Male Access to Sexual Health Services and PrEP

男性获得性健康服务和 PrEP 的机会

• 批准号: 10538658
• 负责人: Philip John Smith
• 金额: $ 10.66万
• 依托单位: DESMOND TUTU HIV FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538658
• 关键词: AIDS prevention; Address; Adherence; Adolescent and Young Adult; Age; Alcohol consumption; Award; Behavioral; Behavioral Sciences; Blood; Caring; Cause of Death; Cessation of life; Child health care; Clinic; Clinical Management; Clinical Trials; Communities; Commuting; Data; Diphosphates; Education; Educational workshop; Enrollment; Epidemiology; Evidence based intervention; Female; Foundations; Gender; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; Health; Health Services; Health behavior; Healthcare; Heterosexuals; Human immunodeficiency virus test; Improve Access; Individual; Intervention; Interview; Location; Measures; Mentors; Mentorship; Methods; Modeling; Outcome; Outcome Assessment; Patients; Pattern; Population; Prevalence; Province; Public Health; Qualitative Methods; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Research Personnel; Resource-limited setting; Science; Scientist; Services; Sexual Health; Sexual Partners; Socioeconomic Status; South Africa; South African; Spottings; Surveys; Tenofovir; Training; Treatment outcome; United States National Institutes of Health; Viral; Visit; Wait Time; Woman; acceptability and feasibility; adverse outcome; age group; aged; antiretroviral therapy; base; behavioral economics; behavioral study; burden of illness; care delivery; cohort; community burden; contextual factors; design; evidence base; experience; girls; health care service; health seeking behavior; high risk; high risk men; human old age (65+); implementation science; improved; innovation; insight; low and middle-income countries; male; male health; men; mortality; multidisciplinary; pre-exposure prophylaxis; preference; premature; prevention service; preventive intervention; prototype; response; sexual health intervention; social stigma; theories; therapy design; transmission process; treatment as prevention; uptake; young man

PROJECT SUMMARY Global HIV prevention efforts have conventionally focused on supporting women and key populations through treatment as prevention resulting in viral suppression (Undetectable = Untransmittable, U=U). This presents the opportunity to develop interventions that support HIV prevention in heterosexual men, aged 15-49 years. Since there are no interventions that address PrEP uptake among HIV seronegative heterosexual men, the scientific goal of this K43 is to develop and prototype an evidence-based intervention to curb HIV acquisition in South African men at high risk of HIV acquisition. Behavioral economics (BE) theory posits that contextual and individual factors influence health behavior. BE will be used to understand these factors associated with pre- exposure prophylaxis (PrEP) uptake in South African men. Candidate: I am a South African behavioral scientist with a background in HIV research in HIV endemic communities in South Africa I am committed to improve health seeking in this population. This K43 will support my training, mentorship, and research towards becoming an independent investigator. Mentoring: I have assembled a multi-disciplinary team with globally recognized expertise in their fields, committed to HIV research in South Africa. My primary mentors are Dr. Alison Buttenheim (U.S. based, behavioral economics intervention design, evidence-based HIV care delivery, mixed methods research), Dr. Linda-Gail Bekker (S.A.-based, clinical trials, PrEP, research in key populations). My co- mentorship team includes: Dr. Joseph Daniels (U.S.-based, qualitative research, HIV prevention and treatment), Dr. Andrew Medina-Marino (S.A.-based, epidemiology, men’s health, implementation science). Training: The K43 will support mentoring and rigorous training to support me to develop expertise in 1) behavioral economics intervention design, 2) cohort design and managing clinical trials, 3) mixed methods research design and analysis. These aims will be supported by mentors who are global leaders in HIV prevention in limited resource communities. Research: HIV prevalence peaks in South African males (45-49 years) later than their female (35- 39 years) counterparts and males tend to choose younger female sexual partners. Reducing HIV acquisition among men living in LMICs is central to breaking this cycle of transmission. The specific research aims of this award are to: 1) investigate the influence of contextual factors on PrEP uptake, 2) describe factors associated with attrition and sustained PrEP use 3) to use BE to develop and prototype an intervention to support PrEP uptake among men. This research is nested in the existing mobile clinic services operating in the Klipfontein district in Cape Town, which was recently awarded a PrEP implementation grant (Bill and Melinda Gates Foundation, PI Bekker) to assess community-based PrEP uptake. This study will advance NIH science on HIV prevention in men in high HIV disease burden communities. The evidence will be used to design a BE informed intervention for a larger clinical trial investigating the impact on reducing HIV acquisition and transmission in men.

项目摘要 通过 作为预防的治疗，导致病毒抑制（无法检测到不可转移，u = u） 在15-49岁的异性恋男性中开发预防艾滋病毒的干预措施的机会。 艾滋病毒血清阴性异性恋男人之间有非地址的准备摄取 该K43的目标是基于偏差的干预措施来遏制南方的艾滋病毒收购 非洲男性患艾滋病毒的高风险。 个人因素会影响健康行为。 南非男性的预防曝光（准备）。 在南非的HIV流行社区的HIV研究背景下，我对改善健康的评论有一些评论 在这个人群中寻求这个K43将支持我的培训，指导和研究 独立调查员指导：我召集了一个全球认可的多学科团队 他们的领域专业知识，致力于南非的HIB HIV研究。 （美国的行为经济学国际设计，基于证据的HIB护理，混合方法 研究），琳达·盖尔·贝克（Linda-Gail Bekker）（基于S.A. 指导团队包括：约瑟夫·丹尼尔斯博士（美国的定性研究，艾滋病毒预防和治疗）， 安德鲁·麦迪纳·玛丽诺（Andrew Medina-Marino）博士（总部位于S.A.，流行病学，男性健康，实施 K43将支持指导和严格的培训，以支持我在1）行为经济学中发展专业知识 干预设计，2）队列设计和管理临床试验，3）混合方法研究设计和设计 分析这些目标将受到艾滋病毒预防艾滋病毒preved资源的指导者的支持 社区。 39年）同行和男性倾向于选择年轻的女性性伴侣 在LMIC的男性中，这是打破这种传播周期的核心。 奖励是：1）调查上下文因素对准备吸收的影响，2）描述因素相关 使用损耗和持续抗抗药预备使用3）用于开发原型和干预措施以支持准备 男性的吸收。 开普敦的地区，最近被授予了预付款赠款（比尔和梅琳达·盖茨 基金会，PI Bekker）评估基于社区的预备措施。 高艾滋病毒疾病负担的男性预防。 干预较大的临床试验的干预措施，调查了减少艾滋病毒收购和传播的影响 男人。