(March 2016- September 2017; CIHR)
Principal Investigator(s): Jean Shoveller and Rod Knight
Co-Investigators and Knowledge Users: Mark Gilbert (BCCDC); Perry Kendall (BCMoH); Jesse Brown (YouthCO HIV & Hep C Society); John Oliffe; Kate Shannon; John Coggon; Bohdan Nosyk; Will Small; Shira Goldenberg; Nathan Lachowsky; Danya Fast; Andrea Krüsi and Putu Duff.
This study focuses on the adaptation of promising interventions that have high relevance to a priority population for HIV and sexually transmitted and blood-borne infections (STBBI) prevention and linkage to care – young gay, bisexual and other men who have sex with men (MSM) under 30 years of age. This study is designed to identify the most efficacious and scalable combinations of interventions (including biomedical, behavioural and structural) as well as to identify strategies for successfully adapting interventions so as to have maximum impact during key transition periods in the life course (e.g., from adolescence to early adulthood). The activities proposed for our team will focus on our local context in British Columbia (BC) the British Columbia Centre for Disease Control’s Get Checked Online (GCO) and YouthCO HIV and Hep C Society’s Mpowerment YVR are preparing to scale-up. These are two promising and potentially synergistic facets of a multi-faceted intervention approach to addressing HIV/STBBI among young MSM. The objectives of this study are to:
- Establish an integrated and multi-disciplinary team of researchers and knowledge users who will build capacity and identify new strategies for successfully adapting promising interventions that address young men’s HIV/STBBI prevention and care needs in British Columbia (BC);
- Utilize GCO and Mpowerment YVR to identify new opportunities for using implementation science frameworks and tools to inform the adaptation and scale-up of integrated, effective and context-sensitive interventions; and
- Identify a new program of research to be launched in BC that will inform effective and ethical adaptation and scale-up of interventions that address HIV/STBBI across a diversity of young men in BC.
The proposed research will be conducted in Vancouver, Canada, and will use a variety of methods to build capacity and identify new strategies for successfully adapting GCO and Mpowerment to address young MSM’s HIV/STBBI prevention and care needs. These methods include: (1) a scoping study to present a ‘snapshot’ of empirical studies in the peer-reviewed literature to assess existing measures/instruments (quantitative and qualitative) that assess STBBI (including HIV) stigma; (2) a small, exploratory study using semi-structured, in-depth interviews with 20 young MSM (ages 15-30) and 20 service providers and policy makers in Vancouver to identify critical adaptation strategies for key transitional periods in young MSM’s life course; (3) the development of a ‘built-for-purpose’ evaluation framework and a corresponding set of factors that impact implementation adaptation and outcomes across: structural, organizational, provider, patient/individual, and innovation levels; and (4) Three Participatory Planning Summits to establish an ongoing community-based structure to guide the proposed and future research, intervention adaptation, as well as on-going planning/practice collaborations.
By using implementation science approaches, our team offers a way to go beyond simply describing the problem – and to focus on building an evidence base for implementing and adapting context-sensitive solutions that address fundamental strategies to reduce stigma, offer new options for accessing treatment, and build new skills and leadership capacity among young MSM. As integral members of our team, the knowledge users (BC Ministry of Health; BCCDC; YouthCO), all of whom are influential decision makers within BC, share in the aim of using new research to adapt GCO and MPowerment YVR to reduce HIV/STBBI stigma and risk among young MSM.