Assessing Sexual Social Networks of Black and Hispanic MSM/Ws in Los Angeles County

Nationally and locally Blacks and Latinos have the highest incidences of HIV/AIDS. When stratifying incidence by gender, Blacks and Latino women have higher rates of HIV infection compared to their White counterparts. A recent “mainstream” hypothesis for the rise in numbers among minority women is that Black and Latino men in concurrent secret sexual relationships with men and Black and Latina women are the “bridgers” of infection between the homosexual (MSM) community and the heterosexual community. Currently no scientific evidence of transmission trends supporting this hypothesis has been documented. Although inferences from surveys such as the Young Men’s Study have been proffered as proof, such studies do not show direct causation. Further, few scientific studies have analyzed the societal and cultural factors that could impact the decision of Black and Latino men to disclose their sexual practices or HIV seropositivity.

The research project involved a two phase mixed methods study (qualitative and quantitative) focusing on cultural, spiritual, racial and gender related factors that facilitate or impede the disclosure of Black and Latino men who have sex with men and women (MSM/W) of their sexual preference or HIV serostatus.

Phase 1 consisted of 9 focus groups with 4 participants each (n=36) and 12 focused interviews (n= 12). All interviewees completed a short survey after the focus group or interview. A racially concordant facilitator conducted each research session. Phase 2 utilized findings from Phase I to construct an ethnographic interview guide. Forty ethnographic interviews (10 African-American MSM/W, 10 Hispanic MSM/W and 20 of their adjacent or peripheral female sexual partners) were conducted.

Feasibility Study of a Community Level, Multi-Component, Intervention for Black MSM

To ascertain the feasibility and acceptability of an intervention among Black men who have sex with men (MSM), to prepare for a community-level randomized trial to test the efficacy of the intervention in reducing HIV incidence among Black MSM.

Approximately 2136 “first wave” participants (267 per site at eight sites) and approximately 400 referred partners (70 per site at six sites). There will be no limit on enrollment of participants referred by “index” participants already in the study (according to the referring scheme in the protocol). Index participants are defined later in the protocol, but can be generally described as those newly identified with HIV infection, those with previously diagnosed HIV infection who are not receiving HIV care, and certain HIV negative participants. Men enrolling for this study who have not been referred by an index participant will be called “first wave” participants. Enrollment of first wave participants will cease when 200 first wave participants eligible for longitudinal follow up have been enrolled. Enrollment of certain sub-categories of first wave participants will be limited according to criteria detailed in the protocol.

Treatment Regimen:

The intervention components provided to participants include: HIV risk-reduction counseling, testing and referral for care STI testing and referral for care Screening for substance use and mental health issues, and provision of counseling and referral for care (if indicated) Engagement with peer-health navigators to facilitate uptake of healthcare and other services Enumeration of up to 20 social and sexual network members by all participants and referral of up to 5 sexual partners by index participants for enrollment into the study

Primary Objectives:

To obtain information needed to design the full community-randomized trial, particularly in the areas of: recruitment of black MSM satisfaction of Black MSM with intervention components uptake of the intervention components by Black MSM, including: Proportion of enrolled participants who agree to HIV testing Proportion of participants who agree to STI testing Proportion of participants who utilize peer navigator referrals Proportion of HIV infected participants entering HIV care Increase in condom use in all participants from enrollment to week 52 Decrease in viral load among HIV infected participants from initiation of HAART to week 52 Decrease in STIs among all participants from enrollment to week 52

Secondary Objectives:

To collect samples, behavioral data and HIV test results to improve laboratory measures of HIV incidence based on samples derived from cross-sectional studies To estimate the HIV incidence rate and the effect of the intervention on the incidence rate through mathematical modeling To describe characteristics of sexual network members of black MSM who are newly diagnosed with HIV infection, or previously diagnosed but not in care To assess attitudes of black MSM toward other prevention interventions To describe social and sexual networks of Black MSM within cities to inform decisions about what constitutes a randomizable unit for a future trial of the intervention.

