Keep It Up

Today, New York City, Los Angeles, San Francisco, Miami, Washington, DC, and Detroit are the epicenters of the HIV/AIDS epidemic in the U.S. Young African American men living in these areas are particularly at risk but difficult to reach and not often the focus of HIV/AIDS prevention efforts.

To address the lack of prevention activities directed at this group, EDC’s Health and Human Development division collaborated with organizations that serve minorities on the development of Keep It Up (KIU), an intervention aimed specifically at young, urban African American men ages 18 to 35. Since New York City has the highest AIDS case rate in the country, the intervention was pilot-tested in Bedford-Stuyvesant, a historically black Brooklyn neighborhood.

“Providing for their families, getting a job—survival—are the priorities for these men. We wanted to design an intervention that took this into account and also reduced the stigma associated with HIV testing,” said EDC’s Deb McLean Leow, who helped pilot-test the intervention.

Unlike other interventions, KIU is customized for black men exclusively. It also offers screening for a variety of health conditions in conjunction with HIV/AIDS testing since young black men have higher rates of other chronic diseases—such as hypertension, diabetes and obesity.

“By embedding HIV testing with other, less stigmatizing health screenings, the overall intervention is more appealing to the target population,” said McLean Leow. “And, the broader focus of KIU helps normalize routine health check-ups for young black men.”

The KIU intervention consists of four core components: Social Marketing, Biological Screening, a Computerized Learning Module, and a Health Profile and Personalized Risk Reduction Plan. The development of each component relied significantly on input from young African American men and women, as well as experts in the field of HIV/AIDS prevention. Specific elements were adapted for the pilot test to ensure the appeal in Bedford-Stuyvesant and eventually other settings nationwide where young black men live and work.

The Social Marketing component enlisted Talib Kweli, a local, well-regarded hip-hop artist, as the spokesperson. To recruit participants, the KIU team employed peer-to-peer network recruitment, $50 “thank you” incentives, and goodie bags of t-shirts and other KIU-emblazoned items.

The free Biological Screening took place at a neutral, easily accessible, non-medical building at Medgar Evers College, centrally located in Bedford-Stuyvesant. The non-invasive screenings included body mass index measurements, blood pressure readings, lung function assessments, and a finger-prick blood sample for cholesterol, diabetes, and HIV testing.

While participants waited for their results, they completed the 45-minute Computerized Learning Module component. This educational component emphasized the importance of safe health behaviors and staying healthy through games and other scenarios. The overarching message: “Keep it up…get your health checked out…It’s for you, it’s for me, it’s for us, it’s for our community.”

After completing the learning module, the men received their Health Profile and Personalized Risk Reduction Plans. Based on the results, men were referred to the appropriate resources to obtain further treatment. They also returned for a 3-month follow-up appointment.

A small sample of 116 men participated in the pilot-study: 96% thought the learning module showed realistic ways for men to protect their sexual health, almost all of them made changes to their exercise routine by the 3-month follow up, and 91% said they had already referred family and friends to KIU. None of the men tested positive for HIV/AIDS.

“That’s what we wanted to find out—how accessible, acceptable, and relevant it was—in addition to being effective in reducing health risks,” said McLean Leow. “Based on the preliminary results of the pilot study, the intervention looks very promising.

So what are the next steps? Conducting an efficacy trial of KIU—to test whether it produces positive results under ideal circumstances—and testing the feasibility of the intervention for use in other settings with the hope that it can be implemented it in other cities across the U.S.