposal aims to utilize a systems dynamic approach using an agent-based model (ABM) to estimate the effectiveness of HIV prevention and substance-abuse interventions for CJI substance-using BMSM. Our project brings together investigators with a proven track record in the study of BMSM, criminal justice settings, substance-abuse intervention, social network analysis, ABMs and HIV clinical care provision. We will adapt a previously developed core open access ABM platform (using Repast Simphony) that includes baseline national data on people and households by geography, as well as the dynamic features of the target population such as incarceration, health center, and activity (time-use) data. We will scale the ABM to three counties: Harris TX, Los Angeles CA, and Cook IL where our team has collected data for model parameterization. Our approach will assess the interplay between social and behavioral variables and viral and host factors in a matter that will be adaptive to temporal, network and setting-specific changes. Our aims are to: 1) Build upon our flexible ABM by incorporating HIV transmission and suppression probabilities at the individual level, including host/viral factors and biologic/behavioral data from HIV prevention and substance-abuse intervention studies; 2) Parameterize this ABM with multiple network data sources available to investigators in each city on specific transition periods of BMSM from the community, to jail, and back to the community/ supervision; such “shocks” lead to social and sexual network formation and disruption. We will supplement these data with newly collected data (n=50/city) specifically on network shocks and HIV prevention and treatment utilization during these critical transition periods; 3) Simulate HIV prevention interventions within criminal justice contexts using the model parameterized in Aim 2. Because our open access Repast Simphony ABM platform is widely used, we will make model parameters, specifications and variables publicly available. This will allow for external validation of our findings and for additional use of the core model by others for context and community-specific integrated HIV prevention and treatment planning in at risk populations.

Project Number: 3R01DA039934-03S1

https://reporter.nih.gov/search/t_ZFuN8IDEyXUzgwJWV1mg/project-details/9480136

Contact PI/ Project Leader

NINA, HARAWA, CORE DIRECTOR, POLICY IMPACT CORE (nharawa@mednet.ucla.edu)

SCHNEIDER, JOHN, ASSOCIATE PROFESSOR OF MEDICINE (jschnei1@medicine.bsd.uchicago.edu)

Organization

UNIVERSITY OF CHICAGO

PUBLIC HEALTH RELEVANCE: Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Because of frequent transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice (i.e., jail and community supervision) involved (CJI) BMSM who use substances represent an important target for intervention. This proposal aims to estimate the effectiveness of HIV prevention interventions and substance-abuse interventions for criminal justice (i.e., jail and community supervision) involved substance-using BMSM.

FOA: PA-12-281 / Study Section: Special Emphasis Panel[ZRG1-AARR-K(05)S]

Project Start Date: 01-July-2015

Project End Date: 30-April-2020

Budget Start Date: 01-May-2017

Budget End Date: 30-April-2018

NIH Categorical Spending

Funding IC: National Institute on Drug Abuse / FY Total Cost by IC: $38,102

9Nov

A.S.K.-PrEP Program (Assistance Services Knowledge-PrEP)

Abstract: The A.S.K.-PrEP (Assistance Services Knowledge-PrEP) program works with extremely high-risk HIV-negative trans women and men who have sex with men to link participants into PrEP medical services. A.S.K.-PrEP consists of individualized, client-centered PrEP navigation sessions to assess PrEP readiness, assess barriers to PrEP initiation and/or adherence, assess readiness for adherence, and to plan for PrEP persistence. Additionally, through the five-session A.S.K.-PrEP intervention, the PrEP navigator works with each participant to remove structural barriers to PrEP initiation/adherence (mental health, substance use [including injection drug use], intimate partner violence, STDs, housing, hormones, sex work), insurance enrollment/patient assistance), link participants into needed ancillary services, all with the ultimate goal of linkage to PrEP and persistent daily PrEP adherence. Discussions of PrEP readiness and individual and structural barriers to PrEP linkage and adherence occur throughout the five sessions. Throughout the duration of the project, participants can opt-in/opt-out of receiving culturally competent, theory-based PrEP adherence support text messages. Each text message has a theoretical conceptual foundation based on Social Support Theory (to provide informational, emotional or instrumental PrEP support), Health Belief Model (to identify or reduce HIV risks) or Social Cognitive Theory (to increase self-regulation skills and self-efficacy for PrEP persistence). A.S.K.-PrEP partners with three local clinics to provide culturally appropriate PrEP medical services.

