Strategies to Prevent HIV Acquisition Among Transgender MSM in the US

美国跨性别男男性接触者预防艾滋病毒感染的策略

• 批准号: 10687266
• 负责人: Sari Reisner
• 金额: $ 74.92万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-19 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10687266
• 关键词: AIDS prevention; Address; Adult; American; Area; Behavior; Behavior Therapy; Behavioral; Biological; Biological Markers; Birth; Black race; Blood; Chlamydia; Clinical; Communities; Computerized Medical Record; Data; Decision Making; Digital Libraries; Diphosphates; Dryness; Ensure; Epidemic; Female; Future; Gender; Gender Identity; Geography; Goals; Gonorrhea; HIV; HIV Seronegativity; HIV risk; Health; Healthcare; Incidence; Individual; Internet; Intervention; Interview; Knowledge; Latinx; Life; Measures; Mediating; Mediation; Mental Health; Methods; Modeling; Motivation; Persons; Pilot Projects; Population; Populations at Risk; Prevention; Prevention strategy; Public Health; Randomized; Regimen; Research; Risk; Sampling; Science; Self Administration; Services; Sex Behavior; Sexual Health; Spottings; Strategic Planning; Surveys; Syphilis; Tenofovir; Testing; Testosterone; US State; United States National Institutes of Health; Work; acceptability and feasibility; behavioral construct; biobehavior; cisgender; comparative efficacy; design; digital; digital delivery; efficacy trial; empowerment; emtricitabine; experience; gender affirmation; health care availability; health care service; health disparity populations; implementation intervention; improved; interest; male; men; men of color; men who have sex with men; open label; peer; penis; pre-exposure prophylaxis; prevent; preventive intervention; primary outcome; recruit; scale up; self testing; sex; skills; social stigma; standard of care; transgender; transgender men; transmasculine; tripolyphosphate; uptake

PROJECT SUMMARY Transgender men who have sex with men (trans MSM) are at-risk of HIV acquisition in the US and require gender-affirming culturally responsive biobehavioral HIV prevention strategies. The goal of the proposed study is to assess the ability of digitally delivered peer-based strategies to improve PrEP uptake in PrEP-indicated HIV-negative adult trans MSM (defined behaviorally as sex with a person who has a penis). This study proposes a digital open-label randomized 2x2 factorial trial (1:1:1:1 randomization) of peer-delivered HIV prevention strategies designed to increase PrEP uptake in trans MSM residing in high HIV incidence geographic hotspots in the Eastern and Southern US. The specific aims are to: (1) Compare the efficacy of individual (PrEP4T: one-on-one peer navigation) and group-based (LifeSkills for Men: small group-based behavioral intervention) peer-delivered HIV prevention strategies implemented over 6 mo to increase PrEP uptake (primary outcome) in 300 PrEP-indicated HIV-negative adult trans MSM; (2) Examine mechanisms by which peer-delivered interventions impact PrEP uptake focusing on healthcare empowerment, trans community support, and information, motivation, and behavioral skills; and (3) Explore PrEP decision-making and intervention experiences qualitatively. Biobehavioral assessments will be conducted every 3 mo for 21 mo with self-administered surveys; remote HIV self-testing (4th gen tests) and biologic measures of PrEP via emtricitabine triphosphate (FTC-TP) and tenofovir diphosphate (TFV-DP) using dried blood spots (DBS) to evaluate uptake of approved TFV-based PrEP regimens in this population; and STIs (gonorrhea, chlamydia, syphilis) via electronic medical record (EMR) releases. The team will use a participatory population perspective to work “with” not “on” trans MSM ensuring meaningful participation of trans MSM. The proposed study is significant by addressing HIV prevention in an underserved NIH health disparities population and will fill critical gaps in biobehavioral HIV prevention and peer-engaged approaches. The study is aligned with US national priorities to implement integrated strategies for HIV prevention in at-risk populations in high HIV incidence geographic hotspots and will advance the 2021-2025 National Strategic Plan to End the HIV epidemic.

项目摘要 与男性发生性关系（Trans MSM）的变性男人在美国处于艾滋病毒的危险中，需要 性别肯定具有文化反应的生物行为艾滋病毒预防策略。拟议研究的目标 是评估基于数字交付的基于同行的策略的能力，以改善预先指示的预期吸收 HIV阴性成人Trans MSM（在行为上与具有阴茎的人的性别定义）。这项研究 提案的数字开放标签随机2x2阶乘试验（1：1：1：1：1随机化）的同伴送达HIV 预防策略旨在增加居住在高艾滋病毒发病率的Trans MSM中的预备力 美国东部和南部的地理热点。具体目的是：（1）比较 个人（Prep4t：一对一的同行导航）和基于组的（男性的救生员：基于小组的小型群体 行为干预）在6个月以上实施的同行提供的艾滋病毒预防策略以增加准备 在300个预测的HIV阴性成人Trans MSM中吸收（主要结果）； （2）检查机制 哪些同行分配干预措施会影响预备摄取，重点是增强医疗保健，跨性别 社区支持以及信息，动力和行为技巧； （3）探索预先决策 和干预经历。生物行为评估每3个月每3个月进行21个月进行 进行自我管理调查；通过 Emtricerabine三磷酸（FTC-TP）和替诺福韦双磷酸（TFV-DP）使用干血点（DBS）到 评估该人群中批准的基于TFV的预备方案的吸收；和stis（淋病，衣原体， 通过电子病历（EMR）发行的梅毒）。团队将使用参与人群的观点 “与“ ON” Trans MSM一起使用，以确保Trans MSM的有意义参与。拟议的研究是 通过在服务不足的NIH健康分配人群中解决艾滋病毒预防的重要意义，并将填补关键 生物行为预防和同伴参与方法的差距。这项研究与美国国家 在高艾滋病毒发病率的高风险人群中实施预防艾滋病毒的综合策略的优先事项 地理热点，并将推进2021 - 2025年国家战略计划，以结束艾滋病毒的流行。