SPNS Community Involvement Project Local Qualitative Process Evaluation

Background: The Special Projects of National Significance (SPNS) initiative is a Health Resources and Services Administration (HRSA) HIV/AIDS program that sought to progress understanding through the support, development and evaluation of inventive models of HIV treatment aimed at young men who have sex with men (YMSM) of color between the ages of 13-24. The project targeted YMSM in Alameda County, California. Methods: Goals were to 1) improve health, well-being, and quality and length of life; and 2) increase medical adherence and decrease unsafe sexual practices. During the Spring and Summer of 2010, 20 semi-structured face-to-face interviews were performed with key informants including both project staff and program participants; and each interview lasted approximately 60 minutes. Identification of major domains served as the basis for content analyses. Results: Forty-eight percent of youth identified as Black, 35% as Latino; and were on average, 21 years old, ranging from 17 years to 24 years. Primary themes were delineated in 9 main categories: staff perceptions of overarching project aims; successes; challenges; overcoming barriers and facilitating success; outreach, recruitment, and enrollment; referral, treatment, and follow-up; challenges of YMSM, seroconversion, and pre-diagnosis; post-diagnosis: linkage to care, support, and youth outcomes; and serostatus disclosure. Conclusion: Findings from interviews with staff and youth intersected in three areas: mental health problems after diagnosis, HIV stigma and serostatus non-disclosure, and non-sexual health youth challenges. There were a number of lessons learned and ideas for future directions.