Increasing HIV/STI Home Testing, Linkage to Care, and Linkage to PrEP via a Digital Intervention among Black Women in a Geographic Hotspot

通过对地理热点地区黑人妇女进行数字干预，增加 HIV/STI 家庭检测、与护理的联系以及与 PrEP 的联系

• 批准号: 10328173
• 负责人: Liesl A Nydegger
• 金额: $ 24.95万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 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 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10328173
• 关键词: Accounting; Adoption; Appointment; Behavior; Behavioral; Behavioral Model; COVID-19 pandemic; Caring; Centers for Disease Control and Prevention (U.S.); Clinic; Communities; Contracts; County; Diagnosis; Diagnostic Reagent Kits; Discrimination; Early Diagnosis; Emergency department visit; Environmental Impact; Epidemic; Ethnic Origin; Evaluation; Failure; Focus Groups; Fright; Future; Geography; Goals; HIV; HIV Seropositivity; HIV diagnosis; HIV risk; High Risk Woman; Home; Hour; Human immunodeficiency virus test; Income; Infection; Intervention; Lead; Link; Location; Low income; Medical; Medical Care Costs; Methods; Modeling; Motivation; Online Systems; Outcome; Participant; Persons; Phase; Population; Preventive service; Protocols documentation; Psyche structure; Race; Randomized; Research; Risk; Self Efficacy; Sexually Transmitted Diseases; Structure; Symptoms; Testing; Texas; Time; Transportation; Treatment Cost; Underserved Population; Woman; acceptability and feasibility; austin; base; black women; community partnership; cost; digital intervention; economic impact; efficacy trial; field study; follow up assessment; follow-up; high risk; home test; infection rate; innovation; pre-exposure prophylaxis; prevent; racial disparity; risk perception; screening; sexual HIV transmission; skills; social; social stigma; therapy design; transmission process; trend; virtual; web-based assessment; web-based intervention

PROJECT SUMMARY: In Travis County, Texas, deemed a HIV geographic hotspot due to high HIV rates, Black women are 18.4 times more likely to contract HIV compared to women of other races/ethnicities. Black women also have higher rates of sexually transmitted infections (STIs) than other women; many STIs have no symptoms, are undiagnosed, and are untreated. Having an STI triples one's risk for contracting HIV. In Travis County, over 20% of women learned one year after contracting HIV that they were HIV-positive, highlighting barriers to testing. Home HIV/STI testing has promise to increase rates of testing by circumventing barriers and thereby reduce medical costs through early detection and care. Home HIV/STI testing is also a prime opportunity to link Black women at high risk for HIV to pre-exposure prophylaxis (PrEP). Yet, home testing alone may not overcome all barriers. Pairing home testing with an intervention designed to increase motivation and overcome barriers has the most promise to increase HIV/STI testing rates. The proposed project draws on 3 components, the situated, information-motivation-behavioral (sIMB) model, mental contrasting, and implementation intentions to develop a new, web-based intervention. This intervention is comprised of 5 sessions: 1) using the HIV/STI home testing kit, 2) mailing in the kit, 3) checking results, 4) obtaining treatment, and 5) attending an appointment for PrEP. Each session is structured the same: information regarding the importance of each behavior (i.e., taking the home test, mailing in the test, checking results, linkage to care, and linkage to PrEP), motivation via mental contrasting (identifying positive outcomes and barriers to each session) and methods to overcome the identified barriers (implementation intentions), and behavioral skills to increase self-efficacy. The project will occur in 3 phases that coincide with the aims to develop and culturally tailor the intervention. 1) Conduct formative research to develop the intervention. Four focus groups (n=4-6), with 24 Black women from Travis County will explore the constructs of sIMB, mental contrasting, and implementation intentions to develop the intervention protocol to be field tested in Aim 2. 2) Field test the intervention. We will test the preliminary feasibility and acceptability of the intervention with 6 participants to make any necessary adjustments for Aim 3. 3) Conduct a feasibility pilot of the intervention. We will determine the feasibility, acceptability, and preliminary efficacy among 60 Black women in Travis County. Participants will be randomly assigned to the intervention or a web-based educational control. We hypothesize that the intervention will be feasible, acceptable, and demonstrate a trend toward efficacy for completion of home testing, linkage to care, and linkage to PrEP. Follow-up web-based assessments will be administered 2-, 4-, and 6-months after baseline. The web-based design of the intervention greatly increases the opportunity for implementation on a large scale. The long-term goal is to increase HIV/STI testing among low-income Black women via scalable and sustainable methods to decrease HIV transmission and subsequent disparities.

项目摘要：在德克萨斯州特拉维斯县，由于艾滋病毒率高，被认为是艾滋病毒地理热点 与其他种族/种族的妇女相比，黑人妇女感染艾滋病毒的可能性高出18.4倍。黑色的 与其他妇女相比，妇女还具有更高的性传播感染（性传播感染）；许多性传播感染没有 症状，未诊断，未经治疗。患有感染艾滋病毒的风险三元。在特拉维斯 县，超过20％的妇女在感染艾滋病毒后一年就学会了自己的艾滋病毒阳性，强调了 测试的障碍。家庭艾滋病毒/STI测试有望通过规避障碍和 从而通过早期发现和护理来降低医疗费用。家庭艾滋病毒/STI测试也是主要的 有机会将艾滋病毒高风险的黑人妇女与预防前的暴露预防联系起来（PREP）。但是，家庭测试 一个人可能不会克服所有障碍。将家庭测试与旨在增加动力的干预措施配对 克服障碍是提高HIV/STI测试率的最大希望。拟议的项目利用 3个组件，位置，信息动机行为（SIMB）模型，心理对比和 实施意图，以开发新的基于网络的干预措施。该干预措施包括5 会议：1）使用HIV/STI家庭测试套件，2）套件中的邮寄，3）检查结果，4）获得治疗， 5）参加预约。每个会话的结构相同：有关 每种行为的重要性（即，参加家庭测试，在测试中邮寄，检查结果，链接到护理， 与准备的联系），通过心理对比进行动机（确定每个人的积极成果和障碍 会议）和克服确定障碍（实施意图）以及行为技能的方法 提高自我效能。该项目将分为3个阶段，与开发和文化相吻合 量身定制干预措施。 1）进行形成性研究以开发干预措施。四个焦点组（n = 4-6）， 来自特拉维斯县的24名黑人妇女将探索SIMB的建筑，心理对比和 实施意图以制定在AIM 2中测试的干预协议2. 2）现场测试 干涉。我们将测试与6名参与者的干预措施的初步可行性和可接受性 对目标进行任何必要的调整。3）进行干预的可行性试点。我们将确定 特拉维斯县60名黑人妇女的可行性，可接受性和初步疗效。参与者会 随机分配给干预措施或基于网络的教育控制。我们假设 干预将是可行的，可接受的，并证明了建立家庭有效性的趋势 测试，与护理的联系以及与PREP的联系。基于后续网络的评估将进行2-，4-，， 基线后6个月。基于网络的干预设计大大增加了机会 大规模实施。长期目标是增加低收入黑色的HIV/STI测试 妇女通过可扩展和可持续的方法来减少HIV传播和随后的差异。