JUNTOS Referral Network for HIV Prevention and Treatment

Overseen By Jorge Limia, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Miami

Disqualifiers: Unable to consent, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 3 months

245 Participants Needed

Trial Summary

What is the purpose of this trial?

The objective of this study is to evaluate the JUNTOS Referral Network as an implementation strategy to enhance the reach of HIV-prevention and treatment services to Latino gay, bisexual, and other men who have sex with men (MSM).

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the JUNTOS treatment for HIV prevention and treatment?

The research highlights the importance of strong connections between general physicians and HIV specialists, which can improve the quality of HIV care. Additionally, optimizing health care systems and engaging physicians in HIV care can enhance treatment outcomes, suggesting that a well-connected referral network like JUNTOS could be effective in improving HIV prevention and treatment. ^{1 2 3 4 5}

How does the JUNTOS Referral Network treatment for HIV differ from other treatments?

The JUNTOS Referral Network is unique because it focuses on creating a network of services to connect people with HIV to comprehensive care, rather than being a direct medical treatment. It emphasizes linking individuals to existing community resources and services, addressing immediate needs like housing, which can be more appealing and effective for marginalized populations. ^{6 7 8 9 10}

Research Team

Audrey Harkness, PhD

Principal Investigator

University of Miami

Eligibility Criteria

This trial is for Latino gay, bisexual, and other men who have sex with men (MSM) as part of an effort to improve HIV-prevention and treatment services. Specific eligibility criteria are not provided.

Inclusion Criteria

Reports suboptimal fidelity to pre-exposure prophylaxis (PrEP) referral guidelines (<80% fidelity)

Identifies as Latino/a/x or Hispanic

Lives in Miami-Dade County, Broward County, or Palm Beach County and anticipates living there for the next three months

Exclusion Criteria

I work as an HIV counselor in a prison.

Latino MSM: Unable to consent

HIV test counselors: Unable to consent

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants access the JUNTOS Referral Network or referral sheet for HIV prevention and treatment services

3 months

Ongoing access through app/website

Follow-up

Participants are monitored for use of biomedical HIV prevention/treatment and HIV status

3 months

Self-report assessments

Extended Follow-up

Continued monitoring of referral fidelity and HIV prevention/treatment engagement

6 months

Treatment Details

Interventions

• JUNTOS

Trial Overview The study is evaluating the effectiveness of the JUNTOS Referral Network in increasing access to HIV-prevention and treatment services among the target population.

Participant Groups

Group I: JUNTOS Experimental Treatment 1 Intervention

Participants in this group will get access to the JUNTOS Referral Network website/app through the 6-month follow up (HIV test counselors) and 3-month follow up (Latino MSM).

Group II: Referral Sheet - HIV test counselors Active Control 1 Intervention

Participants in this group will get access to the referral sheet through the 6-month follow up (HIV test counselors) and 3-month follow up (Latino MSM).

Who Is Running the Clinical Trial?

University of Miami

Lead Sponsor

Trials

976

Recruited

423,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Generalist physicians who are more connected to HIV specialists show improved quality in prescribing HIV medications, with each additional connection leading to a 1.46 percentage point increase in medication quality for their patients.

Enhancing the network connections between generalists and HIV specialists could potentially reduce annual HIV infections by up to 6%, indicating that collaboration among healthcare providers is crucial for better patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physician network connections to specialists and HIV quality of care. Stecher, C.[2022]

A study analyzing health resource utilization among people living with HIV in British Columbia identified distinct profiles of care, highlighting differences between those actively involved in non-HIV care and those with minimal healthcare interaction after initial linkage to care.

The findings suggest that tailored reengagement strategies are necessary to improve HIV care, focusing on missed opportunities in non-HIV healthcare and enhancing collaboration with physicians involved in HIV treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Informing Targeted Interventions to Optimize the Cascade of HIV Care Using Cluster Analyses of Health Resource Use Among People Living with HIV/AIDS. Krebs, E., Min, JE., Bayoumi, AM., et al.[2019]

A study of 21,880 HIV-positive individuals in Haiti found that multi-month dispensing (MMD) of antiretroviral therapy significantly improved retention in care, with a 24.2% increase in retention likelihood when extending dispensing intervals by 30 days.

While MMD is effective for new ART recipients, extending dispensing lengths for those already receiving longer supplies may negatively impact retention, indicating the need for careful consideration in treatment plans.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Estimating the effect of increasing dispensing intervals on retention in care for people with HIV in Haiti. Parrish, C., Basu, A., Fishman, P., et al.[2023]

Strengthening existing antiretroviral therapy (ART) programs may provide significant health benefits in HIV prevention, as many patients are lost at various stages of the care cascade, including testing and treatment initiation.

