Project Silk: A youth-centered structural HIV intervention model for Black men who have sex with men and transgender women

In the United States, young Black men who have sex with men (YBMSM) and young Black transgender women (YBTW) are disproportionately impacted by HIV. However, few evidence-based models developed specifically by and for YBMSM and YBTW communities across the HIV prevention and care continuum exist. The objective of this paper is to describe a comprehensive youth-centered structural HIV intervention model that combines structural and behavioral high-impact prevention to provide a recreation-based community health space for YBMSM and YBTW. Project Silk pairs recreational activities with HIV and STI prevention, counseling, testing, and referral services on- and off-site, nested HIV care linkage/re-engagement, onsite ancillary broad-spectrum social services and mental health care, and social support and social capital initiatives intended to facilitate HIV risk reduction. By incorporating strongly targeted recruitment and engagement strategies and local tailoring, this innovative structural model can be deployed at scale for communities in where programmatic infrastructure is lacking.