Implementation of a Socio-structural Demonstration Project to Improve HIV Outcomes Among Young Black Men in the Deep South.

Abstract

We describe the background, rationale, intervention components, and formative results of a demonstration project aimed to ameliorate five socio-structural barriers to HIV services for young Black men aged 18-29 living with and at risk for HIV in Louisiana. The interventions and activities consisted of (1) five person-centered approaches to enhance linkage to HIV services and improve socio-economic outcomes; (2) the implementation of systematic mystery shopping tests to document instances of housing discrimination; (3) the development and implementation of a multi-prong communications campaign to increase knowledge about the signs of housing discrimination and community resources among young Black men who have sex with men (YBMSM); (4) the integration of HIV/STI services and lesbian, gay, bisexual, and trans (LGBT)-inclusive events on Historically Black Colleges and Universities (HBCUs); and (5) the development of a safe spacefor YBMSM. A multi-method approach was used to evaluate the outcomes of the different interventions. The majority (62%) of participants living with HIV were linked to HIV care and 49% had achieved viral suppression. More than 40% of participants were employed during the project. Thirty-seven percent(37%) of the mystery shopping tests showed definite or possible signs of housing discrimination. The housing campaign's duration was limited with unknown long-term impact among YBMSM. Fifteen cases of syphilis were identified during two HBCU events. A safe space was specifically created for YBMSM at a community-based organization. Multi-component holistic health interventions are needed to improve HIV outcomes and curb the high HIV rates among young Black men, particularly YBMSM in the United States and the Deep South.