Keeping Them in "STYLE": Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care

This research evaluates the effectiveness of a programme created for HIV-infected African-American and Latino young men who have sex with men (YMSM), located in North Carolina, United States, called STYLE (Strength Through Youth Livin’ Empowered). The programme was created to engage and retain this population in HIV primary care services. [Footnotes have been removed by the editor.]

"To address the medical care needs of this underserved population, in 2005, the Health Research and Services Administration (HRSA) created the YMSM of Color Initiative. Utilizing a social marketing campaign targeting youth and members of their sexual and social networks, testing and outreach on college campuses and within the broader community, and a tightly linked medical-social support network, ...STYLE ..., a novel intervention that sought to diagnose, engage, and retain HIV-positive black and Latino YMSM in HIV primary care services [was created]...."

Services included: a peer outreach worker, a case manager, and members of the research staff that formed a medical-social support network for the youth; the creation of weekly support group meetings; and availability of members of the research staff by text and/or phone to assist with appointment scheduling or to answer medical questions. HIV-positive YMSM, identified at STYLE-sponsored HIV testing events or through HIV testing conducted through partner agencies and local health departments, received an appointment with a physician within 72 hours, "creating a near-immediate connection to medical care. Partner agencies and health departments had a strong incentive to refer YMSM to [this] program because it was the only program with services specifically [focusing on] YMSM of color in the region.

While both black and Latino HIV-infected YMSM were recruited into the study, printed outreach materials bearing the STYLE logo were targeted specifically for black MSM; a similar campaign was not designed for Latino MSM. However, other HIV/STD- [HIV/sexually transmitted infection (STI)-] related information distributed at STYLE events and at STYLE clinical sites were made available in Spanish.

In addition to HIV medical care services, STYLE provided clients with ancillary social support services, including case management and support groups, through a partnership with a local AIDS Service Organization (ASO). STYLE was able to leverage the resources of an academic medical center, an ASO and a local historically black University (HBU) as part of an overall strategy to identify, test, and link HIV-positive YMSM of color into medical care."

For this study, 81 YMSM were enrolled; two-thirds of the cohort was newly diagnosed; 83% identified as African American and 11% as Latino. "The pre-STYLE cohort attended 67% of their visits, compared to 80% of attended visits by those enrolled in STYLE (t statistic = 2.16; p = 0.03).... [P]eople who did not meet our strict definition of regular care still attended the majority of their scheduled clinic appointments and maintained consistent contact with program staff through email, SMS texting or attendance at weekly support group meetings. Text messaging and other innovative technologies have been used successfully to increase clinic attendance, improve medication adherence, assist adults and adolescents with chronic disease management, and promote healthy behaviors such as diet, exercise and smoking cessation. Future research should evaluate the use of mobile phone and Internet-based interventions such as adherence counseling, and the ability to schedule walk-in appointments online as a way to maintain greater communication and connection between youth and their HIV care providers."