Study Sites:
• Atlanta: Emory University
• Boston: Fenway Community Health Center
• Los Angeles: University of California Los Angeles
• New York City: New York Blood Center/Harlem Hospital
• San Francisco: San Francisco Department of Public Health
• Washington DC: George Washington University

Interventions, Training Manuals, etc. :
[Download not found]

Community Health Study

There have been few attempts to monitor the risk behaviors and HIV seroprevalence among the general population.

Understanding the HIV epidemic in Los Angeles requires establishing an integrated, multilevel surveillance system for HIV, sexually transmitted diseases (STDs), and the Hepatitis C virus (HCV). Information about sexual and substance use risk behaviors, HIV seroprevalence, and public knowledge, attitudes, and norms regarding HIV are needed for public health planning. A surveillance system will be required in order for Los Angeles to maintain funding for Ryan White and other federal and state funding sources. To begin to develop a method for mounting a comprehensive surveillance system, the City of Los Angeles is planning a study examining the acceptability of anonymous HIV testing and volunteering information about one’s risk behaviors in order to allow planning for HIV-related services.

Most studies of HIV seroprevalence and risk behaviors have been conducted with subgroups identified at high risk for HIV: young gay men, injecting drug users, homeless adolescents, or seriously mentally ill adults. There have been few attempts to monitor the risk behaviors and HIV seroprevalence among the general population (not necessarily from identified high-risk groups). Before any comprehensive surveillance system can be established, the ability to monitor HIV in community settings and among households in neighborhoods with high rates of AIDS cases must be established. To fill this gap, a two-phase project is being initiated by the city in order to assess the acceptability of HIV testing and reporting one’s risk behaviors when approached: 1) in a household survey; or 2) in a neighborhood setting such as a shopping mall, grocery center, theater, or church.

First, the acceptability of gathering HIV-related information from a household will be examined by conducting a supplement to the Los Angeles Health Survey that will be mounted this summer. An anonymous telephone interview will be conducted with random digit dialing of households within the City of Los Angeles. Randomly selected telephone numbers (n=100) will be surveyed on knowledge of transmission of HIV, attitudes and norms towards members of high-risk groups (e.g., gay men) and infected persons, and willingness to anonymously be tested for HIV. All responses will be recorded unlinked from telephone numbers selected by random digit dialing; therefore the identify of all respondents will be unknown and can never be traced. From gathering this information, the acceptability of a household approach as a method of gathering information about HIV-related information will be assessed.

Second, a community with a high rate of AIDS cases will be selected. In this neighborhood, local leaders will be consulted to identify a strategy for sampling community members anonymously and in settings accessible to all community members. In shopping malls in both communities, adults will be asked to anonymously volunteer to participate in a survey of attitudes and norms regarding HIV prevention activities, recent sexual and substance use risks acts, and consent to a saliva-based HIV test. The results of any individual test results will not be available; unmarked samples will be collected in order to indicate a community seroprevalence rate. Interested individuals will be offered an incentive for participating in the survey and test. The willingness of adult members of the community to participate in a study anonymously will be evaluated. Similar to the telephone household survey, no identity of any participant will be obtained. Overall, community rates will be obtained, but no individual information regarding risk or infection status.

The results of these two activities will be used to inform the Los Angeles County Board of Supervisor’s decisions regarding the best method for establishing surveillance methods for HIV infection and predictions regarding the future routes and subgroups for HIV infection. Currently, the County is considering adopting a method of practitioners informing public health officials of all persons testing seropositive for HIV or for a system of unique identifiers for persons who test seropositive for HIV. Both of these systems rely on the identification of seropositive persons, an event that typically occurs about 10 years after a person has become infected. Alternative strategies for monitoring the epidemic, especially among communities with an emerging epidemic must be identified. These studies will inform the strategy selected by the County and may become a national model.

