According to Nikhil Prachand, director of the Surveillance Epidemiology and Research Section at Chicago Department of Public Health ( CDPH ), the agency's Project CHAT initiative strives to get "everywhere" in the community.
"We go out to bars, clubs, beaches, bathhouses, parks, hobby groups, volleyball leagues—you name it, we're there," said Prachand. "We work to find everything from hidden spots to places on Halsted—we strive to get to every venue where gay and bisexual men congregate."
The initiative sends out CDPH staff to various venues throughout the city in order to engage gay and bisexual men in conversations about their perceptions and behaviors. This year marks Project CHAT's fourth cycle. According to CDPH, about 2,200 men have been interviewed in about 300 venues throughout the city. Its data is used to help formulate the agency's strategies to reduce HIV transmission in the city.
"By actually being there and getting information directly from people—we're not collecting it through a clinic, for example—it's a dialogue between the community and us," added Prachand. "We let the community tell the whole story."
Noting an upsurge in interest in men's health issues, Prachand said that it's been necessary to distinguish Project CHAT's research from other studies in Chicago: "We're trying to separate ourselves a little bit and point out that we're the original survey, and show that our survey's been used most widely."
CDPH staff usually takes about six months to design questions for a survey. They poll venue owners and community members to first gauge what concerns might be especially pertinent for gay and bisexual men. The surveys are then carried out over the course of the following six months.
Prachand said that researchers follow a standard set of questions—polling respondents about demographic matters and risk behaviors, for example—but added that the survey is tailored to address new issues.
"In 2005, when there was all this concern over crystal meth, we were able to say that we had data about crystal meth use, and say that we could add questions to understand it more," he noted. "Sure enough, we found that there was a perception that most gay men were running around using crystal meth, but we were [able to respond], 'No, less than one out of ten gay men have ever used crystal meth in their life.'"
This year, many of the new questions pertain to public perceptions of pre-exposure prophylaxis ( PrEP ).
"We've been asking PrEP questions for the last six years," according to Prachand. "We've seen the perception and knowledge of PrEP increase incrementally over that time. But this is the first survey since the FDA approval, and [widespread] third-party reimbursement, so this year we're looking to do a thorough examination of PrEP utilization and access difficulties. We are asking how much it's costing and whether it is changing behaviors. Because the surveys occur at regular intervals, we're able to keep up with current events in the community."
Officials try to visit 50 to 60 venues over the course of each cycle. About five-to-seven CDPH staffers take part, and will randomly approach members of the public to participate. Participants are paid $75 and are offered an HIV test once they finish the survey.
"We do a lot of interface with a lot of venue owners—venue owners know us," said Edgar Gutierrez, Project CHAT's project coordinator. "It's a whole random process, but, once we get there, we're a very friendly face. We like walking away from an event with a participant feeling they've had a 'deep' relationship with the Department of Public Health."
"It's a very customer-oriented approach," added Prachand. "The approach is very scientific, but we rely on the community's input. We rely on building a relationship with the community. We can't just rely on the science. If we showed up with white lab coats and clipboards, we'd never get anywhere."
