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.

项目概要 在美国，与男性发生性关系的变性男性（跨男男性接触者）面临感染艾滋病毒的风险，因此需要 性别肯定、文化响应的生物行为艾滋病毒预防策略 本研究的目标。 是评估以数字方式提供的基于同行的策略的能力，以提高 PrEP 指示的 PrEP 吸收率 HIV 阴性成人跨性别 MSM（行为上定义为与有阴茎的人发生性行为）。 提出对同行传递的 HIV 进行数字开放标签随机 2x2 析因试验（1:1:1:1 随机化） 旨在增加居住在艾滋病毒高发区的跨性别男男性接触者的 PrEP 摄取的预防策略 美国东部和南部的地理热点具体目标是： (1) 比较效果。 个人（PrEP4T：一对一同伴导航）和基于团体（男性生活技能：基于小组） 行为干预）实施超过 6 个月的同伴提供的 HIV 预防策略，以增加 PrEP 300 名 PrEP 呈 HIV 阴性的成年跨性别 MSM 的摄取（主要结果） (2) 通过以下方式检查机制； 哪些同行提供的干预措施会影响 PrEP 的采用，重点关注医疗保健赋权、跨性别者 社区支持以及信息、动机和行为技能；以及 (3) 探索 PrEP 决策 定性的生物行为评估将每 3 个月进行一次，持续 21 个月。 通过自我管理的调查进行远程 HIV 自我测试（第四代测试）和 PrEP 的生物测量 使用干血斑 (DBS) 检测恩曲他滨三磷酸 (FTC-TP) 和替诺福韦二磷酸 (TFV-DP) 评估该人群对经批准的基于 TFV 的 PrEP 方案的采用情况；以及性传播感染（淋病、衣原体、 该团队将采用全民参与的视角。 “与”跨性别男男性行为者合作，而不是“在”跨性别男男性行为者身上工作，确保跨性别男男性行为者有意义的参与 拟议的研究是。 通过解决服务不足的 NIH 健康差距人群中的艾滋病毒预防问题具有重要意义，并将填补关键的空白 生物行为艾滋病毒预防和同伴参与方法方面的差距该研究与美国国家一致。 在艾滋病毒高发区的高危人群中实施艾滋病毒预防综合战略的优先事项 地理热点地区，并将推进 2021-2025 年结束艾滋病毒流行国家战略计划。