Popular Opinion Leader HIV Intervention among Chinese Market Workers

This project is part of the NIMH Collaborative HIV/STD Prevention Trial which adopts a two-arm, randomized community-level design to test the Popular Opinion Leader (POL) HIV prevention intervention model at five international sites (China, India, Peru, Russia, and Zimbabwe). CCH is the lead on the China site.

China, representing 1/4th of the world’s population, has a rapidly emerging HIV epidemic with about 1.2 million individuals already infected, more than the total of all the Asian nations combined. Similar to Africa and India, the country’s 200-250 million labor migrants are a key to the epidemic’s future; however, HIV infection is predominantly occurring in rural settings (75% of population) and migrants transmit the virus heterosexually when moving to the cities annually.

The goals of this project are: 1) to adapt a comprehensive community-level preventive intervention – The Popular Opinion Leader – to populations in China based on data from ethnographic studies and compare the results with the other four international sites which follow the same research procedure; 2) to test the efficacy of this community-level preventive intervention in China as well as the four international sites utilizing both behavioral and biological outcomes; and, 3) to develop a manual that will permit different health care agencies and service providers to conduct rapid ethnographic studies, translate this community-level intervention to different settings and populations, and assess intervention efficacy.

The ability of CCH investigators to successfully implement the project is based on previous successful HIV prevention trials including interventions in China and participation in HIV-related cooperative agreements; support of the project from experienced Chinese collaborators, officials, and organizations; access to sites in China; collaboration with experienced Chinese investigators, several of whom have trained at UCLA; collaboration of the Qualitative Core of the UCLA-NPI with considerable cross-national and cross-site experience; and previous experience in conducting interventions and assessments that are culturally sensitive and appropriate.

Teens and Adults Learning to Communicate (TALC: LA)

Project TALC was funded by the National Institute of Mental Health (NIMH) to evaluate the efficacy of a family-based intervention over time and to contrast the life adjustments of HIV-affected families and their non-HIV-affected neighbors in the current treatment era. Mothers living with HIV (MLH; n = 339) and their school-age children (n = 259) were randomly assigned to receive a behavioral intervention or standard care as the control condition. MLH and their children were compared to non-HIV-affected families recruited at neighborhood shopping markets.

Targeted Risk Group: 

HIV-positive mothers and their adolescent children

Published Journal Articles:

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Links to Interventions, Training Manuals, etc. : 

 Phase 1 – Taking Care Of Myself

Parents’ Curriculum

Phase 2 – Illness

Parents’ Curriculum

  1. TALC LA- Parents Phase 2, Sess 1: What Are My Children's Needs?
  2. TALC LA- Parents Phase 2, Sess 2: Who Will Take Care of My Children?
  3. TALC LA- Parents Phase 2, Sess 3: What Kind of Arrangements Can I Make?
  4. TALC LA- Parents Phase 2, Sess 4: How Do I Start My Plan?
  5. TALC LA- Parents Phase 2, Sess 5: How Can I Really Listen To My Children?
  6. TALC LA- Parents Phase 2, Sess 6: How Can I Tell My Children What I Feel?
  7. TALC LA- Parents Phase 2, Sess 7: How Should I Deal with Problem Behavior?
  8. TALC LA- Parents Phase 2, Sess 8: How Can We Create a Positive Atmosphere at Home?
  9. TALC LA- Parents Phase 2, Sess 9: How Can We Resolve Conflicts at Home? (Part 1)
  10. TALC LA- Parents Phase 2, Sess 10: How Can We Resolve Conflicts at Home? (Part 2)
  11. TALC LA- Parents Phase 2, Sess 11: How Can We Work Together on Selecting a Custodian?
  12. TALC LA- Parents Phase 2, Sess 12: How Can We Deal with Drugs and Alcohol?
  13. TALC LA- Parents Phase 2, Sess 13: How Do I Prevent Pregnancy and Fatherhood?
  14. TALC LA- Parents Phase 2, Sess 14: Where Am I in Making a Custody Plan?
  15. TALC LA- Parents Phase 2, Sess 15: How Can Mothers Encourage Safer Sex?
  16. TALC LA- Parents Phase 2, Sess 16: What is the Mother's Legacy and the Youth's Goals?

