Project dates: July 2011 - April 2017
Co-Investigator: Leonard, Noelle
Co-Investigator: Cleland, Charles
Co-Investigator: Hagan, Holly
Co-Investigator: Perlman, David
Finding individuals who are unaware they are HIV positive and linking them to care is a critical public health priority. Heterosexuals make up more than 25% of new HIV infections but do not test for HIV as frequently as and are diagnosed later than other risk groups. This study focused on Heterosexuals at High Risk (HHR) for HIV living in a high-risk area in Brooklyn, NY. The study evaluated three different strategies to locate heterosexuals at high risk for HIV, offer testing for HIV, and link those to care who are found positive – a “Seek, Test, Treat, and Retain” (STTR) approach. Specifically, the three strategies were: 1) a venue-based sampling approach (N=400), 2) a peer-driven intervention using confidential HIV testing in a two-session intervention (N=3000), and 3) a hybrid study with brief, low threshold anonymous HIV testing followed by confidential linkage to care (N=500). The main outcome for the studies’ “Seek and Test” phases is the proportion of newly identified HIV infections, or “yield.” The main outcomes for the studies’ “Treat and Retain” phases were time to a first appointment at an HIV clinic, retention in care, time to starting HIV medications if it was medically indicated, adherence to medications (if taken), and viral load suppression among those newly diagnosed. This study also directly compared the cost effectiveness of each of the three strategies and conducted qualitative research on barriers to HIV testing and care. Thus the study will provide vital information on strategies to identify undiagnosed HIV infection among an under-studied population at high risk for HIV, as well as on care linkage approaches.
Abstract on NIH RePORTERIndividual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort
BMC Public Health, 21 (1), 2002. doi: 10.1186/s12889-021-12026-7. PMCID: PMC8567631 .
Kutnick AH, Leonard NR, Gwadz MV (2019).
“Like I have no choice”: A qualitative exploration of HIV diagnosis and medical care experiences while incarcerated and their effects
Behavioral Medicine, 45 (2), 153-165. doi: 10.1080/08964289.2019.1591338. PMCID: PMC6730550.
Gwadz M, Leonard NR, Honig S, Freeman R, Kutnick A, Ritchie AS (2018).
Doing battle with “the monster:” How high-risk heterosexuals experience and successfully manage HIV stigma as a barrier to HIV testing
International Journal for Equity in Health, 17 (1), 46. doi: 10.1186/s12939-018-0761-9. PMCID: PMC5910579.
Stevens ER, Nucifora K, Zhou Q, Braithwaite RS, Cleland CM, Ritchie AS, Kutnick AH, Gwadz MV (2018).
Cost-effectiveness of peer- versus venue-based approaches for detecting undiagnosed HIV among heterosexuals in high-risk New York City neighborhoods
Journal of Acquired Immune Deficiency Syndromes, 77 (2), 183-192. doi: 10.1097/QAI.0000000000001578. PMCID: PMC5762425.
Cleland CM, Lanza ST, Vasilenko SA, Gwadz M (2017).
Syndemic risk classes and substance use problems among adults in high-risk urban areas: A latent class analysis
Frontiers in Public Health, 5, 237. doi: 10.3389/fpubh.2017.00237. PMCID: PMC5594078.
Kutnick AH, Gwadz MV, Cleland CM, Leonard NR, Freeman R, Ritchie AS, McCright-Gill T, Ha K, Martinez BY (2017).
It’s a process: Reactions to HIV diagnosis and engagement in HIV care among high-risk heterosexuals
Frontiers in Public Health, 5, 100. doi: 10.3389/fpubh.2017.00100. PMCID: PMC5423945.
Gwadz M, Cleland CM, Perlman DC, Hagan H, Jenness SM, Leonard NR, Ritchie AS, Kutnick A (2017).
Public health benefit of peer-referral strategies for detecting undiagnosed HIV infection among high-risk heterosexuals in New York City
Journal of Acquired Immune Deficiency Syndromes, 74 (5), 499-507. doi: 10.1097/QAI.0000000000001257. PMCID: PMC5341134.
Ritchie A, Gwadz MV, Perlman D, de Guzman R, Leonard NR, Cleland CM (2017).
Eliminating racial/ethnic disparities in AIDS clinical trials in the United States: A qualitative exploration of an efficacious social/behavioral intervention
Journal of AIDS and Clinical Research, 8 (1), 648. doi: 10.4172/2155-6113.1000648. PMCID: PMC5431576.
Collins LM, Kugler KC, Gwadz MV (2016).
Optimization of multicomponent behavioral and biobehavioral interventions for the prevention and treatment of HIV/AIDS
AIDS and Behavior, 20 (Suppl 1), 197-214. doi: 10.1007/s10461-015-1145-4. PMCID: PMC4715714.
Gwadz M, Cleland CM, Kutnick A, Leonard NR, Ritchie AS, Lynch L, Banfield A, McCright-Gill T, del Olmo M, Martinez B (2016).
Factors associated with recent HIV testing among heterosexuals at high risk for HIV infection in New York City
Frontiers in Public Health, 4, 76. doi: 10.3389/fpubh.2016.00076. PMCID: PMC4846660.
Gwadz M, Cleland CM, Hagan H, Jenness S, Kutnick A, Leonard NR, Applegate E, Ritchie AS, Banfield A, Belkin M, Cross B, Del Olmo M, Ha K, Martinez BY, McCright-Gill T, Swain QL, Perlman DC, Kurth AE (2015).
Strategies to uncover undiagnosed HIV infection among heterosexuals at high risk and link them to HIV care with high retention: A “seek, test, treat, and retain” study
BMC Public Health, 15, 481. doi: 10.1186/s12889-015-1816-0. PMCID: PMC4434577.
Gwadz M, Cleland CM, Leonard NR, Kutnick A, Ritchie AS, Banfield A, Hagan H, Perlman DC, McCright-Gill T, Sherpa D, Martinez BY (2015).
Hybrid STTR intervention for heterosexuals using anonymous HIV testing and confidential linkage to care: A single arm exploratory trial using respondent-driven sampling
BMC Public Health, 15 (1), 1133. doi: 10.1186/s12889-015-2451-5. PMCID: PMC4647497.
September 2017