CHALO!: A mobile technology based intervention to accelerate HIV testing and linkage to prevention and treatment

CHALO!：基于移动技术的干预措施，可加速艾滋病毒检测以及与预防和治疗的联系

• 批准号: 10550234
• 负责人: Viraj V Patel
• 金额: $ 59.27万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10550234
• 关键词: AIDS prevention; Acceleration; Address; Affect; Anti-Retroviral Agents; Area; Attention; Awareness; Behavior; Behavior Therapy; Behavioral; Caring; Clinical; Communication; Communities; Continuity of Patient Care; Counseling; Data; Epidemic; Ethics; Facebook; Friends; Fright; General Population; Goals; HIV; HIV Infections; HIV Seronegativity; HIV risk; Health; Home; Human immunodeficiency virus test; India; Individual; Infection; Intention; Internet; Intervention; Knowledge; Link; Measures; Methods; Modeling; Motivation; NIH Office of AIDS Research; Outcome; Participant; Patient Self-Report; Persons; Pilot Projects; Population; Populations at Risk; Prevalence; Prevention; Prevention program; Prevention strategy; Privatization; Professional counselor; Questionnaires; Randomized; Randomized, Controlled Trials; Records; Research; Research Priority; Risk; Sexual Health; Sexual and Gender Minorities; Site; Socialization; Target Populations; Technology; Test Result; Testing; Text; Trust; United States; United States National Institutes of Health; community organizations; design; digital; efficacy evaluation; evidence base; experience; follow-up; gender minority community; global health; high risk; high risk men; improved; innovation; men who have sex with men; mobile computing; online intervention; outreach; peer; pragmatic randomized trial; pre-exposure prophylaxis; prevent; preventive intervention; programs; recruit; research study; same sex behavior; self testing; sexually active; skills; social; social media; social stigma; theories; therapy design; three-arm trial; treatment strategy; trial comparing; uptake; web page; week trial

Background: Despite effective HIV prevention and treatment, the global HIV epidemic continues to grow. Current programs to engage populations at high HIV risk have had limited impact, in part because they do not reach those at highest risk. To reduce the global burden of HIV, new, evidence-based, far-reaching strategies are needed to engage individuals at risk in HIV prevention and treatment. In the U.S. and globally, people are increasingly using mobile/social technologies (SMT) (e.g. dating apps, WhatsApp, Facebook) to socialize and meet partners. While this shift in how individuals socialize has disrupted traditional face-to-face outreach, SMT provides an unprecedented opportunity to engage historically hard-to-reach groups, such as men who have sex with men (MSM), for HIV prevention and treatment. Th goal of this study is to test whether a SMT-based behavioral intervention that includes a digital coupon for free HIV testing (CHALO! 2.0) enhances HIV testing and linkage-to-care among a population that continues to experience high rates of HIV infection in India. The scientific premise of this proposal is that a community-developed, theory-based intervention will engage MSM at high risk of HIV who are reached online, and that the intervention will increase HIV knowledge and enhance motivation and behavioral skills to obtain HIV testing and get linked to HIV prevention (if HIV- uninfected) or HIV treatment (if HIV-infected). The rationale for this research study is that determining efficacy of a rapidly scalable SMT-based behavioral intervention is needed before widespread dissemination. The significance of this research question is that even a modestly effective SMT-based HIV prevention intervention may efficiently reach many individuals at high risk of HIV and lead to increased HIV status awareness, better linkage-to-care, and fewer new HIV infections. Methods: In a pragmatic randomized controlled trial, we will determine whether CHALO! 2.0 results in increased HIV testing and linkage-to-care (prevention or treatment) among sexually active MSM who are unaware of their HIV status (never tested or tested >6 months ago) and are recruited online. We will conduct a 12-week, three arm randomized trial comparing CHALO! 2.0 to two control conditions: an attention-matched SMT-based control (also including a digital coupon for free HIV testing), and a digital coupon only control. Potential Impact: While global health agencies have called for online interventions to engage populations at high HIV risk who are not being reached, few effective models exist and none exist in India, which is home to one of the world’s largest MSM HIV epidemics. This study will address this gap by testing a scalable and replicable online model to engage individuals at high HIV risk and link them to HIV testing and prevention or treatment. This proposal is responsive to NIH PA-18-278: Innovations in HIV Testing…to Optimize HIV Care Continuum Outcomes, and addresses multiple high priority research areas of NIH’s Office of AIDS Research. The proposed model, if found effective, may also accelerate achieving UNAIDS 90-90-90 care targets.

背景：尽管艾滋病毒预防和治疗有效，但全球艾滋病毒流行仍在继续增长。 目前针对艾滋病毒高危人群开展的项目影响有限，部分原因是它们没有 为减轻全球艾滋病毒负担，采取新的、基于证据的、影响深远的战略。 在美国和全球范围内，需要让高危人群参与艾滋病毒预防和治疗。 越来越多地使用移动/社交技术 (SMT)（例如约会应用程序、WhatsApp、Facebook）进行社交和 虽然个人社交方式的这种转变扰乱了传统的面对面交流，但 SMT 提供了前所未有的机会来吸引历史上难以接触到的群体，例如那些有过类似经历的男性 男男性行为（MSM），对于艾滋病毒的预防和治疗本研究的目标是测试是否基于SMT。 包括免费 HIV 检测数字优惠券 (CHALO!2.0) 在内的行为干预可增强 HIV 检测 印度艾滋病毒感染率仍然很高的人群中的护理联系。 该提案的科学前提是，社区制定的、基于理论的干预措施将 让在线接触的艾滋病毒高危男男性接触者参与进来，干预措施将增加艾滋病毒知识 提高动机和行为技能以获得艾滋病毒检测并与艾滋病毒预防联系起来（如果艾滋病毒 未感染）或 HIV 治疗（如果感染 HIV） 本研究的基本原理是确定疗效。 在广泛传播之前，需要快速扩展的基于 SMT 的行为干预。 这个研究问题的意义在于，即使是基于 SMT 的适度有效的艾滋病毒预防干预措施 可以有效地接触到许多艾滋病毒高危人群，并提高人们对艾滋病毒状况的认识，更好地 与护理的联系，以及减少新的艾滋病毒感染。 方法：在一项实用的随机对照试验中，我们将确定 CHALO! 2.0 是否会产生结果 在性活跃的男男性接触者中增加艾滋病毒检测和与护理（预防或治疗）的联系 不知道自己的艾滋病毒感染状况（从未检测过或超过 6 个月前检测过），并且在网上招募我们将进行一次调查。 为期 12 周的三组随机试验，比较 CHALO! 2.0 与两种对照条件：注意力匹配 基于 SMT 的控制（还包括用于免费 HIV 检测的数字优惠券）和仅数字优惠券控制。 潜在影响：虽然全球卫生机构呼吁采取在线干预措施以吸引民众参与 没有接触到艾滋病毒高危人群，几乎不存在有效的模式，而在艾滋病毒发源地印度，则根本不存在这种模式。 世界上最大的 MSM HIV 流行病之一，这项研究将通过测试可扩展的和 可复制的在线模型，让艾滋病毒高危人群参与进来​​，并将他们与艾滋病毒检测和预防联系起来，或 该提案响应 NIH PA-18-278：HIV 检测创新……优化 HIV 护理。 连续体成果，并解决了 NIH 艾滋病研究办公室的多个高度优先研究领域。 如果发现所提出的模型有效，还可能加速实现联合国艾滋病规划署的 90-90-90 护理目标。