 Adolescents’ Curriculum

Phase 3 – Adjustment

New Caregivers and Teens’ Curriculum

  1. TALC LA- New Caregivers and Teens Phase 3, Sess 1: What Do Adolescents and Caregivers/Parents Need from Each Other?
  2. TALC LA- New Caregivers and Teens Phase 3, Sess 3: Dealing with Loss and Grief - Part I
  3. TALC LA- New Caregivers and Teens Phase 3, Sess 4 (Caregivers): Raising an Adolescent
  4. TALC LA- New Caregivers and Teens Phase 3, Sess 4 (Youths): Planning for My Future - Part I
  5. TALC LA- New Caregivers and Teens Phase 3, Sess 5: Dealing with Loss and Grief - Part II
  6. TALC LA- New Caregivers and Teens Phase 3, Sess 6: How Can We Improve Communication - Part I (Effective Expressing)
  7. TALC LA- New Caregivers and Teens Phase 3, Sess 7: Ways of Helping Someone Cope with Loss and Grief
  8. TALC LA- New Caregivers and Teens Phase 3, Sess 8: How Can We Improve Communication - Part II (Active Listening and Responding)
  9. TALC LA- New Caregivers and Teens Phase 3, Sess 9 (Caregivers): Caregiver Support
  10. TALC LA- New Caregivers and Teens Phase 3, Sess 9 (Youths): How Do I Achieve My Goals?
  11. TALC LA- New Caregivers and Teens Phase 3, Sess 10: (Joint) How Can We Deal With Anger in the Relationship?
  12. TALC LA- New Caregivers and Teens Phase 3, Sess 11: How Can I Cope with Sadness?
  13. TALC LA- New Caregivers and Teens Phase 3, Sess 12 (Caregivers): How Should I Deal with Problem Behavior?
  14. TALC LA- New Caregivers and Teens Phase 3, Sess 12 (Youths): How Do I Deal with Fear?
  15. TALC LA- New Caregivers and Teens Phase 3, Sess 13: How Do We Practice Safer Sex, Prevent Pregnancy, and Reduce Alcohol and Drug Use?
  16. TALC LA- New Caregivers and Teens Phase 3, Sess 14: How Can We Resolve Conflicts at Home?
  17. TALC LA- New Caregivers and Teens Phase 3, Sess 15: How Can We Create a Positive Atmosphere at Home?
  18. TALC LA- New Caregivers and Teens Phase 3, Sess 16: Looking to the Future Together, What Can We Do?

Young Adults’ Curriculum

  1. TALC LA- Young Adults Phase 3, Sess 1: How Are Things Going?
  2. TALC LA- Young Adults Phase 3, Sess 2: Planning for My Future - Part I
  3. TALC LA- Young Adults Phase 3, Sess 3: Dealing with Loss and Grief - Part I
  4. TALC- Young Adults Phase 3, Sess 4: Where and How Can Young People Get Support?
  5. TALC LA- Young Adults Phase 3, Sess 5: Dealing with Loss and Grief - Part II
  6. TALC LA- Young Adults Phase 3, Sess 6: Ways of Coping with Loss and Grief
  7. TALC LA- Young Adults Phase 3, Sess 7: Planning for My Future (Part II) - How Do I Achieve My Goals?
  8. TALC LA- Young Adults Phase 3, Sess 8: Hearing and Getting Heard
  9. TALC LA- Young Adults Phase 3, Sess 9: How Can We Deal with Anger?
  10. TALC LA- Young Adults Phase 3, Sess 10: Relationships and Sex (Part 1)
  11. TALC LA- Young Adults Phase 3, Sess 11: Relationships and Sex (Part 2)
  12. TALC LA- Young Adults Phase 3, Sess 12: How Can I Cope with Sadness?
  13. TALC LA- Young Adults Phase 3, Sess 13: Pregnancy and Parenthood
  14. TALC LA- Young Adults Phase 3, Sess 14: How Do I Deal with Fear?
  15. TALC LA- Young Adults Phase 3, Sess 15: How Can I Reduce Substance Use?
  16. TALC LA- Young Adults Phase 3, Sess 16: Looking to the Future