The study proposes a new 'side door' approach to ART, suggesting that understanding patient health-seeking behaviors is crucial for improving the effectiveness of ART programs and ensuring more patients receive timely treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A side door into care cascade for HIV-infected patients? Hallett, TB., Eaton, JW.[2022]

Over half of the 5836 participants in the study experienced gaps in Medicaid enrollment, with male sex and younger age being significant factors associated with these gaps.

Despite these gaps, many individuals maintained viral suppression (VS) after the gap, particularly those who were already virally suppressed before the gap, highlighting the importance of continuous access to antiretroviral therapy and the need for initiatives to support Medicaid enrollment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors Associated With Gaps in Medicaid Enrollment Among People With HIV and the Effect of Gaps on Viral Suppression. Monroe, AK., Myint, L., M Rutstein, R., et al.[2021]

The California Bridge Project successfully linked 49.7% of persons of color and 41.6% of injection drug users (IDUs) living with HIV to care and prevention services, demonstrating effective outreach strategies.

IDUs were less likely to engage with HIV-specific programs but showed a preference for community services that address immediate needs, such as housing, indicating the importance of tailored interventions for marginalized populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Linking HIV-infected persons of color and injection drug users to HIV medical and other services: the California Bridge Project. Molitor, F., Kuenneth, C., Waltermeyer, J., et al.[2022]

The study identified strengths in the care network for people with HIV/AIDS, highlighting the importance of emotional and humanized support provided by health professionals and family members.

However, it also revealed weaknesses, such as a restricted network that struggles to meet the increasing demand for care, indicating a need for improvements in the overall support system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Potentialities and weaknesses in the care network of people with HIV/AIDS. Tonnera, LC., Meirelles, BH.[2017]

A study of 30 HIV/AIDS service organizations in Baltimore revealed that most agencies are well-connected through client referrals and information exchange, but structured coordination is less common, indicating a need for more organized collaboration.

Five organizations were identified as central to the network, playing critical roles in service delivery, which highlights the importance of these agencies in enhancing the effectiveness of HIV/AIDS care in the community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interorganizational relationships among HIV/AIDS service organizations in Baltimore: a network analysis. Kwait, J., Valente, TW., Celentano, DD.[2019]

The combination intervention of acute HIV testing, contract partner notification (cPN), and social contact referral was more effective in eliciting referrals from women and previously diagnosed individuals, suggesting targeted strategies could enhance HIV testing and linkage to care.

When cPN was used alone, it still showed benefits, particularly for women and those with a history of HIV diagnosis, indicating that even simplified approaches can be effective in improving contact tracing and testing outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characterizing Network-Based HIV Testing Interventions to Guide HIV Testing and Contact Tracing at STI Clinics in Lilongwe, Malawi. Maierhofer, CN., Powers, KA., Matoga, MM., et al.[2023]

The study found that interagency networks involved in HIV care showed increased collaboration, particularly in information exchange and client referrals, indicating improved connectivity among organizations serving people living with HIV.

Despite the overall increase in collaboration, the frequency of interactions was lower when focusing on more regular engagements (monthly or greater), suggesting that while connections are growing, consistent communication may still need improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring Changes in Interagency Collaboration Following AIDS United's Positive Charge: A Five-Site HIV Linkage and Retention in Care Program. Jain, KM., Maulsby, C., Kinsky, S., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Physician network connections to specialists and HIV quality of care. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Informing Targeted Interventions to Optimize the Cascade of HIV Care Using Cluster Analyses of Health Resource Use Among People Living with HIV/AIDS. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Estimating the effect of increasing dispensing intervals on retention in care for people with HIV in Haiti. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

A side door into care cascade for HIV-infected patients? [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Factors Associated With Gaps in Medicaid Enrollment Among People With HIV and the Effect of Gaps on Viral Suppression. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Linking HIV-infected persons of color and injection drug users to HIV medical and other services: the California Bridge Project. [2022]

7. Brazil pubmed.ncbi.nlm.nih.gov

Potentialities and weaknesses in the care network of people with HIV/AIDS. [2017]

8. United States pubmed.ncbi.nlm.nih.gov

Interorganizational relationships among HIV/AIDS service organizations in Baltimore: a network analysis. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Characterizing Network-Based HIV Testing Interventions to Guide HIV Testing and Contact Tracing at STI Clinics in Lilongwe, Malawi. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Exploring Changes in Interagency Collaboration Following AIDS United's Positive Charge: A Five-Site HIV Linkage and Retention in Care Program. [2018]