Mhealth for Pre-exposure Prophylaxis Adherence by Young Adult MSM

Mhealth 促进年轻 MSM 遵守暴露前预防

基本信息

批准号：
9347041
负责人：
Patricia Flynn Weitzman
金额：
$ 22.5万
依托单位：
ENVIRONMENT AND HEALTH GROUP, INC.
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-21 至 2019-05-20
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9347041
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Affect African American Age Alcohol consumption Anal Sex Anti-Retroviral Agents Area Boston Brain Car Phone Centers for Disease Control and Prevention (U.S.)Chronic Clinic Community Practice Community of Practice Coupled Decision Making Development Developmental Process Diagnosis Disclosure Doctor of Philosophy Dose Education Effectiveness Ensure Environment Esthesia Female Focus Groups Follow-Up Studies Foundations Funding Goals Gold Grant Guidelines HIV HIV Infections HIV risk Health Health education Hygiene Incidence Individual Informal Social Control Intervention Knowledge Latino Leadership Literature Low income Meta-Analysis Methods Minority Modeling Motivation Participant Patient Education Patients Penetration Pharmaceutical Preparations Phase Prevention Psychology Randomized Randomized Controlled Trials Recommendation Research Research Support Rest Risk Self Efficacy Sleep Small Business Innovation Research Grant Social Network Stress System Teenagers Testing Text Time United States National Institutes of Health Victimization Wood material base black men who have sex with men comparative efficacy condoms cost design efficacy trial evidence base experience high risk improved intervention program mHealth male medication compliance member men men who have sex with men personalized approach pill pre-exposure prophylaxis programs sex social social cognitive theory therapy adherence tool truvada uptake young adult

项目摘要

Abstract: Environment and Health Group, Tufts HIV/AIDS Clinic, and the Boston-area PrEP Community of Practice will collaborate under the leadership of Patricia Weitzman, PhD, to develop and test the feasibility and short-term effectiveness of the first-ever individually-tailored, developmentally- and culturally-sensitive, mobile (mhealth) PrEP adherence tool. It will target culturally-diverse, young adult men ages 20-29 who have sex with men (YMSM). When PrEP is taken daily, it can reduce HIV risk by up to 92%. The CDC estimates PrEP is appropriate for 500,000 MSM in the U.S. Impact models show even modest PrEP adherence could reduce new HIV infections among MSM by 29% over 20 years. The recent rise in HIV infection among young adults age 20-29, particularly minority YMSM, points to the value of PrEP uptake and adherence support for culturally-diverse YMSM. In PrEP trials, younger age was the most consistent correlate with low PrEP adherence. Extensive mobile phone penetration among young adults makes mhealth an ideal, low-cost method for providing PrEP adherence support to YMSM. We bring together a developmental understanding of young adult decision making with principles from social learning theory and positive psychology for supporting PrEP adherence. The proposed project is based on Dr. Weitzman's successful Phase 1 (and current Phase 2) anti-retroviral therapy (ART) mhealth adherence intervention for HIV+ African Americans, which combined tailored pill reminders with age- and culturally-sensitive motivational and educational texts. Experts suggest building PrEP adherence interventions on proven ART adherence interventions as many PrEP adherence facilitators are the same as ART. Moreover, the growing literature on mhealth shows it is a powerful approach to supporting adherence across conditions. In addition to building on our prior ART mhealth tool, we address facilitators/barriers identified in PrEP RCT follow up studies, and CDC PrEP adherence recommendations. Moreover, formative focus groups with diverse YMSM will allow us to identify and target unique adherence barriers and facilitators in this group. The intervention will provide tailored pill reminders with PrEP education texts, as well as developmentally-sensitive motivational texts. We will include sleep hygiene and alcohol use messages, which have direct relevance to young adults. By using a low-cost, accessible mobile phone tool, the intervention eliminates several access barriers to support, which can be a particular problem for low income and minority patients. Our overarching goal is to help stop the rise in HIV among YMSM.

摘要：环境与健康小组、塔夫茨 HIV/AIDS 诊所和波士顿地区 PrEP 实践社区将在 Patricia Weitzman 博士的领导下合作，开发并测试第一个单独定制的可行性和短期有效性，发展和文化敏感的移动（移动健康）PrEP 依从工具。它将瞄准具有文化多样性、年龄在 20-29 岁之间、与男性发生性关系的年轻成年男性 (YMSM)。当 PrEP 为每天服用，可降低高达 92% 的 HIV 风险。 CDC 估计 PrEP 适合美国 500,000 MSM 影响模型显示，即使是适度的 PrEP 坚持也可能会减少新的感染 20 年来，MSM 中的 HIV 感染率增加了 29%。最近艾滋病毒感染率上升 20-29 岁的年轻人，尤其是少数 YMSM，指出了 PrEP 吸收和使用的价值对文化多元化 YMSM 的坚持支持。在 PrEP 试验中，年龄较小是最常见的与 PrEP 依从性低一致相关。手机普及率高年轻人使移动健康成为一种理想的、低成本的方法，为年轻人提供 PrEP 依从性支持 YMSM。我们将对年轻人决策的发展理解与社会学习理论和积极心理学的原则支持 PrEP 坚持。拟议的项目基于 Weitzman 博士成功的第一阶段（以及当前的第一阶段） 2) 针对 HIV+ 非洲裔美国人的抗逆转录病毒治疗 (ART) 移动健康依从性干预，它将量身定制的服药提醒与年龄和文化敏感的动机和教育文本。专家建议在经过验证的 ART 基础上建立 PrEP 依从性干预措施依从干预措施，因为许多 PrEP 依从促进者与 ART 相同。而且，越来越多的关于移动健康的文献表明，它是支持跨领域坚持的有效方法。状况。除了以我们之前的 ART 移动健康工具为基础之外，我们还解决了促进因素/障碍 PrEP RCT 随访研究和 CDC PrEP 依从性建议中确定。此外，具有多元化 YMSM 的形成性焦点小组将使我们能够识别和瞄准独特的目标该群体中的依从障碍和促进因素。干预措施将提供量身定制的药丸使用 PrEP 教育文本以及发展敏感的激励文本进行提醒。我们将包括睡眠卫生和饮酒信息，这些信息与年轻人直接相关成年人。通过使用低成本、易于使用的移动电话工具，干预措施消除了一些获得支持的障碍，这对于低收入和少数族裔来说可能是一个特殊问题患者。我们的首要目标是帮助阻止 YMSM 中艾滋病毒的上升。