Tailoring Delivery of LongActing PrEP for Cisgender (MSM) who Use Methamphetamine

为使用甲基苯丙胺的顺性别 (MSM) 量身定制长效 PrEP

基本信息

批准号：
10760968
负责人：
Vanessa McMahan
金额：
$ 18.31万
依托单位：
PUBLIC HEALTH FOUNDATION ENTERPRISES
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-15 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10760968
关键词：
AIDS prevention Adherence Appointment Behavioral Cities Code Data Data Collection Development Effectiveness Ensure Equity Evaluation Formulation Frequencies Future HIV HIV Infections HIV Seronegativity HIV risk Heterogeneity Hour Housing Implant Incentives Inequity Injections Intervention Interview Location Methamphetamine Modality Modeling Morbidity - disease rate Oral Participant Patient Recruitments Patients Phase Population Prevalence Prevention strategy Provider Reporting Research Risk Sampling San Francisco Services Site Source Subgroup Surveys System Time United States Work cis-male cisgender cognitive interview condomless anal sex experience experimental study follow-up forgetting health disparity high risk informant interest medication compliance men who have sex with men methamphetamine use mortality novel pre-exposure prophylaxis preference prevent programs public health relevance service providers social stigma statistics subcutaneous therapy development transgender women truvada uptake

项目摘要

PROJECT SUMMARY/ABSTRACT Methamphetamine (MA) use and related morbidity and mortality are rapidly increasing in the United States. MA use disproportionately impacts cisgender men who have sex with men (MSM) and is strongly associated with increased risk for HIV acquisition. MA use is also associated with suboptimal pre-exposure prophylaxis (PrEP) adherence, diminishing the benefit of daily, oral PrEP for HIV prevention among MSM who use MA. Long- acting (LA) PrEP is a promising prevention strategy for MSM who use MA, since its effectiveness does not rely on daily medication adherence. In December 2021, long acting cabotegravir (CAB LA) PrEP received FDA approval, after it was found to be superior to daily, oral Truvada. There are other LA PrEP agents in earlier stages of development, including biannual injections and subdermal implants. To help ensure that populations at highest risk for HIV effectively engage in LA PrEP programs, we will assess interest in different LA PrEP formulations, and facilitators, barriers, and preferences for delivery of CAB LA PrEP among MSM who use MA. We will assess the level of interest and correlates of interest in different LA PrEP formulations among MSM who use MA via the 2023 National HIV Behavioral Surveillance (NHBS) survey at five of the western US sites (San Francisco and San Diego, CA; Portland, OR; Seattle, WA; and Denver, CO) (Aim 1). We will explore multilevel (i.e., on the patient, provider, and system level) barriers to and facilitators of LA PrEP use and important attributes of CAB LA PrEP delivery through in-depth interviews (Aim 2). We will interview up to 40 HIV-negative MSM who use MA (up to 20 who have never taken PrEP and 20 who have) and up to 20 key informants (e.g., clinicians, service providers). We will identify important attributes and levels for LA PrEP delivery across interviews to inform a subsequent discrete choice experiment (DCE). Prior to the DCE we will conduct 10 cognitive interviews to ensure that the DCE inputs accurately capture the perspectives shared during the initial interviews. We will then conduct a DCE (Aim 3) to identify preferences for CAB LA PrEP delivery among MSM who use MA using the final attributes and levels from Aim 2. Our findings will inform engagement of MSM who use MA in LA PrEP programs and the development of an intervention that will be evaluated in a future trial.

项目概要/摘要在美国，甲基苯丙胺 (MA) 的使用以及相关的发病率和死亡率正在迅速增加。硕士使用对男男性行为者 (MSM) 的影响不成比例，并且与感染艾滋病毒的风险增加。 MA 的使用还与暴露前预防 (PrEP) 效果不佳有关坚持，减少了使用 MA 的 MSM 中每日口服 PrEP 对 HIV 预防的益处。长的- 对于使用 MA 的 MSM 来说，代理 (LA) PrEP 是一种很有前途的预防策略，因为其有效性不依赖于关于日常用药依从性。 2021年12月，长效卡博特韦（CAB LA）PrEP获得FDA批准在发现它优于每日口服特鲁瓦达后，获得批准。早期还有其他 LA PrEP 制剂开发阶段，包括每年两次注射和皮下植入。为了帮助确保艾滋病毒感染风险最高的人群有效参与 LA PrEP 计划，我们将评估对不同 LA PrEP 配方的兴趣，以及 CAB LA 递送的促进因素、障碍和偏好使用 MA 的 MSM 中的 PrEP。我们将评估不同洛杉矶的兴趣水平和兴趣相关性根据 2023 年国家 HIV 行为监测 (NHBS) 调查，使用 MA 的 MSM 中的 PrEP 配方在美国西部的五个站点（加利福尼亚州旧金山和圣地亚哥；俄勒冈州波特兰；华盛顿州西雅图；以及丹佛） CO）（目标 1）。我们将探讨多层面（即患者、提供者和系统层面）的障碍和通过深入访谈了解 LA PrEP 使用的促进者以及 CAB LA PrEP 实施的重要属性（目标 2）。我们将采访最多 40 名使用 MA 的 HIV 阴性 MSM（最多 20 名从未接受过 PrEP 的人和 20 名以及最多 20 名关键信息提供者（例如临床医生、服务提供者）。我们将确定重要的属性以及通过访谈提供 LA PrEP 的水平，为随后的离散选择实验 (DCE) 提供信息。在 DCE 之前，我们将进行 10 次认知访谈，以确保 DCE 输入准确捕捉在最初的采访中分享的观点。然后，我们将进行 DCE（目标 3）来确定偏好使用目标 2 中的最终属性和水平，在使用 MA 的 MSM 中进行 CAB LA PrEP 交付。我们的发现将告知在 LA PrEP 项目中使用 MA 的 MSM 的参与以及干预措施的制定将在未来的试验中进行评估。