30Oct

HPTN 085: The AMP Study

The AMP Study (also known as HVTN 704/HPTN 085) tests an experimental antibody against HIV. AMP stands for Antibody Mediated Prevention. This is the idea of giving people antibodies that fight HIV to see if they will protect people from becoming HIV infected.

The AMP study tests an antibody called VRC01, a manufactured antibody against HIV. This is a new idea for HIV prevention that is related to what has been done in HIV vaccine research. In traditional HIV vaccine studies, people get a vaccine and researchers wait to see if their bodies will make antibodies against HIV in response to the vaccine. In this study, we will skip that step, and give people the antibodies directly.

VRC01 will be given using intravenous infusions. This is more commonly known as getting an IV, or getting a drip. The IV is given to the study participant every eight weeks for 30-60 minutes. To get an IV, a sterile needle is used to place a small plastic tube into a vein in the participant’s arm. A bag of fluid is hung from a pole and connected to a pump, which controls how quickly the contents of the bag flow through the tube into the participant’s arm.

There will be 3 different groups in this study. One third of study participants will get a higher dose of the antibody in their IV. One third will get a lower dose of the antibody in their IV. One third will get an infusion of sterile salt water without any antibody in it. This is called a placebo. Participants will be enrolled in the study for about two years.

30Oct

HPTN-083

Abstract: Cabotegravir LA (CAB LA) is a long-acting injectable integrase inhibitor, also known as GSK 1265744 LA or 744 LA. This is a Phase 2b/3 study designed to establish the efficacy of CAB LA for pre-exposure prophylaxis (PrEP) in HIV-uninfected men who have sex with men (MSM) and in transgender women (TGW). Small single-dose and multiple-dose studies and Phase 2a safety/tolerability studies have been performed for CAB LA. This PrEP efficacy study is the next developmental investigation of CAB LA in healthy, HIV-uninfected MSM and TGW. CAB LA is the first antiretroviral (ARV) drug being studied as an intervention for HIV prevention prior to regulatory approval of the drug for HIV treatment. A parallel development program for use of cabotegravir (oral and injectable) for treatment of HIV-infected individuals is currently in Phase 2b studies with a salutary safety and efficacy profile to date.

To enroll in HPTN-083, click here for more information.

Project Number: 5um1ai068619-11

30Oct

HPTN-077

Abstract: To evaluate the safety, tolerability, pharmacokinetics and acceptability of the injectable agent, GSK1265744 long-acting injectable (744LA), in healthy, HIV-uninfected men and women. It is a multi-site, double-blind, two-arm, randomized, placebo-controlled trial of the safety, tolerability, and acceptability of 744LA. HPTN-077 will study HIV-uninfected men and women at low to minimal risk for acquiring HIV infection, ages 18 to 65. of approximately 176 men and women, randomized 3:1, with 132 in the active drug arm, and 44 in the placebo arm. It is anticipated that approximately 60% of the enrolled participants will be women. Participants will be randomized to receive daily oral GSK1265744 (30 mg tablets) or daily oral placebo for 4 weeks, followed by a one-week washout, to assess safety and tolerability before they receive injections. After safety and tolerability assessments from the oral phase have been completed (if no concerns are identified), participants will enter the injection phase of the study and will receive two intra-muscular (IM) gluteal injections of 744LA (800 mg, administered as two 400 mg injections) or placebo (matching vehicle control) at three study visits performed at 12-week intervals.