Intervention Model: 

Mothers and their adolescents attended a 16-session cognitive behavioral intervention over eight weeks. For MLH, intervention goals aimed to: 1) improve parenting while ill (i.e., reduce family conflict, improve communication, clarify family roles); 2) reduce mental health symptoms; 3) reduce sexual and drug transmission acts; and 4) increase medical adherence and assertiveness with medical providers. For adolescents, the intervention goals were to: 1) improve family relationships; 2) reduce mental health symptoms; 3) reduce multiple problem behaviors (e.g., drug use, criminal justice acts, school problems, teenage pregnancy); and 4) school retention.

Research Methods:

In a random assignment study, families assigned to take part in Project TALC were compared with families assigned to a control group on mental health and health behaviors, including sexual behavior and substance use. Both intervention and control families were compared to a neighborhood cohort, matched on sociodemographics. Because study participants were followed over two years, longitudinal random effect regression models were used to test the efficacy of the intervention.

Surveys and Scales Used:

  1. Living Situation, Including Neighborhood Problems - Scale
  2. Religion: Attendance and Experience
  3. Financial, Labor, and Educational Experience - Scale
  4. Loss and Grief - Scale
  5. Treatment History - Survey
  6. Social Support - Survey
  7. Romantic Relationships - Survey
  8. Needle Use and Sharing - Survey
  9. Reproductive Health - Survey
  10. Parentification - Survey
  11. Goals Scale
  12. Natural Mentors
  13. Dealing with Mother's Illness - Survey
  14. Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA)
  15. Sexually Transmitted Disease - Survey
  16. Medication Adherence - Survey
  17. Educational (Academic) Experience Assessment
  18. Family Functioning - Scale
  19. Family Composition - Scale
  20. Employment and Labor Experience Assessment - Survey
  21. World Health Organization Quality of Life (WHOQOL) - Survey
  22. Self Harm: Suicide History - Survey
  23. CDC Sexual Behavior Questions (CSBQ)
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  25. Detention and Jail History Assessment - Survey
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  27. Alcohol and Other Drug Abuse (AOD) - Scale
  28. Adolescent Substance Use - Survey
  29. PTSD Index for DSM IV (Adolescent version) - UCLA
  30. Parker Parental Bonding Instrument
  31. Positive and Negative Affect Scale (PANAS)
  32. Network Assessment
  33. Janis Self-Esteem - Scale
  34. Medical Outcomes Study (MOS) Social Support - Survey
  35. Living Situation for Adolescents - Survey
  36. Life Outcome Expectancies Assessment - Survey
  37. Life Goals Assessment - Survey
  38. Life Events Assessment - Survey
  39. House Rules - Scale
  40. HIV Related Incidents - Survey
  41. Healthcare Utilization, Providers, and General Health Assessment: Including STD and Pregnancy - Survey
  42. HIV Testing Assessment - Survey
  43. General Medical History Assessment
  44. Multiple Problem Behavior - DSM Conduct Problems (DSMC) - Conduct Disorder
  45. Conflict Resolution - Conflict Tactics Scale (CTS)
  46. Adult Adolescent Parenting Inventory (AAPI) - Survey
  47. Nutrition and Exercise - Survey
  48. Rosenberg Self-Esteem (RSE) - Scale
  49. Dealing with Illness - Scale

Local Significance: 

There was a lack of significant findings for an intervention effect on HIV-transmission behaviors and mental health. HIV-transmission behaviors were low to begin with and participants had little room for improvement. The populations affected by the HIV epidemic in the U.S. have shifted over the past number of years since a similarly mounted intervention in New York City led to improvements. HIV interventions in the U.S. need to shift their focus to persons living with HIV who are experiencing substantial problems.

