PrEP Initiation and Adherence among Black SMM: A Social Network-Level Intervention

黑人 SMM 中 PrEP 的启动和坚持：社交网络级别的干预

基本信息

批准号：
10403324
负责人：
DEMARC A HICKSON
金额：
$ 30.74万
依托单位：
US HELPING US, PEOPLE INTO LIVING, INC.
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-30 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10403324
关键词：
18 year old AIDS prevention Address Adherence Age Alcohols Americas Area Behavior Behavioral Bisexual Caring Characteristics Clinical Communication Communities Data Decision Making Diagnosis Diffuse Diffusion of Innovation Discrimination Drug usage Epidemic Evaluation Failure Focus Groups Gays Goals HIV HIV Seronegativity HIV diagnosis Health system Homophobia Human immunodeficiency virus test Incidence Individual Influentials Injectable Interpersonal Relations Intervention Latino Manuals Medical Methodology Methods Modeling Motivation Network-based Outcome Participant Phase Pilot Projects Population Prevalence Prevention Prevention strategy Primary Prevention Procedures Protocols documentation Provider Public Health Recommendation Research Research Personnel Resources Role Services Social Network Spottings Structure Testing Trust United States National Institutes of Health Universities Washington Work acceptability and feasibility age group aged base black men community based research condoms cost effective design effectiveness study experience health care settings high risk innovation intervention refinement member men men&apos s group multidisciplinary patient-clinician communication peer pre-exposure prophylaxis preference prospective racial disparity racism recruit sexual minority skills social social norm social stigma social structure substance use theories therapy development uptake

项目摘要

PROJECT SUMMARY Background. The social networks of Black men, including Black gay, bisexual and other Black sexual minority men (SMM), influence their decision-making and HIV-related behaviors (e.g., condom use, HIV testing). Social networking strategies (SNS) interventions have been successful at increasing HIV testing among Black SMM who had never been tested and with unknown HIV status in Washington, D.C. (McCree et al., 2013; Baytop et al., 2014). A recent differential effectiveness study among Black SMM in Washington, DC (conducted at Us Helping Us) demonstrated SNS to be superior to venue testing and partner services in recruiting men that had never been tested (Baytop et al., 2014). SNS interventions also circumvent structural barriers to pre-exposure prophylaxis (PrEP) such as stigma, discrimination and medical mistrust. The proposed study aims are to design and open-phase pilot a low-intensity, cost-effective SNS intervention to increase PrEP initiation among Black SMM. This is critical because Black SMM have the highest HIV incidence in the U.S. and based on current HIV prevention, treatment and care rates, 50% of Black SMM will acquire HIV in their lifetime compared with ~10% of White SMM and 25% of Latino SMM Importantly, this highlights a critical failure of the U.S. public health system. Therefore, focused HIV prevention and social network-based intervention efforts, such as SNS, are warranted to meet the unique needs of Black SMM. Overview of project. The first 12 months (Phase 1: Formative Research) will be an intervention development/adaptation phase. Using a community-based participatory approach (n=18 age- and PrEP use profile-specific focus groups, of at least 4-5 participants each, totaling 72-90), participants will be asked about the social network dynamics and characteristics (e.g., influential network members, communication about PrEP as an HIV prevention method) that influenced their decision to initiate PrEP. Among participants with no PrEP use, they will be asked about the acceptability and feasibility of talking with PrEP-using Black SMM within their respective social network to support initiation along with preferences for relevant PrEP-related information from peers. The following 12 months (Phase 2: Open-phase Pilot Study) will involve conducting an open pilot of the SNS intervention, in up to six batches of up to 5 participants (n=30), allowing for further intervention refinement. This will allow us to demonstrate participant feasibility and acceptance, which includes the ability to recruit network members, feasibility of intervention delivery, and changes in participant behaviors. It will allow for further evaluation of the feasibility of all study procedures, refinement of intervention manual, and provide pilot data to submit an NIH application for a larger prospective trial. Therefore, the expected outcome is a culturally relevant SNS intervention to increase PrEP initiation among Black SMM through PrEP-using social network members.

项目概要背景。黑人男性的社交网络，包括黑人同性恋、双性恋和其他黑人性行为少数族裔男性 (SMM)，影响他们的决策和艾滋病毒相关行为（例如安全套的使用、艾滋病毒测试）。社交网络策略 (SNS) 干预措施已成功提高艾滋病毒检测率华盛顿特区从未接受过检测且艾滋病毒状况未知的黑人 SMM（McCree 等人）等，2013； Baytop 等人，2014）。最近在华盛顿特区黑人 SMM 中进行的一项差异有效性研究（在“我们帮助我们”中进行）证明 SNS 优于场地测试和合作伙伴服务招募从未接受过测试的男性（Baytop et al., 2014）。 SNS 干预也规避了结构性的暴露前预防 (PrEP) 的障碍，例如耻辱、歧视和医疗不信任。拟议的研究目的是设计并开始试验一种低强度、具有成本效益的 SNS 干预措施，以提高 PrEP 的效果黑人SMM之间的启动。这一点至关重要，因为黑人 SMM 的艾滋病毒感染率是美国最高的。根据目前的艾滋病毒预防、治疗和护理率，50% 的黑人 SMM 将在其生活中感染艾滋病毒与大约 10% 的白人 SMM 和 25% 的拉丁裔 SMM 相比，重要的是，这凸显了一个关键因素美国公共卫生系统的失败。因此，重点关注艾滋病毒预防和基于社交网络的社交网络等干预措施有必要满足黑人 SMM 的独特需求。项目概况。前 12 个月（第一阶段：形成性研究）将是一个干预期发展/适应阶段。使用基于社区的参与方法（n = 18 岁和 PrEP 使用针对具体情况的焦点小组，每个小组至少有 4-5 名参与者，总共 72-90 人），参与者将被问及社交网络动态和特征（例如，有影响力的网络成员、有关 PrEP 的交流作为一种 HIV 预防方法）影响了他们启动 PrEP 的决定。没有 PrEP 的参与者使用时，他们将被问及在他们的范围内使用 Black SMM 与 PrEP 进行交谈的可接受性和可行性各自的社交网络支持启动以及对相关 PrEP 相关信息的偏好同行。接下来的 12 个月（第二阶段：开放阶段试点研究）将涉及对 SNS 干预，最多 6 批，最多 5 名参与者 (n=30)，允许进一步干预细化。这将使我们能够证明参与者的可行性和接受度，其中包括能够招募网络成员、干预实施的可行性以及参与者行为的变化。它将允许进一步评估所有研究程序的可行性，完善干预手册，并提供向 NIH 提交更大规模前瞻性试验申请的试点数据。因此，预期结果是文化相关的 SNS 干预，通过使用社交媒体的 PrEP 来提高黑人 SMM 的 PrEP 启动率网络成员。