mHealth Peer Support to Reduce Rates of STIs in Black MSM PrEP Users

mHealth 同行支持可降低黑人 MSM PrEP 用户的性传播感染率

• 批准号: 10462604
• 负责人: Meredith Edwards Clement
• 金额: $ 14.67万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-03 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10462604
• 关键词: AIDS prevention; Address; Adherence; Affect; Anti-Retroviral Agents; Attention; Automobile Driving; Behavioral; Behavioral Sciences; Biometry; Caring; Centers for Disease Control and Prevention (U.S.); Chlamydia; Chlamydia Infections; Clinic; Clinical; Clinical Investigator; Collaborations; County; Data; Diagnosis; Feasibility Studies; Feedback; Financial compensation; Focus Groups; Fumarates; Future; Goals; Gonorrhea; HIV; HIV Infections; Health Technology; Health behavior; Hepatitis C; Homophobia; Housing; Incidence; Income; Individual; Intervention; Interview; Investigation; Knowledge; Medical; Mentorship; Mobile Health Application; Patients; Pharmaceutical Preparations; Physician Executives; Play; Population; Prospective cohort; Protocols documentation; Psychologist; Public Health; Randomized; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Risk Reduction; Role; STI prevention; Sampling Studies; Science; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Social isolation; Statistical Methods; Syphilis; Technology; Tenofovir; Testing; Time; Training; United States; Work; aged; base; behavior influence; black men; black men who have sex with men; care delivery; experience; follow-up; health application; health care availability; health disparity; high risk; improved; infection rate; infection risk; insight; knowledge base; lifetime risk; mHealth; men; men who have sex with men; mobile application; mobile computing; peer support; pre-exposure prophylaxis; primary outcome; public health research; racial disparity; randomized trial; screening; sexual HIV transmission; sexual risk taking; skills; social; social factors; transmission process; young men who have sex with men

PROEJECT SUMMARY Pre-exposure prophylaxis (PrEP) with emtricitibine/tenofovir disoproxyl fumarate (FTC/TDF) has been shown to dramatically reduce transmission of HIV in men who have sex with men (MSM). However, as an antiretroviral medication, it does not protect against other sexually transmitted infections (STIs). Currently in the US, STI rates are at an “unprecedented high,” according to the Centers for Disease Control and Prevention. These elevated rates are especially pronounced in MSM prescribed PrEP and represent a crucial public health problem that requires immediate attention. Dr. Clement's K23 proposal will focus on addressing this problem through the use of mobile health (mHealth) technology in a critically important population with profound health disparities, Black MSM in the South. First, to understand predictors of STIs, she will explore the relationship between social factors (e.g. social isolation) and STI incidence; these relationships will inform research efforts to focus on those at highest risk for STIs. Second, she will investigate facilitators and barriers to STI risk reduction practices through in-depth interviews (IDIs) with Black MSM PrEP users. She will specifically inquire about peer support as a facilitator to STI risk reduction practices, and gather initial feedback on the peer support features of the mSMART application (“app”). Data will be used to adapt the app, which will be further assessed in focus groups. These qualitative studies will give valuable insight into factors driving sexual risk taking that the mSMART app will then target. Third, in a pilot investigation of Black MSM PrEP users with predictive STI risk factors, as identified in the first aim, she will conduct a randomized study to determine the feasibility and preliminary impact of the adapted mSMART app in reducing STI incidence. Through this proposal, Dr. Clement will build upon her experience in STIs with continued pursuit of critical public health research, and as a result be prepared to become a national leader in the field of HIV/STI prevention. Didactic coursework will bolster Dr. Clement's quantitative analytic skills and solidify her knowledge base. Additionally, she will gain training and experience in mHealth technology, a growing field with broad applications for health care access and delivery. She will also gain an appreciation for the application of qualitative science that will serve fruitful in future investigations. The mentorship team, led by Dr. Susanna Naggie, an experienced HIV investigator, will include experts in behavioral science related to PrEP (Dr. Amy Corneli), the use of mHealth technology in Black MSM (Dr. Sara LeGrand), and biostatistics (Dr. Cliburn Chan). Also included as collaborators are Dr. Arlene Seña, an expert in STIs who is Medical Director of the Durham County Department of Public Health, Dr. Mehri McKellar, the Medical Director of the Duke PrEP clinic, Dr. John Mitchell, a clinical psychologist who has pioneered the mobile app mSMART in PrEP users, Dr. Lisa Hightow-Weidman, a recognized leader in the field of technology based interventions aimed at HIV/STI prevention in young MSM, and Dr. Kenneth Mayer, a world expert in biomedical HIV prevention and the intersection of STIs and PrEP. The proposed aims and accompanying training plan will allow Dr. Clement to mature into an independent researcher in HIV/STI prevention and provide a basis for an R01 to implement her mobile technology intervention for STI prevention in Black MSM PrEP users.

