# A Comprehensive Community-based Strategy to Optimize the HIV Prevention and Treatment Continuum for Youth At HIV Risk, Acutely Infected and with Established HIV Infection

> **NIH NIH U19** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2021 · $2,429,844

## Abstract

Project Summary/Abstract
 America's increasing HIV epidemic among youth aged 12-24 and our concurrent failure to identify, link to
care, and achieve viral suppression among youth living with HIV (YLH) suggests the need to identify novel
community-based strategies to leverage gateways and settings where high risk and infected youth can be
engaged in HIV prevention and treatment. Scientific successes reducing HIV viral reservoirs among acutely
infected infants, stopping HIV transmission from HIV-infected adults with undetectable viral loads, and
documenting the efficacy of Treatment as Prevention (TASP) suggest strategies to reduce the trend of
increasing adolescent HIV infections. This U19 will evaluate the usefulness of these advances for youth aged
12-24 at the highest risk of acquiring HIV- gay, bisexual, transgender youth (GBTY) and homeless youth (HY)
– as well as youth living with HIV (YLH) in two HIV epicenters (Los Angeles and New Orleans).
 All GBTY and HY at five gay-identified community-based organizations (CBO) and homeless shelters will be
screened over 18 months. From these screenings, a cohort of 220 YLH and 1,500 highest risk seronegative
GBTY and HY will be formed. Over 24 months, this cohort will be repeatedly tested at four month intervals for
sexually transmitted infections (STI) and serious drug use, and with 4th Gen HIV tests if seronegative, in order
to identify acutely infected youth, engage youth in medical care, and monitor outcomes. Youth are triaged to:
 Study 1: Acute infection. Using 60 ARV-naive YLH with established infection as controls, we expect to
identify 36 YLH with acute infection. All youth with acute infections will be aggressively treated with at least four
highly potent antiretroviral therapies (ARV) and repeatedly assessed to examine if prolonged viral suppression
is achieved, with reduced viral reservoirs to potentially allow ARV- free HIV remission.
 Study 2: Stepped care for YLH. Adapting strategies to manage chronic illnesses, we will conduct a RCT
comparing a Standard Care Arm (repeated assessments every four month and an Automated Messaging and
Monitoring Intervention [AMMI]) to Stepped Care. In the Stepped Care Arm, increasingly more intense
interventions are delivered if viral load is detectable: a) the Standard Care Arm; b) an AMMI that is tailored to
comorbidities of the specific YLH; or c) a Coach to support during crises, make treatment referrals, and brief
interventions. Dried blood spots will monitor viral load and, on a small sample, ARV adherence over time.
 Study 3: Engaging seronegative youth in the HIV Prevention Continuum. Youth will be randomized to either:
a) an AMMI Arm; b) Peer-Support plus AMMI Arm; c) eNavigator and an AMMI arm; or d) Peer-Support plus
eNavigator plus AMMI Arm. Each condition aims to optimize the HIV Prevention Continuum.
 An interdisciplinary team of basic, clinical, and applied researchers with expertise in HIV, STI, behavioral
interventions, biomedical interve...

## Key facts

- **NIH application ID:** 10397368
- **Project number:** 3U19HD089886-05S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** MARIA ISABEL FERNANDEZ
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $2,429,844
- **Award type:** 3
- **Project period:** 2021-06-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10397368

## Citation

> US National Institutes of Health, RePORTER application 10397368, A Comprehensive Community-based Strategy to Optimize the HIV Prevention and Treatment Continuum for Youth At HIV Risk, Acutely Infected and with Established HIV Infection (3U19HD089886-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10397368. Licensed CC0.

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