A Longitudinal Study of HIV Incidence and Engagement in HIV Prevention and Care

Proyecto V.I.D.A. (VIH Información Distribución y Acción): A Longitudinal Study of HIV Incidence and Engagement in HIV Prevention and Care Among MSM in Colombia is designed to address critical needs in HIV prevention research by using innovative technology to enroll and follow large-scale epidemiological cohorts of those at highest risk of infection in Latin America.

In partnership with CES Universidad in Colombia, Proyecto VIDA will replicate established Internet- based strategies—employed successfully by the research team in Together 5000 and AMETHST—to enroll a new cohort of 5,000 HIV-negative men who have sex with men (MSM) ages 18 to 49 in Colombia and follow them annually for three years. The design features of this study were chosen specifically to identify (a) individual-, network-, and contextual-level determinants of HIV seroconversion and PrEP uptake/discontinuation, (b) participation/retention in the HIV continuum of care including individual-/network-/contextual-level determinants, and (c) missed HIV prevention opportunities among those seroconverting or stopping PrEP care. Our goal is to inform interventions to further reduce HIV acquisition and transmission. We chose to focus on MSM in Colombia because they are disproportionately impacted by HIV—HIV prevalence estimates among MSM in Colombia ranged from 11.4-26.4%. With ~52 million residents, Colombia is the 3rd largest country in Latin America, the 2nd largest in South America, and the largest Spanish-speaking country in South America.

Participants will complete annual at-home self-administered rapid HIV testing (results submitted via a digital photo of the test paddle), as well as at-home online surveys—a strategy we have used successfully in Together 5000 and AMETHST. In addition to being referred for care, study participants who HIV seroconvert or quit PrEP will complete a semi-structured telephone/zoom interview to identify missed HIV prevention opportunities, as well as contextual factors/circumstances surrounding seroconversion. We will also monitor newly seroconverting participants’ movement through the HIV care continuum or PrEP care.

Aim 1 (UG3 Phase, FY1-2): Establish a cohort of 5,000 HIV-vulnerable (HIV-negative) MSM in Colombia, all of whom complete baseline online surveys and at-home self-administered HIV testing, as well as consent for longitudinal follow-up. In so doing, determine PrEP uptake and HIV incidence and engagement in HIV treatment 12 months after study enrollment (in FY2).

Aim 2 (UH3 Phase, FY3-5): Follow the cohort for 3 years to identify (a) individual-, network-, and contextual-level determinants of HIV seroconversion and PrEP uptake/discontinuation, (b) participation/retention in the HIV continuum of care including individual/network/contextual-level determinants, and (c) missed HIV prevention opportunities among those seroconverting or stopping PrEP care. Our goal here is to inform interventions to further reduce HIV acquisition and transmission.