An Acceptance Based PrEP Intervention to Engage Young Black MSM in the South

基于接受的 PrEP 干预措施，以吸引南方年轻的黑人男男性接触者

• 批准号: 10407649
• 负责人: Trisha Arnold
• 金额: $ 19.36万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10407649
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Anxiety; Award; Awareness; Behavior; Behavioral; Caring; Chronic; Client satisfaction; Clinic; Clinic Visits; Clinical; Communities; Consent; Coupled; Data; Data Analyses; Development; Education; Educational workshop; Emotions; Epidemic; Esthesia; Evidence based intervention; Future; HIV; HIV Infections; HIV risk; Health behavior; Hospitals; Incidence; Individual; Intervention; Interview; K-Series Research Career Programs; Literature; Measures; Mediator of activation protein; Medical; Memory; Mentors; Modality; Modeling; Monitor; Names; Outcome; Participant; Perception; Permeability; Pharmaceutical Preparations; Phase; Pilot Projects; Policies; Population; Prevention; Process; Promoting Action on Research Implementation in Health Services framework; Provider; Psychologist; Public Policy; Publishing; Questionnaires; Randomized; Randomized Controlled Trials; Reading; Reproducibility; Research; Research Personnel; Research Priority; Research Project Grants; Respiration; Rhode Island; Risk; Running; Scientist; Services; Specific qualifier value; Testing; Therapeutic Intervention; Thinking; Training; Transportation; United States National Institutes of Health; acceptability and feasibility; base; behavior change; behavioral outcome; black men who have sex with men; brief intervention; care costs; career; community barrier; cost; design; experience; flexibility; health disparity; implementation science; improved; infection risk; innovation; mindfulness; motivational enhancement therapy; pre-exposure prophylaxis; prevention service; primary outcome; psychologic; racial minority; secondary outcome; sexual minority; side effect; social; social stigma; standard of care; success; theories; therapy design; uptake; young adult

PROJECT SUMMARY/ABSTRACT Young Black men who have sex with men (YBMSM) have a high incidence of HIV, particularly in the South. Thus, interventions tailored to YBMSM to enhance engagement in prevention services are urgently needed. Engagement in PrEP care among YBMSM is less then optimal. The modified social ecological model (MSEM) defines the multi-level domains of HIV infection risk among key populations. Barriers to PrEP use among YBMSM occur at each level: 1) individual, 2) social and sexual network, 3) community, 4) policy, and 5) stage of the HIV epidemic. Examples include individual (e.g. perception of HIV risk), social and sexual network (e.g. stigma), community (e.g. lack of medical services), and public policy (e.g. cost of care). The boundary between each level is permeable, thus each is considered in the proposed study. Utilizing components of Acceptance and Commitment Therapy (ACT), we will design an intervention to improve PrEP uptake, persistence, and adherence. We will use a generalized framework for the adaptation of EBIs to inform the development of a brief intervention for PrEP tailored to YBMSM, named ACTPrEP. ACT addresses barriers by promoting: 1) present moment awareness, 2) acceptance of internal and external experiences, and 3) engagement in behaviors that are consistent with values. To maximize utility, ACTPrEP will be delivered by a PrEP navigator. Candidate: Dr. Arnold is a medical clinical psychologist/scientist with a research background in HIV related studies in the South. Her career has focused on HIV intervention and prevention. Building on prior research, she is applying for a five-year K23 Career Development Award. Mentoring: An exceptional team of senior investigators serve as mentors. Dr. Brown is the Primary Mentor and has expertise in the designing and implementing of PrEP Interventions. Four co-mentors bring complementary expertise in PrEP delivery for YBMSM in the South and adherence monitoring (Dr. Mena); adapting behavior change interventions (Dr. Gaudiano); implementation science (Dr. Elwy); and quantitative data analyses (Dr. Jones). Research: The proposed aims are 1) Gather data from YBMSM (n = 20) and clinic staff (n = 10) through in- depth interviews to assess measures, intervention design, and barriers; 2) Develop ACTPrEP utilizing Aim 1 data and working iteratively with experts; and 3) Evaluate ACTPrEP feasibility and acceptability through a randomized control trial (n=66) and compare ACTPrEP vs. enhanced standard of care on uptake, adherence, and PrEP persistence. Trainings: Dr. Arnold will receive specific training in designing, adapting, and testing theory-based interventions, addressing health disparities with racial and sexual minorities, implementation science, and quantitative analyses through coursework, seminars, workshops, directed readings, and mentored research. These training and research experiences will establish the candidate’s career as an expert in clinically informed behavior change interventions. The candidate is supported by Rhode Island Hospital.

项目概要/摘要 与男性发生性关系的年轻黑人男性 (YBMSM) 的艾滋病毒感染率很高，特别是在 因此，迫切需要针对 YBMSM 采取干预措施，以加强预防服务的参与。 YBMSM 参与 PrEP 护理的程度不够理想。 (MSEM) 定义了重点人群中 HIV 感染风险的多层次领域。 YBMSM 之间的影响发生在各个层面：1) 个人，2) 社会和性网络，3) 社区，4) 政策，以及 5) 艾滋病毒流行阶段的例子包括个人（例如艾滋病毒风险的认知）、社会和性网络。 （例如耻辱）、社区（例如缺乏医疗服务）和公共政策（例如护理费用）。 每个级别之间都是可渗透的，因此在拟议的研究中考虑了每个级别。 接受和承诺疗法 (ACT)，我们将设计一种干预措施来提高 PrEP 的吸收率， 我们将使用一个适应 EBI 的通用框架来告知 开发针对 YBMSM 的简短干预措施（名为 ACTTrEP）可解决障碍。 促进：1）当下意识，2）接受内部和外部经验，以及3） 参与与价值观一致的行为 为了最大化效用，ACTPrEP 将由一个人提供。 PrEP 导航员：Arnold 博士是一位具有研究背景的医学临床心理学家/科学家。 她在南方从事艾滋病毒相关研究，主要从事艾滋病毒干预和预防工作。 根据之前的研究，她正在申请为期五年的 K23 职业发展奖：杰出奖。 高级研究人员团队担任导师，布朗博士是主要导师，在该领域拥有专业知识。 PrEP 干预措施的设计和实施四位共同导师带来了 PrEP 方面的互补专业知识。 在南方实施 YBMSM 并监测遵守情况（Mena 博士）； 干预措施（高迪亚诺博士）；实施科学（埃尔维博士）和定量数据分析（琼斯博士）。 研究：拟议的目标是 1) 通过内部收集从 YBMSM (n = 20) 和诊所工作人员 (n = 10) 收集数据 深度访谈以评估措施、干预设计和障碍；2) 利用目标 1 制定 ACTTrEP 数据并与专家反复合作；3) 通过以下方式评估 ACTPrEP 的可行性和可接受性： 随机对照试验 (n=66) 比较 ACTPrEP 与强化护理标准在摄取、依从性、 和 PrEP 持久性培训：Arnold 博士将接受设计、调整和测试方面的专门培训。 基于理论的干预措施，解决种族和性别少数群体的健康差异，实施 通过课程作业、研讨会、讲习班、定向阅读和定量分析 这些培训和研究经验将奠定候选人作为专家的职业生涯。 候选人得到罗德岛医院的支持。