International Significance:

While the focus of U.S.-based HIV interventions need to shift, interventions for the general HIV population may be effective outside the U.S.

Together Learning Choices (TLC)

TLC (Together Learning Choices) is an HIV prevention and health promotion intervention developed for HIV-positive teens and youth (ages 13 to 29). TLC is delivered in small groups using cognitive-behavioral strategies to change behavior. It provides young people living with HIV the tools and skills necessary to live their best lives and to be able to make healthy choices. The goal of the intervention is to help these young people maintain health, reduce transmission of HIV and infectious diseases, and improve their quality of life. TLC is a product of extensive collaboration among researchers, staff from public and private agencies serving the population, and members of the intended population, representing diverse backgrounds and perspectives.

TLC consists of two sequential modules that totaled 16 sessions. Each module has eight sessions and is designed to be delivered by two Facilitators in a group setting.

  •  The Staying Healthy module encourages healthy living by focusing on health maintenance and forging effective partnerships with health care providers.
  • The Acting Safe module is dedicated to primary and secondary HIV prevention by addressing sex- and substance use-related risk behaviors and reducing new infections and reinfections.

– The goal of this study was to design, pilot test, and evaluate an intervention for service providers to address HIV-related stigma and its impact on health service delivery and adequate care.
TLC is a science-based behavioral intervention that has demonstrated evidence of effectiveness in reducing risky behaviors, such as unprotected sex, or in encouraging safer ones, such as using condoms and other methods of practicing safer sex. It is offered by the Centers for Disease Control and Prevention (CDC) through the Replicating Effective Programs (REP) and Dissemination of Effective Behavioral Interventions (DEBI) at www.effectiveinterventions.org.

Targeted Risk Group:
Young People Living with HIV (YPLH) aged 13 to 24 in original efficacy trial and aged 13-29 in . The majority of participants were African-American and Latino.

Intervention model:
Small group intervention.
Original intervention manuals available here:

Module 1 – Staying Healthy

CDC funded replication manual: TLC Implementation Manual
TLC Broadsheet

Research Methods:
Group randomized trial with immediate intervention and delayed (waitlisted) control conditions. Assessment interviews conducted every three months over 24 months.

Local Significance:
The intervention reduced sexual risk behaviors, substance use, and emotional distress, and increased social support and other positive coping styles.

HIV Technology Transfer in Los Angeles

The aims of the HIV Technology Transfer in Los Angeles project are to document and develop resources for technology transfer among HIV/AIDS community-based organizations (CBOs) serving Los Angeles communities. Several CBOs have publicly commented on the gap between current mandates to implement and evaluate evidence-based HIV interventions and the resources that are available to meet these requirements. A long-term objective is to share CBOs insights into using science-based interventions and to increase the training, materials and other resources they need to carry out HIV prevention. CHIPTS and the City of Los Angeles AIDS Coordinator (ACO) seek to assist CBOs in meeting these objectives. The potential impact of the study is enhanced implementation of evidence-based interventions in Los Angeles and throughout California.

The process of adapting evidence-based interventions into CBO settings is known as technology transfer. The Technology Transfer Model (TTM) outlines three primary phases of this process: pre-implementation, implementation, maintenance and evolution. The pre-implementation phase consists of identifying the need for an intervention, acquiring information, assessing the fit between an intervention and the goals and activities of the organization, and preparing the organizational staff. Implementation includes obtaining technical assistance and conducting process evaluation of the interventions. Finally, maintenance and evolution includes ensuring the presence of staff that can continue to implement the intervention, organizational change, and program evolution.

