Feasibility and Acceptability of an MI-based Telehealth Intervention for Bacterial STI Screening

基于 MI 的远程医疗干预细菌性传播感染筛查的可行性和可接受性

• 批准号: 10663458
• 负责人: Akshay Sharma
• 金额: $ 23.4万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-10 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663458
• 关键词: Anatomy; Attitude; Awareness; Behavioral; Bisexual; Blood specimen; CD4 Lymphocyte Count; COVID-19 pandemic; Caring; Centers for Disease Control and Prevention (U.S.); Chlamydia; Client; Clinic Visits; Clinical Trials; Collection; Counseling; Data; Diagnosis; Early Diagnosis; Early treatment; Epididymitis; Evaluation; Fingers; Fright; Gays; Gonorrhea; HIV; Health; Height; Home; Individual; Infection; Inflammatory; Intervention; Interview; Knowledge; Left; Medical; Mental Health; Methods; Modeling; Monitor; Motivation; Orchitis; Participant; Patients; Perception; Persons; Pharyngeal structure; Phase; Population Heterogeneity; Prevention; Privacy; Problem Solving; Proctitis; Provider; Public Health; Recommendation; Rectum; Reporting; Research; Risk; Sampling; Self Efficacy; Seminal; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Site; Specimen; Stigmatization; Swab; Syphilis; Syphilis Serodiagnosis; Test Result; Testing; Time; Ulcer; United States; Urethra; Urine; Videoconferencing; Viral; Viral Load result; acceptability and feasibility; antiretroviral therapy; computed tomography screening; improved; indicated prevention; intrinsic motivation; men who have sex with men; motivational enhancement therapy; national surveillance; novel; pharyngeal swab; prostatitis; recruit; rectal; screening; screening guidelines; sexual HIV transmission; sexual health intervention; sexually active; skills; social networking website; surveillance data; telehealth; therapy adherence

PROJECT SUMMARY/ABSTRACT Gay, bisexual and other men who have sex with men living with HIV (GBMSM-LWH) bear a heavy burden of bacterial sexually transmitted infections (STIs) such as gonorrhea (GC), chlamydia (CT) and syphilis. Left untreated, bacterial STIs may lead to serious health complications. Inflammatory and ulcerative STIs can also facilitate the onward sexual transmission of HIV in the presence of inadequate viral suppression. Timely diagnosis and treatment are key to prevention. Sexually active GBMSM-LWH engaged in HIV medical care are not being screened for GC, CT and syphilis at least annually, as recommended. Home specimen self-collection has increasingly been used to screen for bacterial STIs in studies conducted with diverse populations. Telehealth has also demonstrated promise in managing mental health and increasing antiretroviral therapy adherence in people living with HIV. Only few studies have combined home specimen self-collection with live audio/video (AV) conferencing, all of which have been restricted to people without HIV. None have focused on GBMSM-LWH or incorporated motivational interviewing (MI), a client-centered, strengths-based counseling approach that seeks to support individuals towards positive behavioral change. Integrating home specimen self-collection from different anatomical sites of possible exposure with MI delivered via live AV conferencing might offer a unique solution to engage GBMSM-LWH in bacterial STI screening. MI-guided discussions have the potential to increase participants’ knowledge of bacterial STIs, enhance their intrinsic motivation to protect themselves and their sex partners, improve their self-efficacy for specimen self-collection, and problem-solve barriers to seeking treatment (if warranted) and repeat testing. Our sequential explanatory mixed-methods study seeks to explore the feasibility and acceptability of a novel MI-based telehealth intervention for sexually active GBMSM-LWH. In Phase 1, we will recruit 75 participants via mobile dating apps and social networking websites, and deliver a 3- component intervention: (i) a pre-test live AV conferencing session involving an MI-guided discussion to elicit awareness of bacterial STIs and fill any knowledge gaps, bolster the perceived importance of regularly screening for GC, CT and syphilis, and improve self-efficacy for specimen self-collection, (ii) self-collecting at home and returning by mail a finger-stick blood sample (for syphilis testing), a urine sample (for GC and CT testing), a pharyngeal swab (for GC and CT testing) and a rectal swab (for GC and CT testing), and (iii) a post-test live AV conferencing session involving an MI-guided discussion to prepare participants for receiving test results and formulate personalized action plans for seeking treatment (if warranted) and repeat testing. In Phase 2, we will conduct in-depth interviews with a purposively selected subsample of 20 participants who complete progressively smaller subsets of the pre-test session, specimen return for bacterial STI testing, and the post-test session to elucidate attitudes, facilitators and barriers related to engaging in each component of our intervention.

项目摘要/摘要 同性恋，双性恋和其他与艾滋病毒（GBMSM-LWH）发生性关系的男人都有沉重的燃烧 细菌性传播感染（STI），例如淋病（GC），衣原体（CT）和梅毒。左边 未经治疗的细菌性传播感染可能导致严重的健康并发症。炎症和溃疡性性传播感染也可以 在病毒抑制不足的情况下，促进艾滋病毒的性传播。及时 诊断和治疗是预防的关键。从事HIV医疗护理的性活跃的GBMSM-LWH是 不建议您每年至少每年筛选GC，CT和梅毒。家庭标本自我收集 在与大型种群进行的研究中，已经增加了用于筛选细菌性传播感染的细菌。远程医疗 还表现出在管理心理健康和增加抗逆转录病毒疗法遵守方面的希望 患有艾滋病毒的人。只有很少的研究将房屋标本自我收集与实时音频/视频结合在一起 （AV）会议，所有这些会议都仅限于没有艾滋病毒的人。没有人专注于GBMSM-LWH 或成立动机访谈（MI），一种以客户为中心的基于优势的咨询方法 试图支持个人进行积极的行为改变。整合房屋标本自收集 通过实时AV会议提供的MI可能接触的不同解剖位点可能会提供独特的 在细菌性STI筛查中吸引GBMSM-LWH的解决方案。 MI引导的讨论有可能 增加参与者对细菌性传播感染的了解，增强他们保护自己的内在动机 他们的性伴侣，提高他们的自我收集的自我效率，并解决问题的障碍 治疗（如果有保证）和重复测试。我们的顺序挖掘混合方法研究旨在探索 新型基于MI的远程医疗干预对性活跃的GBMSM-LWH的可行性和可接受性。在 第1阶段，我们将通过移动约会应用程序和社交网站招募75名参与者，并提供3-- 组件干预：（i）预测试现场直播的会议会议，涉及MI引导的讨论 认识细菌性传播感染并填补任何知识空白，加强了定期筛查的感知重要性 对于GC，CT和梅毒，并改善了标本自我收集的自我有效，（ii）在家中自我收集和 通过邮件返回手指粘的血液样本（用于梅毒测试），尿液样本（用于GC和CT测试），一个 咽拭子（用于GC和CT测试）和直肠拭子（用于GC和CT测试），以及（iii）测试后现场AV 会议会议涉及MI指导的讨论，以准备参与者接受测试结果和 制定个性化的行动计划，以寻求治疗（如果有必要）和重复测试。在第二阶段，我们将 对20名参与者的通常选择的子样本进行深入的访谈 测试前会话的较小子集，细菌STI测试的标本回报和测试后测试 会议阐明与参与我们干预的每个组成部分有关的与会者，促进者和障碍。