Proyecto PACTo: Enhanced HIV Care Access and Retention for Drug Users in San Juan, Puerto Rico, 2013-2014

This study evaluates the effectiveness of the Enhanced HIV Care Access and Retention Intervention in achieving HIV virologic suppression among HIV-infected substance users in San Juan, Puerto Rico. The implementation process and cost of the enhanced care approach, including implications for cost effectiveness, feasibility of expansion, and sustainability are also included in the evaluation process. This study consists of two multi-component phases: a pre-trial phase and a trial phase. The pre-trial phase consists of ethnographic and pre-implementation interviews, HIV provider surveys and a survey of employees within a community-based agency that is an integral part of trial implementation. Ethnographic and pre-implementation qualitative interviews were conducted prior to implementation of the trial to inform the development of assessment tools and the intervention, and to inform the selection of the appropriate neighborhoods/areas from which to recruit HIV-infected substance users. Employees of Iniciativa Comunitaria de Investigacion, Inc. (ICI), an existing community-based, non-profit organization that is responsible for conducting HIV testing, recruitment and outreach for the study, were invited to complete a survey to assess organizational readiness for change at ICI. HIV providers in major cities in Puerto Rico will be invited to complete a survey to assess their treatment practices and other issues pertaining to HIV care. The trial phase consists of an Assessment Cohort, a multicomponent Enhanced HIV Care Access and Retention Intervention, and an HIV Care Cohort.