Project Number: 5UM1AI068619-11

26Oct

Hope Social Media Intervention for HIV Testing and Studying Social Networks

Abstract: In a randomized controlled trial, with 6-month and 1-year follow-up, this application aims to evaluate whether the Harnessing Online Peer Education (HOPE) social media intervention can be used to increase HIV self- testing among African American and Latino men who have sex with men (MSM), and to analyze the changing social network characteristics of participants in this intervention. Innovative approaches to HIV prevention and treatment are critical in the attempt to control the spread of HIV, especially among African American and Latino men who have sex with men (MSM), who are at the highest risk for HIV. Community-based HIV prevention strategies, such as peer leader diffusion models, have been successful in spreading HIV-risk behavior reductions, but require time and economic resources. With the recent increase in social media usage among African American and Latino MSM, social media and online social networks such as Facebook might be used to efficiently and cost-effectively deliver evidenced-based, peer-led HIV prevention interventions. Advances in testing technology, such as home-based HIV testing, can be integrated into an online HIV prevention intervention to allow participants to anonymously test for HIV without risking the stigmatization associated with in-person testing. Because social networking interventions provide rich data on social network characteristics (e.g., the number of friends participants make over time, content of health communication within online networks), this information can be recorded and used to improve intervention delivery. Results from our Los Angeles HOPE pilot study have already demonstrated a) the feasibility and acceptability of using social networking technologies to deliver peer-led HIV prevention among African American and Latino MSM, b) interest in home-based HIV testing among these populations, and c) the relationship between social network dynamics and HIV prevention behavior change. However, additional research is needed with a larger sample to determine the large-scale effectiveness of using social media to increase HIV testing and linkage to care among African American and Latino MSM. In this study, HIV negative African-American and Latino MSM will be invited to join an online (private) Facebook group related to HIV prevention and interact with peer leaders trained in HIV prevention over 12 weeks, with 6-month and 1-year follow-up. Compared to control group participants receiving 12 weeks of peer- delivered general health information over Facebook groups, we predict that participants receiving 12 weeks of peer-delivered HIV prevention information will be more likely to take a home-based HIV test. We will also measure participants’ social network data to assess the relationship between changing social network dynamics (e.g., density, network size) and intervention effects.

Project Number: 5R01MH106415-03

https://reporter.nih.gov/search/PAZ4BFXiRUWUpX1Uq9YqZA/project-details/9211389

Contact PI/ Project Leader

YOUNG, SEAN, ASSOCIATE PROFESSOR (syoung5@hs.uci.edu)

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

PUBLIC HEALTH RELEVANCE: The ability to rapidly deliver community-based HIV interventions is critical to controlling the spread of HIV in high-risk populations in Los Angeles and the rest of the world. This project is particularly significant because it 1) deals with groups who are the most impacted by HIV, African American and Latino men who have sex with men (MSM), 2) deals with MSM who are particularly important to reach due to the fact that many use the Internet to find sex partners, and 3) seeks to use social network analysis as an additional innovative tool for enhancing the effectiveness of social media-based HIV prevention intervention among high-risk population.

FOA: PA-14-132 / Study Section: Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section[BSPH]

Project Start Date: 08-April-2015

Project End Date: 31-January-2020

Budget Start Date: 01-February-2017

Budget End Date: 31-January-2018

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF MENTAL HEALTH / FY Total Cost by IC: $556,208