项目概要 使用恩曲他滨/富马酸替诺福韦二吡呋酯 (FTC/TDF) 进行暴露前预防 (PrEP) 研究表明，该药物可显着减少男男性行为者 (MSM) 中艾滋病毒的传播。 作为一种抗逆转录病毒药物，它不能预防其他性传播感染 (STI)。 根据疾病中心的数据，目前在美国，性传播感染的发病率处于“前所未有的高水平” 控制和预防。这些升高的比率在 MSM 规定的 PrEP 中尤其明显。 克莱门特博士的 K23 是一个需要立即关注的重要公共卫生问题。 提案将重点通过使用移动医疗（mHealth）技术解决这一问题 在健康差异巨大的极其重要的人群中，首先是南方的黑人男男性行为者。 性传播感染的预测因素，她将探索社会因素之间的关系（例如 隔离）和性传播感染发病率；这些关系将为研究工作提供关注 其次，她将调查降低性传播感染风险的促进因素和障碍。 通过与黑人 MSM PrEP 用户进行深度访谈 (IDI) 进行实践，她将专门询问。 关于同行支持作为性传播感染风险降低实践的促进者的信息，并收集有关 mSMART 应用程序（“应用程序”）的对等支持功能将用于调整该应用程序。 将在焦点小组中进一步评估这些定性研究将为我们提供有价值的见解。 mSMART 应用程序将针对的驱动性冒险的因素第三，在试点调查中。 正如第一个目标中所确定的，具有预测性传播感染风险因素的黑人 MSM PrEP 用户中，她将 进行随机研究以确定改编的可行性和初步影响 Clement 博士将通过 mSMART 应用程序减少性传播感染的发病率。 不断追求重要的公共卫生研究，并因此获得了性传播感染方面的经验 准备成为艾滋病毒/性传播感染预防领域的国家领导者。 此外，她还将增强克莱门特博士的定量分析技能并巩固她的知识基础。 获得移动医疗技术方面的培训和经验，这是一个不断发展的领域，具有广泛的健康应用 她还将欣赏定性科学的应用。 由苏珊娜·纳吉 (Susanna Naggie) 博士领导的指导团队将在未来的研究中取得丰硕的成果。 经验丰富的 HIV 调查员，将包括与 PrEP 相关的行为科学专家（Amy 博士） Corneli）、移动医疗技术在黑人 MSM 中的应用（Sara LeGrand 博士）和生物统计学（Dr. Corneli）。 Cliburn Chan) 的合作者还有性传播感染 (STI) 医学专家 Arlene Seña 博士。 达勒姆县公共卫生部主任，医疗主任 Mehri McKellar 博士 杜克 PrEP 诊所的约翰·米切尔 (John Mitchell) 博士是一位临床心理学家，也是这款移动应用程序的先驱 PrEP 用户中的 mSMART，Lisa Hightow-Weidman 博士，技术领域公认的领导者 旨在预防年轻男男性接触者艾滋病毒/性传播感染的干预措施，以及肯尼思·梅耶尔博士， 艾滋病毒生物医学预防以及性传播感染和 PrEP 交叉领域的专家 拟议的目标和 随附的培训计划将使克莱门特博士成长为一名独立研究员 HIV/STI 预防并为 R01 实施移动技术干预提供基础 用于黑人 MSM PrEP 用户的性传播感染预防。

项目成果

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study.

• DOI: 10.2196/43019
• 发表时间: 2023-02-27
• 期刊: JMIR FORMATIVE RESEARCH
• 影响因子: 2.2
• 作者: Clement, Meredith Edwards;Lovett, Aish;Caldwell, Sylvia;Beckford, Jeremy;Hilgart, Michelle;Corneli, Amy;Flickinger, Tabor;Dillingham, Rebecca;Ingersoll, Karen
• 通讯作者: Ingersoll, Karen

Evaluation of an HIV Pre-Exposure Prophylaxis Referral System: From Sexual Health Center to Federally Qualified Health Center Pre-Exposure Prophylaxis Clinic.

HIV 暴露前预防转诊系统的评估：从性健康中心到联邦合格的健康中心暴露前预防诊所。

• DOI: 10.1089/apc.2021.0050
• 发表时间: 2021
• 期刊: AIDS patient care and STDs
• 影响因子: 4.9
• 作者: Lillis,Rebecca;Beckford,Jeremy;Fegley,Joshua;Siren,Julia;Hinton,Bruce;Gomez,Samuel;Taylor,StephanieN;Butler,Isolde;Halperin,Jason;Clement,MeredithEdwards
• 通讯作者: Clement,MeredithEdwards

Preexposure Prophylaxis Outcomes in an Urban Community in North Carolina: Discontinuation of Care and Sexually Transmitted Infections.

• DOI: 10.1097/olq.0000000000001288
• 发表时间: 2021-03-01
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Clement ME;Nicchitta M;Sun Y;Ellis A;Chakraborty H;McGee K;Eagle C;Frye J;Taylor D;Okeke NL;Johnston B;Seña AC;McKellar M
• 通讯作者: McKellar M

Characteristics of Mpox Infections in Louisiana in the 2022 Outbreak.

路易斯安那州 2022 年爆发的 Mpox 感染特征。

• DOI: 10.1089/aid.2023.0011
• 发表时间: 2023
• 期刊: AIDS research and human retroviruses
• 影响因子: 1.5
• 作者: Essajee,NabilM;Oddo-Moise,Hope;Hagensee,MichaelE;Lillis,RebeccaA;Maffei,Joanne;Butler,Isolde;Lovett,Aish;Sokol,Theresa;Clement,MeredithE
• 通讯作者: Clement,MeredithE