Center For AIDS Research

Sophia Hussen, MD, MPH

Funded by: NIH CFAR Supplement: Minority HIV/AIDS Fund; Ending the HIV Epidemic

Project Period: 8/1/19 - 7/31/20



Mental Health Care Integration for Young Black MSM

Project Summary
Young Black gay, bisexual and other men who have sex with men (YBMSM) have disproportionately high rates of HIV infection and suboptimal rates of engagement in HIV care. High rates of depressive symptoms contribute to this problem; however, treatment for depression is hindered by multiple barriers to mental (MH) care at the patient, provider and clinic levels. There is a need for culturally- and developmentallyrelevant interventions to improve MH care engagement among YBMSM, in order to improve both HIV and MH outcomes. Integration of HIV and MH care could help to reduce disparities affecting YBMSM, if done in a way that is culturally and developmentally relevant. Our long-term goal is to adapt and sustainably implement a set of existing evidence-based care engagement interventions to specifically address HIV and MH care engagement among YBMSM, in an intervention we will call the Cross-disciplinary HIV Integrated with Mental Health Support (CHIMES) model. This CFAR Supplement application proposes a preimplementation study in which we will refine the CHIMES model and comprehensively assess the climate for implementing it in two HRSA/Ryan White-funded clinics in Atlanta, Georgia. The rationale for the project is that the influences on HIV and MH care are often overlapping and/or synergistic, and that cultural and developmental considerations are critically important to understanding these factors. The research study will pursue two specific aims: (1) To identify and describe factors that may shape future implementation of integrated HIV-MH services for YBMSM; and (2) To develop program objectives, methods and protocols for CHIMES, a culturally-tailored intervention designed to enhance engagement in integrated HIV and MH care among YBMSM living with HIV. Our work will be guided by the Consolidated Framework for Implementation Research (CFIR) and conducted in collaboration with a planning group including representatives of the two clinics and a local community-based organization. Upon completion of our Aims, we will have created a detailed roadmap for effective implementation of a culturally- and developmentally-tailored strategy for enhancing uptake of integrated HIV and MH services among YBMSM. The proposed research is highly significant because of its potential to inform effective strategies for improving HIV viral suppression among YBMSM.

Relevance
The proposed project seeks to develop strategies for improving engagement in HIV and mental health care for young Black gay, bisexual, and other men who have sex with men (YBMSM). This project is relevant to public health because YBMSM are disproportionately impacted by HIV and depression, but face more barriers to care for both conditions. Our proposal is responsive to the Ending the HIV Epidemic Initiative mandate to implement evidence-based strategies to improve adherence and retention in care.