26Oct

Adapting the Hope Social Media Intervention to Reduce Prescription Drug Abuse

Abstract: This proposal seeks to determine the feasibility, acceptability, and preliminary effectiveness of applying the Harnessing Online Peer Education (HOPE) intervention, or peer support social media community model, to reduce prescription drug abuse among chronic opioid non-cancer pain patients. Prescription drug abuse has reached epidemic proportions in recent years. Chronic opioid therapy, prescribed to treat patients experiencing chronic pain, is the most frequently abused of all prescription medications. Complications from chronic opioid misuse/abuse include respiratory suppression, infectious disease transmission, drug dependence/addiction, and fatal overdose. Chronic non-cancer pain patients with the following risk factors are at the highest risk for complications: 1) High dosage of opiods, 2) opioid use with concomitant use of sedatives (polysubstance use), and 3) aberrant medication-related behaviors (e.g. early refills requests). Although low cost, novel interventions are needed to reduce these risk behaviors before they lead to addiction and overdose, few studies have focused on this area. Community-based approaches, such as peer leader and peer support interventions, have been successful in creating health behavior change and could be applied to reduce opioid abuse. However, because peer support groups often require in-person visits and a great deal of time and financial resources, these groups have high drop-out rates. With the recent increase in social media/online communities, these technologies could be used as cost-effective platforms to deliver peer support interventions for opioid abuse and overdose. The HOPE intervention is an evidenced-based peer-led social media intervention provided over Facebook that has been successfully used to change health behaviors. However, no published research has studied whether the HOPE approach, or other social media-based peer social support interventions can be adapted to reduce prescription drug abuse, making this an important feasibility study. We propose the following specific aims to address this research: Specific Aim 1: Explore (qualitatively) how the HOPE social media-based intervention can be adapted for opioid abuse/overdose prevention among patients on chronic opioid therapy. Specific Aim 2: Assess the feasibility, acceptability, and preliminary effectiveness of applying th HOPE model to reduce opioid abuse/overdose risk among high-risk chronic non- cancer pain patients. Secondary aim: Explore the feasibility of using participants’ publicly-viewable social media conversations to better understand prescription opioid abuse and to improve intervention implementation. The pilot data collected from this study will be used to develop an R01 proposal for a larger randomized trial designed to assess the effectiveness of using social media to scale peer-led prescription drug abuse interventions to reduce prescription opioid abuse and polysubstance use among chronic opioid users.

Project Number: 5R21DA039458-02

https://reporter.nih.gov/search/8qC8nINxEEyRsUXqvC-aLw/project-details/8919331

Contact PI/ Project Leader

YOUNG, SEAN, ASSOCIATE PROFESSOR (syoung5@hs.uci.edu)

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

PUBLIC HEALTH RELEVANCE: The ability to use low cost, novel technologies, such as social media, to deliver social support, community- based drug abuse interventions is critical to controlling drug addiction and the increasing number of overdoses. This project is particularly significant because it 1) attempts to address prescription drug abuse, the top cause of injury-related death in the United States, 2) seeks to adapt an evidenced-based, social media-delivered, peer support intervention to reduce risk factors for prescription opioid and polysubstance-related addiction and overdose, allowing the potential for these methods to be rapidly and cost-effectively scaled using social media, and 3) seeks to explore the use of new methods of using social media free-text group conversations to understand participant perspectives to provide additional observational data and improve future intervention delivery.

FOA: RFA-CA-14-009 / Study Section:ZCA1-TCRB-B(O2)

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

Project Start Date: 01-September-2014

Project End Date: 31-August-2018

Budget Start Date: 01-September-2015

Budget End Date: 31-August-2018

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $169,527

26Oct

Mining Real-Time Social Media Big Data to Monitor HIV: Development and Ethical Issues

