The impact of alcohol use and alcohol-interactive toxicity beliefs on pre-exposure prophylaxis (PrEP) adherence among gay, bisexual, and other men who have sex with men: A social network approach

饮酒和酒精相互作用毒性信念对同性恋、双性恋和其他男男性行为者的暴露前预防 (PrEP) 依从性的影响：社交网络方法

• 批准号: 10538253
• 负责人: Jace DeWayne Pierce
• 金额: $ 3.74万
• 依托单位: UNIVERSITY OF HOUSTON
• 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 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10538253
• 关键词: AIDS prevention; Accounting; Adherence; Advertising; Affect; Alcohol consumption; Alcohol dependence; Alcohols; Anti-Retroviral Agents; Area; Behavior; Belief; Bisexual; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Code; Coitus; Contracts; Counseling; County; Diffuse; Dose; Ego; Event; Exposure to; Future; Gays; Goals; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Heterosexuals; Hour; Individual; Intervention; Interview; Knowledge; Lesbian Gay Bisexual Transgender Queer; Measures; Medicine; Minority Groups; National Institute on Alcohol Abuse and Alcoholism; Oral; Participant; Perception; Persons; Pharmaceutical Preparations; Phase; Poison; Population; Public Health; Regimen; Reporting; Research; Research Personnel; Research Support; Risk; Risk Behaviors; Risk Factors; Risk-Taking; Schedule; Social Network; Strategic Planning; Tablets; Techniques; Time; Toxic effect; Trust; alcohol risk; alcohol testing; antiretroviral therapy; base; binge drinking; condomless anal sex; demographics; design; diaries; drinking; experience; hazardous drinking; health disparity; high risk; interest; men; men who have sex with men; minority health disparity; pill; pre-exposure prophylaxis; prevent; recruit; sexual minority; skills; therapy adherence; trustworthiness; truvada

PROJECT SUMMARY/ABSTRACT Gay, bisexual, and other men who have sex with men (GBM) in the U.S. experience striking health disparities related to alcohol use and HIV. Heavy alcohol use is a significant threat to adherence to antiretrovirals (e.g., antiretroviral therapy [ART]) among GBM managing HIV. However, it is unclear if alcohol use impacts adherence to Pre-Exposure Prophylaxis (PrEP) for preventing HIV. PrEP is used by >35% of U.S. GBM and can be taken either daily or taken in sequence around a sexual event (i.e., event-driven PrEP). PrEP is a highly effective oral antiretroviral but studies have demonstrated suboptimal adherence for both PrEP regimens. Heavy alcohol use and specific beliefs related to mixing alcohol and PrEP may contribute to suboptimal adherence. For instance, >60% of GBM interested in taking PrEP falsely believe that mixing alcohol with PrEP results in a toxic combination (i.e., interactive toxicity beliefs). Like other erroneous beliefs (e.g., HIV is manmade), interactive toxicity beliefs may diffuse across the social network and, subsequently, influence adherence. The proposed study will employ an egocentric social network interview and a semi-weekly diary phase over five weeks to (1) examine associations between heavy alcohol use and PrEP adherence, and (2) to test alcohol-interactive toxicity beliefs and social network characteristics as risk factors for PrEP non-adherence. GBM (N=100) who are taking PrEP will be recruited via brick-and-mortar entities (e.g., LGBTQ+ centers and bars), local health clinics, and online advertising in Harris County, TX (i.e., the greater Houston area). At baseline, participants will complete demographics and measures of interactive toxicity beliefs. Participants will also complete an egocentric social network interview designed to obtain information on up to 20 alters (i.e., people in the social network). The interview will capture alter expression of interactive toxicity beliefs, PrEP and alcohol use, closeness, trust, overall connectedness, demographics, and norms. Participants will then complete five weeks of semi-weekly diaries that assess alcohol use, PrEP use, and HIV risk behaviors. This research can inform future PrEP-related counseling techniques and interventions aimed at correcting PrEP misconceptions and increasing adherence. The project supports the 2017-2021 strategic plan of NIAAA by advancing research in two areas. First, the project has the goal of identifying ways in which alcohol can influence the use of HIV-related medications, specifically PrEP (Goal 1C). Second, the project may enhance the public health impact of NIAAA-supported research, by focusing on how alcohol contributes to suboptimal PrEP adherence among a population with alcohol-related disparities (Goal 5). Moreover, the project contributes to research on health disparities of minority populations, which is a cross-cutting NIAAA research theme. Through this project, I will obtain the knowledge, skills, and experience needed to develop into a cutting-edge alcohol and HIV researcher that focuses on sexual minorities.

项目摘要/摘要 在美国，与男性发生性关系的男同性恋，双性恋和其他男人（GBM） 与饮酒和艾滋病毒有关。大量饮酒是遵守抗逆转录病毒病的重大威胁（例如， GBM管理HIV的抗逆转录病毒疗法[ART]）。但是，目前尚不清楚酒精使用是否影响依从性 预防前预防（PREP）预防HIV。 PREP> 35％的美国GBM使用，可以服用 每天或围绕性事件（即事件驱动的准备）进行顺序进行。准备是高效的口头 抗逆转录病毒但研究表明，两种准备方案的依从性次优。大量的酒精使用 与混合酒精和准备有关的特定信念可能有助于次优依从性。例如， > 60％的GBM有兴趣做准备的兴趣，认为将酒精与预备混合会导致有毒 组合（即交互式毒性信念）。像其他错误的信念一样（例如，艾滋病毒是人为的），互动 毒性信念可能会在整个社交网络中扩散，随后会影响依从性。提议 研究将在五个星期内采用以自我为中心的社交网络访谈和半周的日记阶段到（1） 检查大量饮酒和依从性之间的关联，以及（2）测试酒精相互作用的毒性 信念和社交网络特征是准备不遵守的风险因素。 GBM（n = 100）正在服用 PREP将通过实体实体（例如LGBTQ+中心和酒吧），当地卫生诊所和 在德克萨斯州哈里斯县（即大休斯顿地区）的在线广告。在基线时，参与者将完成 人口统计学和互动毒性信念的度量。参与者还将完成以自我为中心的社会 网络访谈旨在获取有关最多20个变化的信息（即社交网络中的人们）。这 访谈将捕获互动毒性信念，预备和酒精使用，亲密，信任， 总体联系，人口统计和规范。然后，参与者将完成五个星期的半周 评估酒精使用，准备使用和艾滋病毒风险行为的日记。这项研究可以告知未来预备 旨在纠正准备误解并提高依从性的咨询技术和干预措施。 该项目通过在两个领域进行研究来支持NIAAA的2017 - 2021年战略计划。首先，项目 目的是确定酒精可以影响与HIV相关药物的使用，特别是 准备（目标1C）。其次，该项目可以增强NIAAA支持研究的公共卫生影响， 专注于酒精如何促进与酒精有关的人群中次优的准备 差异（目标5）。此外，该项目有助于研究少数族裔人口的健康差异， 这是一个横切的NIAAA研究主题。通过这个项目，我将获得知识，技能和 需要发展为侧重于性少数群体的尖端酒精和艾滋病毒研究人员所需的经验。