CBO staff who have been involved in the three phases of technology transfer can offer rich insights on best practices and lessons learned in their communities. Up to 18 science-based programs have been or are being implemented in Los Angeles. Up to two staff from each of these programs are eligible to participate (N = 36). Eligible participants for this study completed close-ended background surveys regarding their organization’s characteristics and were interviewed for up to 90 minutes. Participants were paid $30 for each interview completed. Interviews were conducted twice with staff from these programs. The first wave of interviews asked about pre-implementation and implementation phases of technology transfer. The second wave of interviews, scheduled when many of the programs finished at least one cycle of implementation, asked about maintenance and evolution. Surveys were summarized and used to describe the general organizational characteristics of CBOs using evidence-based programs. Interviews were transcribed, coded and analyzed for techniques, challenges, strategies, and resources used or needed by the CBOs.

Interventions, Training Manuals, etc. :

  1. HIV Technology Transfer in LA (developing resources for technology transfer among HIV/AIDS community-based organizations)- Interview Questions
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HIV/STD Risk Behaviors in Methamphetamine User Networks

SATH-CAP stands for the Sexual Acquisition and Transmission of HIV Cooperative Agreement Program. The overall goal of SATH-CAP is to better understand how patterns of sexual and drug use behaviors along with other social and environmental factors, such as other sexually transmitted diseases, places where people gather for sex and drug activities, and types of partnerships, influence the spread of HIV/AIDS from people currently at high risk for HIV/AIDS, like drug users and men who have sex with men (MSM), to those at a lower risk.

Specifically, the study seeks to answer these primary questions:

  • To what extent do HIV infections among drug-using populations spread to uninfected drug users and non-drug users through drug-related and/or sexual transmission behaviors?
  • What individual (behavioral, biological), network, and structural characteristics influence the speed, extent and path of the spread?

The SATH-CAP includes five research centers, a scientific and logistical coordinating center at RAND, and the funder, the National Institute on Drug Abuse (NIDA). The research centers are:

  • Research Triangle Institute (RTI)
  • University of California, Los Angeles (UCLA)
  • University of Illinois, Chicago (UIC)
  • Yale University
  • The Biomedical Center (BMC), St. Petersburg, Russia, Andrei Kozlov

Los Angeles County Methamphetamine Prevention Initiative

There is a significant unmet need in Los Angeles County for methamphetamine-specific training, and community service agencies and outreach workers need education and training on effective approaches to engage and serve persons in the community at risk. Training and technical assistance is also needed for service providers on the latest evidence-based methamphetamine treatment approaches.

More specifically, trainings are needed that cover methamphetamine-specific issues crucial for the development of skills by medical providers, clinicians and outreach workers serving clients who use methamphetamine and address specific concerns around providing culturally appropriate care for specific populations. These trainings address issues such as: mental health considerations, psychological complications, sexual and cybersex addiction and current evidence based treatments.

This training project included the following activities:

  • Providing consultation and technical assistance to the Los Angeles County Alcohol and Drug Program Administration (ADPA) and the Office of AIDS Programs and Policy (OAPP)
  • Developing training curricula and module for ADPA or OAPP-funded substance abuse or HIV/AIDS treatment providers
  • Developing and disseminating web-based training module
  • Providing in-service trainings for Los Angeles County Methamphetamine Task Forces
  • Providing in-service trainings for ADPA and OAPP-funded Drug Abuse and HIV prevention agencies serving young women
  • Providing tailored technical assistance

Family-Focused HIV Disclosure Intervention in Thailand

This is a Mentored Research Scientist Development Award (K01). HIV disclosure is a key stressor among HIV-affected families in Thailand, and the impact radiates throughout the family. By addressing HIV disclosure as a family matter, the proposed study aims to develop and pilot a culturally tailored intervention in Northeastern Thailand in Nakhon Ratchasima Province.

In Phase 1, formative research will be conducted using in-depth interviews with 20 People Living with HIV (PLH), 20 family members, and 10 healthcare providers to explore the concerns, barriers and motivators around HIV disclosure.  In Phase 2, we will develop a culturally tailored HIV disclosure intervention by engaging 20 PLH through a series of focus groups.  In Phase 3, we will pilot test the intervention with 40 PLH and compare their physical, psychological and social outcomes with the outcomes of 40 PLH in the standard care group. Follow-up assessments with PLH will be conducted at 6 months.