Abstract: Social “big data” holds information with wide-ranging implications for addressing issues along the HIV care continuum. Social big data refers to information from social media and online platforms on which individuals and communities create, share, and discuss content. One in four people worldwide, or over a billion people, are publically documenting their activities, intentions, moods, opinions, and social interactions on these sites. They are doing so with increasing volume and velocity, including 400 million “tweets” per day on Twitter and 4.75 billion content items shared per day on Facebook. With an increasing number of these platforms supporting access to publicly-available user data, social big data analysis is a promising new approach for attaining organic observations of behavior that can be used to monitor and predict real-world public health problems, such as HIV incidence. New tools such as social data are therefore needed to supplement existing HIV data collection methods. In preliminary research, our team developed the first approach that identifies psychological and behavioral characteristics from social big data (>550 million tweets) found to be associated with HIV diagnoses. Since groups at the highest risk for HIV (e.g., minority populations) are the fastest growing Twitter users, and because social media users have been found to publicly share personal information, we identified and collected tweets suggesting HIV risk behaviors (e.g., drug use, high-risk sexual behaviors, etc.) and modeled them alongside CDC statistics on HIV diagnoses. We found a significant positive relationship between HIV- related tweets and county-level HIV cases, controlling for socioeconomic status measures and other variables. The problem is that this approach is not currently scalable for use by HIV researchers and public health organizations. Although public health agencies are interested in mining social data to address HIV, current tools are not accessible to most health scientists, as the tools require advanced computer science expertise. For example, analyzing 500 million tweets a day requires expertise in big data engineering, advanced machine learning, natural language processing, and artificial intelligence. Developing a single platform for mining social data that has been designed and tested by and for HIV researchers could provide a significant impact on HIV prevention, testing, and treatment. We seek to create a single automated platform that collects social media data; identifies, codes, and labels tweets that suggest HIV-related behaviors; and ultimately predicts regional HIV incidence. Because of the potential ethical issues associated with mining people’s data, we also seek to interview staff at local and regional HIV organization and participants affected by HIV to gain their perspectives on the ethical issues associated with this approach. The software developed from this application will be shared with HIV researchers and health care workers to provide additional tools that can be used to combat the spread of HIV.

Project Number: 1R56AI125105-01A1

https://reporter.nih.gov/search/jRCGXVrkakWONMVPH59sPA/project-details/9317061

Contact PI/ Project Leader

YOUNG, SEAN, ASSOCIATE PROFESSOR (syoung5@hs.uci.edu)

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

PUBLIC HEALTH RELEVANCE: Project Narrative Surveillance and monitoring of HIV and related risk behaviors is a top priority. This project is of particularly high impact because it seeks to develop software to allow researchers to analyze real-time conversations from social media big data to monitor HIV diagnoses. It also will provide data on the ethical issues associated with the increasing number of these “social data mining” approaches. The software developed from this application will be shared with HIV researchers and health care workers to provide additional tools that can be used to combat the spread of HIV.

FOA: PA-15-273 / Study Section: Special Emphasis Panel[ZRG1-AARR-F(92)S]

Project Start Date: 01-September-2016

Project End Date: 31-August-2019

Budget Start Date: 01-September-2016

Budget End Date: 31-August-2019

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES / FY Total Cost by IC: $671,438

26Oct

Mining the Social Web to Monitor Public Health and HIV Risk Behaviors

Abstract: Surveillance and monitoring of risk behavior and disease is a top priority of many health-related agencies and organizations, including the UN AIDS, Centers for Disease Control and Prevention (CDC), and local public health and epidemiology departments. Identification and localization of changes in risk behaviors and disease can dramatically improve public health outcomes and reduce health-related costs, by providing data on where interventions are needed and how to direct public health efforts. For example, HIV researchers, public health departments, and government organizations, have attempted to identify and monitor HIV risk behavior (e.g., sexual intercourse and illicit drug use) and HIV outbreaks to improve prevention and treatment efforts and curb a growing HIV epidemic. Social media use has been rapidly increasing, and data from these technologies might be leveraged for identification of HIV risk behaviors, such as sexual- and drug-related risk behaviors. Although researchers have developed methods of using social media to monitor HIV and public health behaviors and outcomes, these methods require extensive manual time, technical expertise, and multiple software platforms to process these big data. Advances in technology, including technology infrastructure, data mining, and machine learning approaches, can be leveraged to provide tools that can be used to create a single automated platform for extracting free-text social media conversations, labeling these conversations to identify health risk-related behaviors, and using these labels to monitor disease outbreaks. We propose to create a single automated platform that collects social media (Twitter) data; identifies, codes, and labels tweets that suggest HIV risk behaviors; and provides an output that is acceptable for HIV researchers, public health workers, and policymakers to monitor HIV risk behaviors and outcomes. The tools developed from this application will be open source, tailored for use for epidemiologists and public health departments, and will be available for integration with other software tools to improve the effectiveness of public health monitoring systems.

