Optimizing PrEP Utilization among Alcohol and Other Drug (AOD) Using Women of Color

使用有色人种女性优化酒精和其他药物 (AOD) 的 PrEP 使用

• 批准号: 9408198
• 负责人: JESSY G DEVIEUX
• 金额: $ 21.89万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9408198
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Advocacy; Affect; African American; Alcohol consumption; Alcohols; Area; Assessment tool; Awareness; Biological; Biological Markers; Caring; Centers for Disease Control and Prevention (U.S.); Color; Communities; Community Participation; Comorbidity; Continuity of Patient Care; Country; County; Data; Dependence; Development; Disadvantaged; Drug usage; Economics; Educational workshop; Epidemic; Evidence based intervention; FDA approved; Face; Feasibility Studies; Female; Florida; Funding; Future; Gender; Goals; HIV; HIV diagnosis; Haitian; Health Personnel; High Prevalence; Individual; Institutes; Instruction; Intervention; Label; Latina; Latino; Lead; Male Condoms; Manuals; Measures; Mediation; Methods; Modeling; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Oral; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Pharmacy facility; Policies; Population; Predisposition; Prevention program; Prevention strategy; Procedures; Provider; Recommendation; Research; Research Personnel; Risk; Rural; Safe Sex; Shapes; Source; Structure; Surveys; Testing; Training; Update; Ursidae Family; Voice; Woman; Work; alcohol and other drug; alcohol research; base; biobehavior; collaborative care; community based participatory research; comparison group; design; education access; ethnic minority population; experience; fight against; gender difference; health disparity; implementation research; improved; instrument; intervention program; meetings; member; men who have sex with men; multi-component intervention; pre-exposure prophylaxis; programs; public health relevance; racial and ethnic disparities; screening; sex; social; symposium; theories; therapy development; uptake; working group

Project Summary As we edge closer to the half century mark of the HIV epidemic, the disproportionate effect on women of color in the U.S. continues to be jolting. Women overall have been at a disadvantage in the epidemic due to gender differences and norms that shape biological, social and economic vulnerability. Racial and ethnic disparities magnify the risk. Co-factors such as alcohol and other drug (AOD) use intersect and reinforce other comorbidities. Living in a high prevalence area significantly hardens the risk and makes it tougher to overcome. Options to help women stay HIV negative have been limited. However, this obstacle shifted several years ago with FDA approval and CDC endorsement of oral pre-exposure prophylaxis (PrEP). Yet, the majority of U.S. women do not know that PrEP can be a female-controlled strategy or that it applies to them—and backup has not been forthcoming from providers or their communities. What is most disturbing, however, is the absence of PrEP as an accessible strategy among women of color in high impact regions of the country. This developmental U34 responds to RFA-AA-17-013, which prioritizes community based participatory research (CBPR) to develop implementation models for women that address alcohol and HIV in high impact regions and communities. The proposed study will produce an evidence- and CBPR-driven PrEP implementation intervention to enhance uptake and optimize use among women of color in South Florida, which is currently the highest impact region of the U.S. with HIV rates recently determined by the CDC to be the highest in the nation. The study builds upon the team’s experience in alcohol/HIV intervention and CBPR in South Florida and preliminary work with stakeholders from the greater Miami and Fort Lauderdale areas to develop a multi- level PrEP intervention program for African American, Latina, and Haitian women who engage in risky sex and AOD use. The study includes researchers from the Southern HIV and Alcohol Research Consortium (SHARC) and will inform the design of target and comparison groups and other features of a U01 for further study within the NIAAA CHAART Consortia. Guided by the social ecological framework, the study will: identify needs, priorities, and community strengths and develop a PrEP continuum during a summit to engage stakeholders (Aim 1); produce a replicable implementation program, including manuals, materials, instruments, and procedures, through the formation of a Community Advisory and Advocacy Board (Aim 2); and conduct an exploratory pilot among 120 multi-ethnic women of color in Broward and Miami-Dade counties to test fidelity, feasibility and acceptability and measure PrEP uptake and adherence and retention in care over a 6 month period. The study will utilize biomarkers in a subsample to compare with self-reports and pharmacy refill measures. It will be among the first to develop a PrEP intervention in the South for women of color, and is thus in line with the specific high funding priorities of the Office of AIDS Research on cross-cutting research to reduce health disparities in developing implementation approaches for bio-behavioral strategies such as PrEP.

项目摘要 随着我们更接近HIV流行的半个世纪，对有色女性的影响不成比例 在美国，仍在努力。由于性别，妇女总体在流行病中遭受了灾难 构成生物学，社会和经济脆弱性的差异和规范。种族和种族差异 放大风险。诸如酒精和其他药物（AOD）之类的副因素使用相交并加强其他 合并症。生活在高患病率区域会大大严重严重的风险，使其更难 克服。帮助女性保持艾滋病毒阴性的选择受到限制。但是，这个障碍改变了几个 几年前，FDA批准和CDC认可口服预防预防（PREP）。但是，大多数 美国妇女不知道准备可以是女性控制的策略，或者它适用于她们，并且 备份尚未来自提供者或其社区。然而，最令人不安的是 在该国高影响力地区，有色妇女之间没有预备作为一项可访问的策略。这 发展U34对RFA-AA-17-013的响应，该响应优先于社区参与研究 （CBPR）开发针对高影响区域中酒精和艾滋病毒的妇女的实施模型以及 社区。拟议的研究将产生证据和CBPR驱动的PREP实施 干预以增强南佛罗里达州有色女性的吸收和优化使用，目前是 美国最近确定的艾滋病毒率最高的艾滋病毒率最高。 国家。该研究以团队在南佛罗里达州酒精/艾滋病毒干预和CBPR的经验为基础 以及与大迈阿密和劳德代尔堡地区的利益相关者的初步合作，以发展多种多样 非裔美国人，拉丁裔和海地妇女的水平准备干预计划，他们从事风险的性行为和 AOD使用。该研究包括来自南部艾滋病毒和酒精研究联盟（Sharc）的研究人员 并将告知目标和比较组的设计以及U01的其他功能，以进一步研究 NIAAA Chaart Consortia。在社会生态框架的指导下，研究将：确定需求， 优先事项以及社区优势并在峰会期间继续进行准备，以吸引利益相关者 （目标1）;制定可复制的实施计划，包括手册，材料，工具和 程序，通过成立社区咨询和倡导委员会（AIM 2）；并进行 布劳沃德和迈阿密戴德县的120名有色妇女的探索性飞行员，以测试富达， 在6个月内的可行性和可接受性，并衡量预备的摄取和依从性和保留率 时期。该研究将在子样本中利用生物标志物与自我报告和药房补充相比 措施。它将是最早在南方为有色女性开发准备干预措施的人之一，因此 根据艾滋病办公室研究的特定高资金优先级 减少健康差异在开发生物行为策略（例如PREP）的实施方法中。