Estimating the Impact of a Multilevel, Multicomponent Intervention to Increase Uptake of HIV Testing and Biomedical HIV Prevention among African?American/Black Gay, Bisexual and Same-gender Loving Men

评估多层次、多成分干预措施对提高非裔美国人/黑人同性恋、双性恋和同性男性对艾滋病毒检测和艾滋病毒生物医学预防的影响

• 批准号: 10484484
• 负责人: Keosha Tarheshia Bond
• 金额: $ 80.28万
• 依托单位: CITY COLLEGE OF NEW YORK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10484484
• 关键词: AIDS prevention; AIDS/HIV problem; Adherence; Affect; African American; Anxiety; Area; Behavior; Bisexual; Black American; Black Populations; Black race; Cognitive; Collaborations; Communities; Consult; Cox Proportional Hazards Models; Discrimination; Dissemination and Implementation; Empirical Research; Enrollment; Epidemic; Exposure to; Feedback; Feeling; Focus Groups; Fright; Fumarates; Gays; Gender; Geography; HIV; HIV Infections; Homophobia; Human immunodeficiency virus test; Immunoassay; Individual; Interruption; Intervention; Interview; Lateral; Length; Love; Measures; Media Campaign; Medical; Medical Records; Methods; Modeling; Motivation; Navigation System; Newly Diagnosed; Outcome; Patient Self-Report; Persons; Pharmaceutical Preparations; Population; Prevention; Printed Media; Quasi-experiment; Randomized; Research; Resistance; Self Care; Self Efficacy; Series; Services; Social support; Tenofovir; Testing; Time; Training; Trust; United States; Urine; aged; base; black men who have sex with men; coping; design; effectiveness testing; empowerment; evidence base; experience; four-arm study; high risk; implementation framework; interest; internalized stigma; intervention mapping; men; men who have sex with men; metropolitan; multi-component intervention; novel; peer; peer support; point of care testing; pre-exposure prophylaxis; preventive intervention; primary outcome; program dissemination; programs; racism; recruit; response; secondary outcome; self testing; service providers; side effect; skills; social; social media; social stigma; standard of care; uptake; urban area; urban dwelling; usability

ABSTRACT Increasing access to and uptake of biomedical prevention (PEP/PrEP) is critical to ending the epidemic in the United States (US) among gay, bisexual and other men who have sex with other men (MSM). This is particularly true for urban, African-American or Black MSM, who are disproportionately affected by HIV and would thus benefit from more HIV testing, which is now recommended every 3-6 months for key groups and is the gateway to treatment and prevention. NYC is the metropolitan area in the US with the largest number of newly diagnosed HIV infections among MSM and 89-94% of all people living with HIV/AIDS (PLWHA) in the US reside in urban areas. Although such urban areas often have robust testing and PEP/PrEP dissemination programs, consistent testing and PEP/PrEP uptake is unacceptably low among urban-dwelling Black MSM. There is thus a need for interventions to support both HIV testing and PEP/PrEP uptake by accelerating existing implementation and dissemination efforts. Most HIV testing and PEP/PrEP uptake interventions focus on individual-level navigation of system/structural barriers and/or cognitive antecedents (intentions, motivation, skills) to behavior; few focus on reducing stigma/discrimination-related barriers to testing/PEP/PrEP via self-testing, empowerment, peer support and community norms. To fill this gap, we propose to test an intervention composed of evidence-based and novel intervention components, designed by our study team, that operate at multiple levels and can be integrated into CBO-delivered HIV prevention programming to support HIV testing and PEP/PrEP uptake. We will estimate additive and interactive effects of the components, that include a single-session, peer-based HIV self-testing component, a three-session PEP/PrEP navigation enhancement component, and a social and print anti-intersectional stigma media campaign, using factorial and quasi-experimental designs. The primary outcomes are HIV testing (while not on PrEP/PEP) and PrEP uptake. Secondary outcomes include consistent HIV testing (2+ tests at least 3 months apart in 9 months); PEP uptake; PrEP/PEP adherence (self-report/medical record/urine test). To achieve the study aims, we will enroll 480 PrEP-eligible Black MSM (aged 18-55) living in Central Brooklyn into the study and randomize them to one of four study arms and follow them over 18 months. Our study, which represents a collaboration between a community-based organization currently engaged in PEP/PrEP uptake programming and an academic research team, is designed to identify the added value of components that operate at different levels and are designed to increase individual-level HIV testing and biomedical HIV prevention use among a group highly vulnerable to HIV.

抽象的 增加生物医学预防（PEP/PREP）的访问和吸收对于结束流行病至关重要 在同性恋，双性恋和其他与其他男人发生性关系的男人（MSM）中，美国（美国）。尤其是 对于城市，非裔美国人或黑人MSM而言，他们受艾滋病毒的影响不成比例，因此 受益于更多的艾滋病毒测试，现在建议每3-6个月对关键组进行一次，并且是网关 进行治疗和预防。纽约市是美国的大都市地区 MSM中的艾滋病毒感染和89-94％的艾滋病毒/艾滋病患者（PLWHA）居住在Urban 区域。尽管这样的城市地区经常进行强大的测试和PEP/PREP传播计划，但一致 在城市居住的黑色MSM中，测试和PEP/PREP的吸收较低。因此需要 通过加速现有的实施和 传播努力。大多数HIV测试和PEP/PREP吸收干预措施都集中在个人级别导航上 行为的系统/结构障碍和/或认知前因（意图，动机，技能）；很少的重点 通过自我测试，授权，同伴来减少测试/PEP/PREP的污名/歧视相关障碍/PEP/PREP 支持和社区规范。为了填补这一空白，我们建议测试由循证的干预措施 由我们的研究团队设计的新型干预组件，这些组件在多个层面上运作，可以是 集成到CBO提供的HIV预防程序中，以支持HIV测试和PEP/PREP吸收。我们 将估计组件的添加和交互式效应，其中包括单会，基于同伴的艾滋病毒 自我测试组件，三局PEP/PREP导航增强组件以及社交和印刷品 使用阶乘和准实验设计的抗间接污名媒体运动。主要 结果是艾滋病毒测试（虽然不进行PREP/PEP）和PREP吸收。次要结果包括一致 艾滋病毒测试（9个月内至少有3个月的2个测试）； pep摄取；准备/PEP依从性（自我报告/医疗 记录/尿液测试）。为了实现研究的目的，我们将注册480个符合预选的黑色MSM（18-55岁） 布鲁克林中部进行研究，并将它们随机为四个研究臂之一，并在18个月内跟随它们。 我们的研究代表了目前从事的社区组织之间的合作 PEP/PREP吸收编程和学术研究团队旨在确定 在不同级别运行并旨在增加个人级别的艾滋病毒测试的组件和 高度容易受到艾滋病毒的群体中的生物医学艾滋病毒预防使用。