TY - JOUR
T1 - Client-Centered Care Coordination (C4™) for HIV/STI Prevention
T2 - a Theoretical, Conceptual, and Methodological Overview—HIV Prevention Trials Network (HPTN) 073
AU - for the HPTN 073 Study Team
AU - Nelson, La Ron E.
AU - Wilton, Leo
AU - Whitfield, Darren L.
AU - Williams, Geoffrey C.
AU - Mayer, Kenneth H.
AU - Komárek, Arnošt
AU - Boyd, Donte T.
AU - Beauchamp, Geetha
AU - Fields, Sheldon D.
AU - Wheeler, Darrell P.
N1 - Funding Information:
The authors thank the study team and participants of HPTN 073. The authors also thank the following individuals for their support during the process of developing the integrated intervention model and its implementation during the HPTN 073 study: Rashad Burgess (Gilead Sciences), Patricia Coury-Doniger (University of Rochester), Lisa Hightow-Weidman (University of North Carolina Chapel Hill), Christopher Hucks-Ortiz, Craig Hutchinson, Irene Kuo (George Washington University), Jonathan P. Lucas (fhi360), Manya Magnus (George Washington University), Peter McGrath (University of Rochester), Christopher Niemiec (University of Rochester), Scott Rose (fhi360), Steve Shoptaw (University of California Los Angeles), Phaedra Watkins, Christopher Chauncey Watson (Gilead Sciences), and the HPTN 073 Study Team.
Funding Information:
This research was supported by cooperative award UM1 AI068619 to HIV Prevention Trials Network from the National Institute of Allergy & Infectious Diseases, National Institute of Mental Health, and National Institute of Drug Abuse. This manuscript was also made possible through core services and support of the Yale University Center for Interdisciplinary Research on AIDS P30MH062294.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/9
Y1 - 2022/9
N2 - Introduction: There are few culturally informed, theory-driven evidence-based strategies to support PrEP use among Black MSM. This paper describes the theoretical foundation and conceptual development of C4™ to support the prevention of HIV and other STIs. Methods: C4™ integrates self-determination theory with comprehensive risk counseling and services using an integrative anti-racism lens. C4™ was implemented in a 52-week HIV prevention demonstration project to facilitate PrEP use and adherence among Black MSM (N = 226) in three US cities from 2014 to 2017. Results: PrEP use was 79%, with 91% of PrEP users starting within 30 days. Twelve-month retention in C4™ was 92%. Care coordination encounters focused primarily on clients’ needs related to PrEP adherence (43%) and sexual health (19%). Over the 12-month period, a substantial proportion of the men made progress towards their PrEP adherence goals at the 8-week (83%), 26-week (75%), and 52-week (81%) study visits. Conclusions: C4™ is a multi-level, multi-component intervention that dually targets individual-level motivations and capacities of Black MSM and the healthcare facility-level attitudes, behaviors and processes that characterize the climates where Black MSM receive services. Policy Implications. Public health policy efforts to scale-up PrEP may consider C4™ as a tool to optimize the use of PrEP and PrEP program retention with Black MSM. C4™ is also a tool for healthcare facilities to transform their models of service delivery towards improving the implementation PrEP services, including ensuring racial equity in the prevention impact of novel PrEP formulations such as long-acting injectable and potential future long-acting oral regimens.
AB - Introduction: There are few culturally informed, theory-driven evidence-based strategies to support PrEP use among Black MSM. This paper describes the theoretical foundation and conceptual development of C4™ to support the prevention of HIV and other STIs. Methods: C4™ integrates self-determination theory with comprehensive risk counseling and services using an integrative anti-racism lens. C4™ was implemented in a 52-week HIV prevention demonstration project to facilitate PrEP use and adherence among Black MSM (N = 226) in three US cities from 2014 to 2017. Results: PrEP use was 79%, with 91% of PrEP users starting within 30 days. Twelve-month retention in C4™ was 92%. Care coordination encounters focused primarily on clients’ needs related to PrEP adherence (43%) and sexual health (19%). Over the 12-month period, a substantial proportion of the men made progress towards their PrEP adherence goals at the 8-week (83%), 26-week (75%), and 52-week (81%) study visits. Conclusions: C4™ is a multi-level, multi-component intervention that dually targets individual-level motivations and capacities of Black MSM and the healthcare facility-level attitudes, behaviors and processes that characterize the climates where Black MSM receive services. Policy Implications. Public health policy efforts to scale-up PrEP may consider C4™ as a tool to optimize the use of PrEP and PrEP program retention with Black MSM. C4™ is also a tool for healthcare facilities to transform their models of service delivery towards improving the implementation PrEP services, including ensuring racial equity in the prevention impact of novel PrEP formulations such as long-acting injectable and potential future long-acting oral regimens.
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U2 - 10.1007/s13178-022-00687-x
DO - 10.1007/s13178-022-00687-x
M3 - Article
AN - SCOPUS:85123606842
SN - 1868-9884
VL - 19
SP - 1365
EP - 1382
JO - Sexuality Research and Social Policy: Journal of NSRC
JF - Sexuality Research and Social Policy: Journal of NSRC
IS - 3
ER -
