Social Media Based Peer Led Intervention to Facilitate PrEP in YMSM of Color

基于社交媒体的同行主导干预促进 YMSM of Color 中的 PrEP

• 批准号: 9095438
• 负责人: Viraj V Patel
• 金额: $ 18.47万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-23 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9095438
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Adherence; Adoption; Affect; Age; Anti-Retroviral Agents; Attitude; Award; Behavior Therapy; Behavioral; Bisexual; Clinic; Clinical Trials; Color; Communities; Complement; Control Groups; Data; Data Analyses; Development; Development Plans; Diffusion of Innovation; Education; Effectiveness; Epidemic; Ethics; Exposure to; Financial compensation; Fostering; Future; Gays; Goals; HIV; HIV Infections; HIV risk; Health; Heterosexuals; Incidence; Individual; Insurance Carriers; Intention; Intervention; Interview; K-Series Research Career Programs; Knowledge; Latino; Link; Low income; Medicaid; Mentors; Methods; New York City; Oral; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Population; Prevention program; Prevention strategy; Preventive Intervention; Process Measure; Prophylactic treatment; Qualitative Methods; Qualitative Research; Randomized; Randomized Clinical Trials; Regimen; Research; Research Personnel; Risk; Site; Structure; Target Populations; Technology; Testing; Time; Training; aged; base; behavior test; biobehavior; career development; community based participatory research; comparative effectiveness; condoms; cost; design; effectiveness trial; efficacy testing; empowered; evidence base; experience; high risk; improved; innovation; interest; longitudinal analysis; men; men who have sex with men; novel; nutrition; peer; prevent; primary outcome; randomized trial; research and development; secondary outcome; sex; social media; theories; tool; transmission process; trend; uptake; young man; young men who have sex with men

DESCRIPTION (provided by applicant): Young men of color who have sex with men (YMCSM, ages 13-29) experience the highest rates of new HIV infections in the U.S., with existing prevention interventions failing to reach most of this hard to reach population. Recent developments in HIV prevention, however, hold promise to help reverse the trend of rising HIV rates in YMCSM, as well as the overall burden of HIV. Pre-exposure prophylaxis (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, has demonstrated efficacy for reducing HIV acquisition risk in multiple high-risk populations. At the same time, increasingly ubiquitous use of social media (e.g. Facebook, Twitter, online dating sites) by young people, including low- income YMCSM, provides an efficient avenue to identify and reach many otherwise hard to reach YMCSM. The overall goal of this mentored career development award proposal is to develop and pilot-test a social media-based peer-led intervention to promote PrEP uptake in YMCSM. We will use mixed methods and a 'diffusion of innovation' framework to: (1) determine factors associated with interest in and adoption of PrEP among YMCSM; (2) develop Empowering with PrEP (E-PrEP), a social media-based peer-led intervention to increase PrEP uptake in YMCSM; and (3) pilot-test the feasibility and preliminary efficacy of E-PrEP for increasing intention to use and adoption of PrEP by YMCSM. With guidance from a multi-disciplinary team of expert mentors, I will conduct in-person qualitative interviews with users and non-adopters of PrEP to identify current facilitators of and barriers to its uptake. Using the 'diffusion of innovation' theoretical framework to interpret our findings, I ill then partner with YMCSM peer leaders to develop a social media-based intervention to facilitate PrEP uptake. The resulting E-PrEP intervention will use online messaging and discussions directed by peer leaders to provide education on PrEP, increase interest in PrEP use, and facilitate access to PrEP. We will then conduct a pilot randomized trial of E-PrEP (versus exposure to online messaging and discussions promoting general health and nutrition) in YMCSM ages 18-29 to assess E-PrEP's feasibility and preliminary efficacy for increasing self-reported intention in and uptake of PrEP among YMCSM. We hypothesize that, compared to a control group exposed to non-overlapping online contents focused on general health topics, participants randomized to E-PrEP will be more likely to express intention to use and to use PrEP. Once we have preliminarily determined an effect size for E-PrEP's efficacy, we will submit an R01 application to test E-PrEP among YMCSM in a multi-center randomized trial. During the award period, I will develop expertise in social media- and technology-based health interventions, including associated ethical challenges, and I will also pursue advanced training in longitudinal and qualitative data analysis. Completion of my planned research and career development activities will allow me to become an independent investigator of novel bio-behavioral interventions for improving the health of hard to reach populations.

描述（由申请人提供）：与男性发生性关系的年轻有色人种男性（YMCSM，13-29 岁）在美国新发艾滋病毒感染率最高，而现有的预防干预措施未能覆盖到大多数难以覆盖的人群。然而，艾滋病毒预防方面的最新进展有望帮助扭转 YMCSM 艾滋病毒感染率上升的趋势以及艾滋病毒的总体负担。暴露前预防 (PrEP) 是一种口服抗逆转录病毒治疗方案，由未感染 HIV 的个体每天服用，以预防 HIV 感染，已证明可以有效降低多个高危人群的 HIV 感染风险。与此同时，包括低收入 YMCSM 在内的年轻人越来越普遍地使用社交媒体（例如 Facebook、Twitter、在线约会网站），这为识别和接触许多原本难以接触到的 YMCSM 提供了有效的途径。 该指导性职业发展奖提案的总体目标是开发和试点基于社交媒体的同行主导干预措施，以促进 YMCSM 中 PrEP 的采用。我们将使用混合方法和“创新扩散”框架来： (1) 确定 YMCSM 对 PrEP 的兴趣和采用相关的因素； (2) 开发 PrEP 授权 (E-PrEP)，这是一种基于社交媒体的同行主导干预措施，以提高 YMCSM 中 PrEP 的采用率； (3) 试点测试 E-PrEP 的可行性和初步功效，以提高 YMCSM 使用和采用 PrEP 的意愿。在多学科专家导师团队的指导下，我将与 PrEP 的使用者和非采用者进行面对面的定性访谈，以确定当前采用该方法的促进因素和障碍。使用“创新扩散”理论框架来解释我们的发现，然后我将与 YMCSM 同行领导者合作开发基于社交媒体的干预措施，以促进 PrEP 的采用。由此产生的 E-PrEP 干预将使用由同行领导指导的在线消息传递和讨论来提供 PrEP 教育，提高对 PrEP 使用的兴趣，并促进获得 PrEP。然后，我们将在 18-29 岁的 YMCSM 中进行 E-PrEP 的试点随机试验（与接触促进一般健康和营养的在线消息和讨论相比），以评估 E-PrEP 在增加自我报告意向和吸收方面的可行性和初步功效YMCSM 中的 PrEP。 我们假设，与暴露于关注一般健康主题的非重叠在线内容的对照组相比，随机接受 E-PrEP 的参与者更有可能表达使用和使用 PrEP 的意图。一旦我们初步确定了 E-PrEP 疗效的效应大小，我们将提交 R01 申请，在 YMCSM 中进行多中心随机试验来测试 E-PrEP。在获奖期间，我将发展基于社交媒体和技术的健康干预方面的专业知识，包括相关的道德挑战，并且我还将接受纵向和定性数据分析方面的高级培训。完成我计划的研究和职业发展活动将使我能够成为新型生物行为干预措施的独立研究者，以改善难以接触人群的健康。