Adapting a mobile HIV prevention app to increase uptake of HIV and STI testing among rural men who have sex with men

改造移动艾滋病毒预防应用程序，以提高农村男男性行为者对艾滋病毒和性传播感染检测的接受度

• 批准号: 10213963
• 负责人: Jeb Jones
• 金额: $ 56万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213963
• 关键词: AIDS prevention; Address; Affect; Alcohol or Other Drugs use; American; Attitude; Biological; Caring; Cellular Phone; Charge; Data; Data Collection; Early Diagnosis; Effectiveness; Epidemic; Epidemiology; Feedback; Frequencies; Future; Geography; Goals; HIV; HIV Infections; Health Personnel; Health Resources; Healthcare; Home environment; Human immunodeficiency virus test; Hybrids; Incidence; Infection; Internet; Intervention; Latino; Mediating; Mental Health; Methods; Modification; Participant; Persons; Phase; Population; Prevention program; Prevention strategy; Preventive Intervention; Preventive service; Provider; Qualitative Methods; Randomized Controlled Trials; Reporting; Research Design; Respondent; Rest; Risk; Risk Assessment; Rural; Rural Community; STI prevention; Same-sex; Self Administration; Self Assessment; Self Efficacy; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Social Environment; Southeastern United States; Suburban Population; Surveys; Testing; United States; United States Dept. of Health and Human Services; Update; Urban Population; Viral; age group; arm; base; cost; efficacy testing; experience; follow-up; health care settings; high risk; infection risk; innovation; intervention cost; intervention effect; intervention program; men; men who have sex with men; mobile application; motivational enhancement therapy; pre-exposure prophylaxis; programs; randomized controlled design; rectal; rural Americans; rural area; sexual HIV transmission; sexual identity; smartphone Application; social stigma; success; synergism; transmission process; trend; trial design; uptake

Abstract Uptake of HIV/STI testing among men who have sex with men (MSM) in the rural southern US is low. However, HIV/STI testing is a fundamental gateway to preventive services, such as pre-exposure prophylaxis (PrEP), and treatment provision. Thus, it is critical that we identify methods to increase uptake of HIV/STI testing among this population that is disproportionately affected in terms of HIV and STI incidence. Because of the biological synergy in transmission and acquisition risk between HIV and STIs, programs that target both HIV and STIs will have a greater epidemiological impact compared to programs that treat these infections in isolation. We propose to adapt an existing, efficacious HIV prevention app, HealthMindr, for MSM in rural areas to address issues specific to this population such as increased experiences of stigma and reduced access to culturally competent care. We will then test the efficacy of the adapted HealthMindr app to increase uptake of HIV/STI testing over 24 months of follow-up among MSM in the rural South. The app will include components for self-administered risk assessments, developing and supporting a plan for frequent HIV/STI testing, and the ability to order HIV/STI at-home self-test kits. Previous trials of app-based HIV prevention have provided self- test kits free of charge. It is an open question whether men would use self-test kits if they were available at a charge. Additionally, despite the availability of free HIV/STI self-test kits, large proportions of men still do not complete HIV tests and even fewer complete STI tests. Thus, we will evaluate the effect of two different intervention components on HIV/STI uptake in a 2x2 factorial trial design: cost of HIV/STI self-test kits ordered through the app (free versus self-pay) and a motivational interview to enhance the existing app content and increase self-efficacy to develop and follow through with a testing plan. All participants will receive the new MyHealth app, redeveloped from the HealthMindr app for rural MSM. Men in the control arm (Arm 1) will have access to self-pay HIV/STI self-test kits and will not receive a motivational interview, men in Arm 2 will have access to self-pay HIV/STI self-test kits and will receive a motivational interview, men in Arm 3 will have access to free HIV/STI self-test kits and will not receive an motivational interview, and men in Arm 4 will have access to both free HIV/STI self-test kits and a motivational interview. This study design will allow us to observe the main effects of the cost of HIV/STI self-test kits and the motivational interview, as well as the interaction between the two interventions, on HIV/STI testing uptake over 24 months of follow up.

抽象的 美国南部农村地区的男男性行为者 (MSM) 接受 HIV/STI 检测的比例较低。 然而，艾滋病毒/性传播感染检测是预防服务的基本途径，例如暴露前预防 （PrEP）和治疗规定。因此，我们必须找到增加 HIV/STI 感染率的方法 在艾滋病毒和性传播感染发病率方面受到不成比例影响的这一人群中进行检测。由于 HIV 和 STI 之间传播和感染风险的生物协同作用，针对两者的计划 与治疗这些感染的项目相比，艾滋病毒和性传播感染将产生更大的流行病学影响。 隔离。我们建议为农村地区的 MSM 改造现有的有效艾滋病毒预防应用程序 HealthMindr 解决该人群特有的问题，例如耻辱经历增加和获得服务的机会减少 具有文化能力的护理。然后，我们将测试改编后的 HealthMindr 应用程序的功效，以提高对 对南方农村地区的男男性行为者进行了超过 24 个月的艾滋病毒/性传播感染检测。该应用程序将包含组件 进行自我管理的风险评估，制定和支持频繁的艾滋病毒/性传播感染检测计划，以及 能够订购 HIV/STI 家庭自检套件。之前基于应用程序的艾滋病毒预防试验已经提供了自我 免费测试套件。如果有自检工具，男性是否会使用，这是一个悬而未决的问题。 收费。此外，尽管有免费的艾滋病毒/性传播感染自检套件，但很大一部分男性仍然没有这样做 完整的艾滋病毒检测，而完整的性传播感染检测则更少。因此，我们将评估两种不同的效果 2x2 析因试验设计中 HIV/STI 吸收的干预措施：订购 HIV/STI 自检套件的成本 通过应用程序（免费与自付费）和动机访谈来增强现有的应用程序内容和 提高制定并执行测试计划的自我效能。所有参与者都将收到新的 MyHealth 应用程序是根据 HealthMindr 应用程序重新开发的，适用于农村 MSM。控制臂（第 1 臂）中的人员将有 第 2 组的男性将获得自费的 HIV/STI 自检套件，并且不会接受动机性访谈 第 3 组的男性将获得自付费用的 HIV/STI 自检套件，并将接受动机性访谈 获得免费的 HIV/STI 自检套件，并且不会接受动机性访谈，第 4 组中的男性将接受 获得免费的艾滋病毒/性传播感染自检套件和动机访谈。这项研究设计将使我们能够 观察 HIV/STI 自检套件和动机访谈的成本的主要影响，以及 两种干预措施之间的相互作用，对 24 个月的随访中 HIV/STI 检测的采用率产生影响。

项目成果

Willingness to use and preferences for long-acting injectable PrEP among sexual and gender minority populations in the southern United States, 2021-2022: cross-sectional study.

• DOI: 10.1002/jia2.26077
• 发表时间: 2023-03
• 期刊: Journal of the International AIDS Society
• 影响因子: 6

Willingness to Participate in and Preferences for Studies of mHealth HIV Prevention Interventions: Cross-Sectional Study Among Sexual and Gender Minority Groups in the Southern United States.

参与移动医疗艾滋病毒预防干预研究的意愿和偏好：美国南部性少数群体的横断面研究。

• DOI: 10.1007/s10461-023-04005-3
• 发表时间: 2023
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Jones,Jeb;Stephenson,Rob;Edwards,OWinslow;Merrill,Leland;Martinez,CristianAcero;Sullivan,PatrickS
• 通讯作者: Sullivan,PatrickS