Roots of Risk : A model for technology based HIV prevention with Black Youth

Kelisha PeartYouth Campaign Coordinator Black Coalition for AIDS Prevention

Cause| • Black, African and Caribbean people accounted for 18.5% (1/5th) of all new

HIV infections in Ontario (Remis, 2006) In comparison Black people account for only 9% (1/10th)of Toronto’s entire population (Statistics Canada, 2001).

• Rates of HIV infection in Toronto’s Black communities have more than doubled since the year 2000

• Youth in Toronto are increasingly at risk for HIV infection • Youth are the highest infected group in relation to STIs such as Chlamydia

and Gonorrhoea • Low level of HIV knowledge (Roberstion,2007)• Low transfer rate of HIV knowledge • HIV prevention programs in Toronto tend to be temporary and short-term

and are largely based on information (ie. this is how you use a condom)

Black CAP Process|

Recommendation Flow

Chart|

MAC AIDS FUND|

MAC AIDS Fund’s Global Youth HIV Prevention Initiative

August 2008

Result |• ROOTS OF RISK PROGRAM

– Community level intervention – 24 months program– Mix of evidence-informed approaches

• Popular Opinion Leader Model• Social Marketing Design • Youth-led programming

– Involving female and male youth from 30 straight and 10 BMSM community

Objectives| POL

• Recruit 50 youth to act as Popular Opinion Leaders

• Provide youth with the means to distribute resources and information through technologies ( Cell phones)

• Increase HIV/AIDS knowledge transfer

• Develop risk reduction strategies

• Monthly session focusing on HIV related issues

• Distribute condoms, and resources • Promote the campaign in a range of media – print ads, transit ads, and

other events• Increase community access to HIV/AIDS info and services

Social Marketing • Leverage POL network to disseminate HIV

related info• Distribute weekly sexual health and relationship

messages • Create traffic to two of Black CAP’s websites

for youth (onenightyourchoice.com and getthelowdown.ca)

Onenightyourchoice.com

Getthelowdown.ca

Program Process|POL

• Recruitment of 50 POLs

– 30 straight identified, 20 LGBT

– Outreach - Black Youth programming, Community networks, Mass Email, Face Book

• Recruitment Style

– Group session

• POL Orientation Training Session

– 2 Full Day Orientation Training Session

• HIV/STI 101, Effective Outreach,Technology,Privacy, Support (Group Facilitators/POL Leads)

– Receive starter kit – Cell phone, T-shirt, bag, resources ect.

Social Marketing • Monthly Session / POL Campaign Delivery

– STI, HIV, Relationship, Peer counseling, Testing ect – Message development – Creative Marketing – Online skyp meetings

Evaluation• Evaluation, Support & Monitoring

– Pre/mid point and post evaluation, POL lead support, Contact sheet• Celebration

– Congratulate youth for completing the program and receive honorarium – Event that highlight marketing activities by youth, inclusive space for queer and straight

youth, promotional event for POL and there networks to be exposes to campaign.

Model|

Branding|Marketing Strategy

Text Message| POL develop message to inform and

educate peers in language used by youth

References: – Pop culture– Music – Statistics– Services – Current trends or Topics

Text Format|SAMPLE • BODY: (Make luv not war condoms r cheaper

than guns) • KNOWLEGDE: X # of youth btw 14-24 hav

HIV n don’t kno • RIPPLE (Send to 5 friends that u luv) • WEBSITE www.onenightyourchoice.com

Text Examples|• 22000 ppl get swin flu evry1 want 2 wear a mask 33 milli

AIDS cases no 1 wants to wear a condom. Condoms reduces the spread of HIV ~onenightyourchoice.com

• About half of African n Caribbean n black ppl in Ontario who have HIV don’t know. Do u know ur status? ~getthelowdown.ca

• Sex is like Mac Donald (I’m lovin it). Oral is like Subway (Eat fresh). HIV is like Gatorade (Is it in you?). Test 4 HIV 6mth-1yr~getthelowdown.ca

• Beyonce says if u like it u sud hav put a ring on it. A latex one. Rap it up~onenightyourchoice.com

• Ways 2 test 4 HIV a) blood test w/ needle b) rapid test (drop of blood) ~onenightyourchoice.com call 416-3922437

POL Developed Creative Marketing |• Documentary

• Community Events

• Photography

• Youth Zine

• Facebook Twitter

• Weekly HIV info groups

• Concerts

• Clubs

• Creating club events

• Web sites

• Magazine

Tracking the Ripple Effect|

• Website hits

• Monthly reports number of text sent

Evaluation| • Pre – Purpose to identify HIV and STI

knowledge level, risk reduction, frequency of HIV related conversation,

• Mid-term – feedback around program model • Post- Gauge change in knowledge self Peer,

risk behaviour change, frequency of HIV related conversation, suggested program changes

Evaluation Highlights|Demographics:- Age 16-22- Majority are first generation Canadians- All parents were born in Africa or the Caribbean - Listed as religious or did not disclose religion- Most reported HIV negative, or declined to report

HIV Knowledge: Pre program - ½ POL reported that there HIV knowledge was “Average”

Mid-term: ¾ youth express HIV knowledge to be “a lot” at mid point of program

Sexual Health Clinics : Majority don’t go to Clinic

top reasons:

Fear of being judged or embarrassed by staff

Services not friendly towards youth

Provide confidential services

Frequency of HIV related conversations

Pre- Averaged 3-6 conversation per month

Post- Average 6-9 conversation per month

Acquisition of knowledge

Number of text sent: 12000

“I always felt very comfortable to do it, whether people wanted to receive the messages or not.”~ POL (sending out text message)

“I feel like I’m helping out my friends”~ POL (sending out text messages)

“I didn’t feel comfortable once I saw my friends enter the club. So I stopped covering the table”~ POL (Outreach in club)

Lessons Learned|• Testing program- Implementation of buddy testing sub

program- Peer Supporting Peer through the testing process• Cyber Stigma • Mode of communication- Communication starts with SMS

transcends to social networking site then to real world interactions. To obtain STI information but not services for ½ of youth

• Headset- Mobile devices should be equipped with Qwerty boards and Data plans. Multiple send SMS function

•Recruitment- aggressive recruitment in youth LBGT space a result of spaces being undefined and hard to access LGBT youth participation was low.•Retention- Motivation for youth to stay in the program decreases if the initial drive was based getting a free phone or honorarium in comparison to youth who were interested in activism

Next Steps• Research ways to track messages beyond

peer networks (stage two)

• Post evaluation

• Duplication and sustainability