Project Number: 5U01HG008488-03

https://reporter.nih.gov/search/wGDkOF_9CkKSicIItK2mYA/project-details/9307573

Contact PI/ Project Leader

YOUNG, SEAN, ASSOCIATE PROFESSOR (syoung5@hs.uci.edu)

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

PUBLIC HEALTH RELEVANCE: Surveillance and monitoring of health-related risk behavior is a top priority of many agencies and organizations. This project is particularly significant because it seeks to develop software to allow researchers and epidemiologists to analyze real-time free-text conversations from social media to monitor HIV and public health-related risk behaviors and disease outbreaks. Results can be used to provide additional observational and surveillance data and to improve future intervention delivery.

FOA: RFA-HG-14-020 / Study Section: Special Emphasis Panel[ZRG1-BST-N(50)R]

Project Start Date: 18-September-2015

Project End Date: 31-May-2019

Budget Start Date: 01-June-2017

Budget End Date: 31-May-2019

NIH Categorical Spending

Funding IC: OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH / FY Total Cost by IC:$392,952

26Oct

Engaging Seronegative Youth to Optimize HIV Prevention Continuum

Abstract: Young people at highest risk for HIV in the U.S. will be gay, bisexual transgender youth (GBTY) and homeless youth (HY) in communities with high HIV incidence and overwhelmingly Black and Latino. Focusing on Los Angeles and New Orleans, seronegative youth at highest risk for HIV will be screened in homeless shelters and gay-identified community-based organizations (CBO). A cohort of 1500 seronegative youth will be recruited that is 82% male (79% GBTY), 66% Black, 16% Latino, and 18% white, non-Hispanic. About 27% will be 12-17 and 73% between 18-24 years old. All youth will be followed longitudinally over 24 months at four month intervals and tested for HIV, STI, serious substance abuse, health care utilization, and comorbid conditions – a Prototypical Retention/Prevention (R/P) Strategy. Over 24 months, acutely HIV infected youth will be triaged to Study 1. This Prototypical R/P Strategy operationalizes the CDC’s recommendations for the engagement of GBTY in repeat HIV testing, linkage to care, and options for combination prevention (PrEP, PEP – with behavioral interventions). Building on this team’s extensive experience with behavioral and mobile/social media interventions, a randomized controlled trial (RCT) will be conducted with four intervention conditions: 1) an Automated Messaging and Monitoring Intervention (AMMI), which will use texts to diffuse prevention messages daily and to monitor risk behaviors weekly (n=900); 2) a Peer Support intervention on a social media platform (i.e., Facebook) in which young people will post messages and stories about their experiences preventing HIV, plus the AMMI (n=200); 3) an eNavigator intervention in which a B.A.-level staff supports youth, primarily through texting and social media, but also in-person meetings, to provide support in crisis situations, refer to treatment, and assist in gaining access to health care and other services, plus Peer Support and AMMI (n=200); and, 4) a combined intervention of eNavigator, Peer Support, and AMMI (n=200). A single outcome will be composed of six key behaviors (access to medical care, accessing and adherence to PrEP or PEP, treatment of all STI, and 100% condom use). In addition to evaluating the added benefit of increasing levels of intervention, the brief 7- item weekly text-messaging monitoring surveys will provide approximately 100,000 weekly reports of indicators of primary and secondary outcomes that can inform our understandings about the relationships between risk and comorbid states. This study will have policy implications for the allocation of resources to HIV testing resources in local communities, the uptake and scalability of text and social media interventions, and the models for diffusing evidence-based interventions (EBI) globally (without requiring replication with fidelity to a manual).

Project Number: 5U19HD089886-02

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