Mobile Adaptation and Testing of a Uniquely Targeted HIV Intervention for Young Transgender Women

针对年轻跨性别女性的独特针对性艾滋病毒干预措施的移动适应和测试

• 批准号: 9765545
• 负责人: Lisa Mary Kuhns
• 金额: $ 30万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-21 至 2020-09-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9765545
• 关键词: AIDS prevention; Address; Adolescent and Young Adult; Age; Anus; Attitude; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Chicago; Chlamydia; Cities; Comorbidity; Continuity of Patient Care; Control Groups; Counseling; Enrollment; Environment; Focus Groups; Funding; Genitourinary system; Goals; Gonorrhea; HIV; HIV Infections; HIV diagnosis; HIV risk; HIV/STD; Individual; Interdisciplinary Study; Intervention; Knowledge; Los Angeles; Mediation; Mediator of activation protein; Mental Depression; Modality; Modification; Motivation; National Institute of Mental Health; Online Systems; Outcome; Participant; Persons; Population; Population Decreases; Prevalence; Prevention; Prevention program; Preventive Intervention; Process; Randomized; Randomized Controlled Trials; Research; Research Project Grants; Risk; Risk Behaviors; Safe Sex; Services; Sexual Health; Sexual Partners; Site; Syphilis; Target Populations; Technology; Testing; Trauma; Update; Vagina; base; burden of illness; community based participatory research; condoms; data format; effective intervention; efficacy testing; empowerment; evidence base; group intervention; high risk; interest; intervention effect; intimate partner violence; mHealth; member; mobile computing; pre-exposure prophylaxis; prevent; primary outcome; psychosocial; secondary outcome; self esteem; sex; skills; social; social exclusion; socioeconomics; standard of care; therapy development; transgender; transgender women; transmission process; treatment arm; usability; user centered design

The goals of this proposed study are to adapt “LifeSkills”- an efficacious and uniquely targeted group- based HIV prevention intervention for young transgender women (YTW) ages 16-29, at risk for HIV transmission or acquisition- to a mobile platform; and once adapted, to conduct a full-scale randomized controlled trial (RCT) to determine its efficacy in decreasing HIV risk behavior. In the U.S., YTW are a key population at high risk of HIV infection, with HIV prevalence estimates in U.S. among urban YTW ranging from 19-22%. Evidence suggests that socioeconomic marginalization, and related psychosocial co- morbidities drive high levels of HIV-related risk YTW, indicating a need for comprehensive HIV prevention programs targeted to their unique circumstances and vulnerabilities. To date there are no evidence-based HIV prevention interventions (EBIs) for YTW listed in the CDC compendium of EBIs; interventions are needed that are widely scalable to the practice environment. We will address this gap via the following study aims: 1) adapting LifeSkills to a mobile web-based platform, including 1a) revising and updating the LifeSkills intervention to include expanded biomedical HIV prevention and treatment modalities (e.g., PrEP and HIV Treatment as Prevention); 1b) adapting the intervention content for mobile deployment with the larger investigative team and YTW at each enrollment site via qualitative focus groups, user-centered design sessions, and usability testing. 2) Pilot testing the adapted mobile intervention to enhance feasibility and acceptability with 40 YTW ages 16-29 at-risk of HIV acquisition or transmission (10 participants/site) and prepare for full implementation. 3) Testing the efficacy of the mobile LifeSkills intervention in comparison to a delayed intervention control group on the primary outcome: number of condomless sex acts (anal and vaginal; 4-month recall) without protection of PrEP/ART; and secondary outcome: acquisition of HIV/STIs (urogenital/anal chlamydia and gonorrhea, syphilis). Furthermore, we will: 3a) examine mediation in HIV risk between intervention groups by the conceptual mediators of the intervention: transgender adaptation/integration, collective self-esteem/empowerment, information, motivation, and behavioral skills. 3b) assess the efficacy of the mobile LifeSkills intervention in comparison to the control condition on outcomes across the HIV prevention and care continuum, including PrEP/HIV care linkage, initiation, and retention, with assessment of effect modification by HIV status (lab-confirmed).

这项拟议研究的目标是适应“生活技能”——一个有效且独特的目标群体—— 针对 16-29 岁有艾滋病毒风险的年轻跨性别女性 (YTW) 进行艾滋病毒预防干预 传输或采集到移动平台；一旦适应，即可进行全面的随机化 在美国，YTW 是一项关键的对照试验（RCT），以确定其降低 HIV 危险行为的功效。 HIV 感染高危人群，美国城市 YTW 中的 HIV 患病率估计范围 19-22% 的证据表明，社会社会边缘化和相关的心理社会问题。 发病率导致艾滋病毒相关风险较高，表明需要进行全面的艾滋病毒预防 迄今为止，还没有针对其独特情况和脆弱性的计划。 CDC EBI 干预纲要中列出的针对 YTW 的 HIV 预防干预措施 (EBI) 包括： 我们将通过以下方式解决这一差距。 研究目标： 1) 使 LifeSkills 适应基于移动网络的平台，包括 1a) 修订和更新 生命技能干预包括扩大艾滋病毒生物医学预防和治疗方式（例如 PrEP 1b) 调整干预内容以适应移动部署 通过定性焦点小组、以用户为中心，在每个报名地点建立更大的调查团队和 YTW 2）试点测试适应性移动干预以增强可行性 40 岁 16-29 岁有艾滋病毒感染或传播风险的 YTW 的可接受性（10 名参与者/地点） 并为全面实施做好准备 3) 测试移动生活技能干预的有效性。 与延迟干预对照组主要结局的比较：无套性行为的次数 没有 PrEP/ART 保护和次要结果的行为（肛门和阴道；4 个月回忆）； 感染艾滋病毒/性传播感染（泌尿生殖道/肛门衣原体和淋病、梅毒）此外，我们将：3a)。 通过干预的概念中介来检查干预组之间艾滋病毒风险的中介： 跨性别适应/融合、集体自尊/赋权、信息、动机和 3b) 与对照相比，评估移动生活技能干预的效果。 整个艾滋病毒预防和护理连续过程的结果条件，包括 PrEP/艾滋病毒护理联系， 启动和保留，并根据 HIV 状态评估效果修改（实验室确认）。

项目成果

A Uniquely Targeted, Mobile App-Based HIV Prevention Intervention for Young Transgender Women: Adaptation and Usability Study.

针对年轻跨性别女性的独特针对性、基于移动应用程序的艾滋病毒预防干预措施：适应性和可用性研究。

• 发表时间: 2021
• 影响因子: 7.4
• 作者: Kuhns, Lisa M;Hereth, Jane;Garofalo, Robert;Hidalgo, Marco;Johnson, Amy K;Schnall, Rebecca;Reisner, Sari L;Belzer, Marvin;Mimiaga, Matthew J
• 通讯作者: Mimiaga, Matthew J