Results of a Randomized Wait-List Controlled Trial of CAYA: A Nurse Case Management HIV Prevention Intervention for Youth Experiencing Homelessness.

Autor: Maria DS; Cizik School of Nursing, Center for Nursing Research, University of Texas Health Science Center at Houston, Houston, TX, USA. Diane.M.SantaMaria@uth.tmc.edu., Nyamathi A; Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA., Lightfoot M; Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA., Paul M; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA., Quadri Y; Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA., Padhye N; Cizik School of Nursing, Center for Nursing Research, University of Texas Health Science Center at Houston, Houston, TX, USA., Businelle M; TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA., Fernandez-Sanchez H; Cizik School of Nursing, Center for Nursing Research, University of Texas Health Science Center at Houston, Houston, TX, USA., Jones JT; Cizik School of Nursing, Center for Nursing Research, University of Texas Health Science Center at Houston, Houston, TX, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12.
DOI: 10.1007/s10461-024-04544-3
Abstrakt: Youth experiencing homelessness (YEH) face challenges that increase their susceptibility to HIV/STIs. Nurse case management is effective in managing the complex needs of populations experiencing homelessness and reducing HIV risk. A randomized wait-list control study conducted between September 2019 to May 2023 evaluated the CAYA "Come As You Are" intervention. This nurse-led HIV prevention for YEH aged 16-25 years focused on the uptake of HIV prevention methods: pre- and post-HIV exposure prophylaxis (PrEP, nPEP), HIV/STI testing and treatment, sober sex, and condom use. Secondarily, we examined intervention impact on housing stability. Descriptive statistics were calculated by study arm. Multiple imputation (m = 10) was used for missing values and intervention effects were estimated from Bayesian multilevel models with noninformative priors. Participants (N = 450) were 21.1 years old on average, 62% Black, 11% Hispanic, 11% White, and 10% other race and reported being homeless for an average of 3 years. An intervention effect was found for PrEP use, which showed a larger increase from baseline to first follow-up (OR = 3.27; 95% Cr.I.: 1.13 to 10.14). No intervention impact was found for nPEP use, HIV and STI cases, sober sex, or condom use. Sheltering arrangements improved from baseline to the first follow-up in both groups with increase in shelter stability (OR = 3.85; 95% Cr.I.: 1.61 to 10.30) and decreased shelter transiency (OR = 0.29; 95% Cr.I.: 0.14 to 0.60). This study demonstrates that a personalized, nurse-led HIV prevention approach increased uptake of some but not all HIV prevention strategies among YEH. CLINICAL TRIAL REGISTRATION NUMBER: NCT03910218.
Competing Interests: Declarations The authors declare no potential conflicts of interest with respect to the research, authorship, or publication of this article. Research reported in this publication was supported by the National Institutes of Health (Award No. R01NR017837). No copyrighted material, surveys, instruments, or tools were used in the research described in this article. Written informed consent was obtained from all individual participants included in the study, including permission to publish aggregate data. This research was reviewed and approved by the Institutional Review Board at the University of Texas Health Science Center (Protocol # HSC-SN-18-0993).
(© 2024. The Author(s).)
Databáze: MEDLINE
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