Youth and AIDS Project's HIV Prevention Program

Investigators: Gary Remafedi, Susan Reynolds, John Yoakam, & Kevin Cwayna

A community and university partnership launched this program to provide education, peer support, counseling, and case management to gay and bisexual male adolescents between 13 and 21 years of age, who are at high risk for HIV/AIDS. The program begins with an initial two-hour interview for individualized HIV/AIDS risk assessment and risk reduction counseling. Youth then participate in a 90-minute interactive peer education program designed to provide clear, factual information in an atmosphere of mutual support. The program's lessons are reinforced in an educational video. Optional peer support groups meet weekly, if youth wish to attend. Finally, there is a one-hour follow-up visit for reassessment and referrals, as needed, to medical and social services. A field study of the program was conducted with a predominantly white sample of males, ages 13-21, who identified themselves as gay or bisexual. Following the intervention, the 139 participants reported less frequent unprotected anal intercourse and more frequent use of condoms. A reduction in substance abuse, particularly amphetamines and amyl nitrate, was also recorded. Click here to view more detailed information on this program.

mDOT Program: For Individuals Receiving Highly Active Antiretroviral Therapy (HAART)

Investigators: Cynthia R. Pearson, PhD, Mark Micek, MD, Jane M. Simoni, PhD, Eduardo Matediana, MD, Diane P. Martin, PhD, & Stephen Gloyd, MD, MPH

The mDOT Program aims to increase adherence to highly active antiretroviral therapy (HAART) for individuals living with HIV/AIDS through peer-provided directly observed therapy. The program significantly increased adherence to HAART at 6-week, 6-month, and 1-year follow ups and significantly increased the number of program participants achieving more than 90% adherence after 6 months. Peer educators are trained during a 2-day workshop to deliver directly observed therapy and support HAART adherence. After training, peer educators monitor morning HAART doses during the 6-week program period. Peer educators provide social support, adherence advice and health information to participants throughout the program. Peer educators complete refresher training every three months throughout the program. The mDOT Program was originally implemented in Beira, Mozambique, at a large-volume public institution providing free specialized HIV care and antiretroviral medications. Although this program was designed to operate in an HIV clinic or hospital, it may be feasible for other community-based organizations serving individuals living with HIV to implement the mDOT program. Click here to view more detailed information on this program.