Project STYLE Strength Through Youth Livin Empowered

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Project STYLE(Strength Through Youth Livin
Empowered)

• Lisa Hightow, MD, MPH
• UNC Chapel Hill

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Background

• Early 2003 recognized an outbreak of HIV
  infection on North Carolina college campuses
  
• Retrospective review of all state HIV
  surveillance records of men aged 18-30 diagnosed
  from 2000-April 2005

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1403 Men Aged 18-30 Newly Diagnosed with HIV
in North Carolina, 2000-April 2005
206 Cases previous positives or not available
for review
1197 Cases (85)
1040 Non College Students 87
157 College Students 13
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Cases of HIV infection among non-college men aged
18-30
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Cases of HIV infection among college and
non-college men aged 18-30
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157 HIV-Infected College Students
133 African American (84.7)
44 Male and female sex partners (33.1)
6 Female sex partners (4.5)
79 Male sex partners (59.4)
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Factors Associated with College

• College students more likely
• OR 95CI
• African American 3.19 1.99-5.15
• Diagnosed with recent infection
  3.17 1.84-5.44
  
• Both male and female sex partners 3.03 2.01-4.57
  
• Report anonymous sex 1.52 1.06-2.19
• Meet sex partners in
• Gay bars/clubs 2.01 1.37-2.96
• Internet 5.76 3.81-8.70
• College campus 16.79 7.39-38.90

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Project Goals

• Goal 1 Increase identification, testing and
  enrollment in enhanced HIV services for young MSM
  of color at risk for or infected with HIV in
  North Carolina
• Goal 2 Improve linkage to and retention in care
  for HIV clients
  
• Goal 3 Provide quality care and prevention
  messages for young sero-positive MSM of color
  

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Project STYLE Team

• UNC Chapel Hill
• Lisa Hightow, MD, MPH Co-PI, clinic physician
• Peter Leone, MD Co-PI
• Justin Smith Project Coordinator
• Andre Brown Research Assistant
• Marcie Fisher-Borne, MSW, MPH Research Assistant

• North Carolina Central University
• David Jolly, DrPH co-investigator
• Outreach worker TBD
• Alliance of AIDS Services- Carolina
• Sebastian Battle Outreach Worker

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Connecting with Our Community

• On campus outreach
• Contact established with seven colleges in the
  region
  
• Program staff will work with each college to
  design programming
  
• Sponsoring social events
• Partnering with student organizations, including
  Greek letter organizations
  
• HIV 101 presentation to academic classes and
  student organization
  
• Free, Confidential Rapid HIV Testing

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Connecting with Our Community

• Off campus outreach
• Gay-identified nightclubs
• Urban nightclubs (non-gay identified)
• Concerts
• Churches
• Step Shows
• Balls
• Internet sites (i.e. Adam4Adam.com)
• Sex parties

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Outreach Photos
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S.T.Y.L.E. Survey Highlights

• Findings from a Survey of Young Men of Color

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About the Survey

• Designed to explore knowledge, attitudes and
  behavior with respect to HIV testing
  
• Administered as pen and paper survey
• Participants were given 20 Wal Mart Gift Card as
  incentive for completion
  

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About the Survey

• 40 men recruited at two venues
• John Legend Concert
• Popular Neo-Soul Singer
• Capital Corral (CCs)
• Thursday Hip-Hop Night
• Only night that draws primarily African American
  Men in the Triangle
  

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Demographics- Race/Ethnicity
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Demographics- Education
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Sexual Identity
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Number of Sexual Partners
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Effective Strategies

• Question What are ways that your school could
  improve its efforts to educate and test students
  for HIV?
  
• 88 responded that integrating HIV information
  into courses would be effective
  
• 85 responded that having more student groups
  talking about HIV would be effective
  
• 85 responded that specific programs for men of
  color would be effective
  
• 77 reported that more HIV testing venues would
  be effective in this regard
  

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Motivation for Getting Tested
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Factors Considered in Choosing to Test

• Nearly 62 of respondents said that cost of the
  test was either not important at all or slightly
  important
  
• 82 responded that confidentiality was very
  important
  
• 52 of the respondents cited confidentiality as
  the single most important factor
  
• 54 responded that turn around time for results
  was very important

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Where do people test?
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Barriers to Testing at Student Health

• Confidentiality
• Students often work there
• Cost
• Appointment/testing times
• Location
• One student health facility located directly
  across from the cafeteria

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STYLE testing events

• Apple Chill April 2005
• Location Downtown Chapel Hill Street Festival
• Turnout 75
• Festifall October 2005
• Location Downtown Chapel Hill Street Festival
• Turnout 137
• World AIDS Day December 2005
• Location UNC Center for Healthy Student
  Behaviors
  
• Turnout 228
• NC State February 2006
• Location NC State University Student Center
• Turnout 110

• Pre-Spring Break Testing March 2006
• Location UNC Center for Healthy Student
  Behaviors
  
• Turnout 151
• Apple Chill April 2006
• Location Downtown Chapel Hill Street Festival
• Turnout 156
• Latino Health Fair April 2006
• Location Latino Health Fair, local Chapel Hill
  Catholic Church
  
• Turnout 48
• Livingstone College April 2006
• Location Livingstone College, Salisbury, NC
• Turnout 107

• Totals 1021 individuals tested, 4 positive
  results
  

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Testing Event Photos
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World AIDS Day Event Compared with Student Health
Testing
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World AIDS Day Event Compared with Student Health
Testing
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Overall Satisfaction with WAD Event

• Of respondents to question about future testing
  preferences, (N190) 96.3 would prefer to have
  the OraQuick test done compared to 3.7 who would
  prefer a conventional blood test
• Yall did a good job making this comfortable
  and not so awkward
  
• I thought it was great that the rapid test was
  offered for free, which means more people could
  come get tested.
  

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Conclusions

• Tested almost as many students during one time
  event as at student health all year
  
• Tested more minority students and MSM during WAD
  event
  
• Tested more previously untested students during
  WAD event
  

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2006-2007 College Testing Tour

• Supplemental funding from Gilead Foundation to do
  rapid testing on 10 North Carolina colleges
  
• Combine testing with education, games,
  entertainment to increase participation
  
• Located on campus but separate from student
  health
  
• Remove barriers for testing at student health
  expressed by students

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Advertising for testing tour

• Local media- newspapers, college newspapers
• Urban radio spots
• 30 second commercial airing on local WB/ UPN
  stations

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Unique aspects of STYLE testing events

• Free, rapid, oral testing
• Group or individual pre-test counseling
  encouraging friends coming in for testing
  together
  
• Graduate students as counselors- promotes
  youth-friendly environment
  
• Close enough in age to undergrads to be seen as
  understanding, but removed from undergraduate
  social circles- less confidentiality concerns
  
• Physician on-site for referral of all positive
  cases
  
• Co-sponsorship with campus organizations promotes
  student buy-in
  

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Acknowledgements

• Justin Smith
• Peter Leone
• Sebastian Battle
• Andre Brown
• Keith McAdam
• Marcie Fisher-Borne
• David Jolly
• Andrew Kaplan
• GW YES Center

• Byrd Quinlivan
• Better World Advertising
• Laini Jarrett-Echols
• Cindy Gay
• Kristin Ito
• Maureen Boland
• Lizzie Torrone
• Sandi McCoy