Intervention to reduce drug use and HIV incidence among high PrEP priority partnered YMSM

减少 PrEP 重点合作伙伴 YMSM 中吸毒和艾滋病毒发病率的干预措施

• 批准号: 9926851
• 负责人: Tyrel J Starks
• 金额: $ 92.2万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9926851
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Age; Agreement; Alcohol or Other Drugs use; Attention; Behavior Therapy; Behavioral; Biological; Biological Assay; Biological Markers; Blood; Centers for Disease Control and Prevention (U.S.); Collection; Communication; Couples; Data; Development; Dose; Drug Targeting; Drug usage; Education; Epidemic; Face; Funding; Future; Gender; Goals; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV risk; Hair; Heterosexuals; Incidence; Individual; Infection; Intervention; Intervention Studies; Interview; Joints; Link; Logistics; Measures; Mediating; Modeling; Motivation; Nature; Participant; Pharmaceutical Preparations; Prevention; Prevention strategy; Provider; Public Health; Randomized; Recommendation; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction Behavior; Sampling; Sampling Biases; Services; Sex Behavior; Sexual Health; Spottings; Structure of nail of finger; Tenofovir; United States; United States National Institutes of Health; Vulnerable Populations; Work; attentional control; base; condomless anal sex; control trial; cost; effectiveness implementation study; effectiveness trial; efficacy testing; eligible participant; experience; follow up assessment; group intervention; health care settings; innovation; interest; intervention effect; men; men who have sex with men; motivational enhancement therapy; multimodality; novel; pre-exposure prophylaxis; prevent; prevention service; primary outcome; psychoeducation; recruit; response; service intervention; sex; skills; skills training; theories; transmission process; uptake; young man; young men who have sex with men

Project Summary CDC recommendations identify MSM in non-monogamous relationships and those in relationships with an HIV positive partner as candidates for PrEP. Estimates suggest as many as 79% of new HIV infections among young MSM (YMSM; ages 18-29) are transmitted between main partners. Drug use is an established correlate of HIV transmission risk. For partnered men, relational factors (e.g., sexual agreements) contextualize drug use and both drug use and sexual agreements predict receptivity to PrEP. Together, these findings point to the need for integrated intervention services – targeting drug use and sexual health –tailored for partnered YMSM. Such services are essential to addressing the HIV epidemic in the US. In response, our team has developed a 4-session MI-based intervention targeting PrEP uptake/adherence, HIV TRB, and drug use among partnered YMSM. PARTNER (Prevention And Risk: Treatment with a New Emphasis on Relationships) is delivered to individual YMSM in relationships (not couples), which enhances the scalability of the proposed intervention. Our preliminary pilot work has established the acceptability and feasibility of PARTNER. The primary goal of the current study is to test the efficacy of PARTNER relative to an attention-matched educational control condition used in previously funded NIH studies with HIV-negative YMSM. We propose to recruit 240 HIV-negative partnered YMSM who report recent drug use and sexual behavior consistent with CDC guidance for PrEP candidacy into a randomized control trial. As part of a secondary aim, this project seeks to enhance the range of biological measures for PrEP adherence currently available. The field standard for assessing tenofovir metabolites is dried blood spot assay; however, fingernail assay has high acceptability and lower cost. We propose to validate fingernail samples for PrEP adherence by correlating results obtained from fingernail samples with dried blood spot data. The study team is led by Dr. Tyrel J. Starks (PI), a new investigator with substantial experience in the study of relationship factors associated with sexual health and MSM in relationships. He has collaborated on numerous projects examining the nature of sexual agreements and their association with substance use and HIV transmission risk behavior. He is supported by a study team which includes Dr. Jeffrey Parsons, the PI of multiple intervention studies targeting sexual health and substance use. He is also joined by Dr. Monica Gandhi, an expert in biological assessment for PrEP adherence who has pioneered the use of novel matrices in previous NIH- funded studies. The team brings extensive experience in behavioral intervention research, relationship research, and biomedical assessment.

项目概要 CDC 建议识别非一夫一妻制关系中的 MSM 和非一夫一妻制关系中的 MSM 与作为 PrEP 候选者的 HIV 阳性伴侣的关系估计也有同样多的结果。 年轻 MSM（YMSM；18-29 岁）中新感染 HIV 的 79% 是在 对于有伴侣的男性来说，吸毒与艾滋病毒传播风险密切相关。 关系因素（例如，性协议）将吸毒置于背景之中，并且吸毒和吸毒都与吸毒有关。 性协议预示着对 PrEP 的接受程度，这些发现共同表明了对 PrEP 的需求。 综合干预服务 – 针对吸毒和性健康 – 为合作伙伴量身定制 YMSM。此类服务对于解决美国的艾滋病毒流行问题至关重要。 作为回应，我们的团队开发了一种针对 PrEP 的 4 次基于 MI 的干预措施 合作伙伴 YMSM 的摄取/依从性、HIV TRB 和药物使用（预防）。 和风险：以新的关系为重点的治疗）被交付给个人 YMSM 关系（不是夫妻），这增强了所提议的干预措施的可扩展性。 初步的试点工作已经确立了PARTNER的可接受性和可行性。 当前研究的目标是测试 PARTNER 相对于注意力匹配的有效性 先前资助的 NIH 研究中使用的教育控制条件是 HIV 阴性 YMSM。 我们建议招募 240 名 HIV 阴性 YMSM 伙伴，他们报告近期吸毒情况并 性行为符合 CDC 关于 PrEP 候选随机对照的指导 作为次要目标的一部分，该项目旨在扩大生物的范围。 目前有评估替诺福韦的现场标准。 代谢物是干血斑试验，但指甲试验的可接受性较高， 我们建议通过关联结果来验证指甲样本的 PrEP 依从性。 从具有干血斑数据的指甲样本中获得。 该研究团队由具有丰富经验的新研究员 Tyrel J. Starks 博士 (PI) 领导 他研究与性健康和男男性接触者相关的关系因素。 合作开展了许多项目，研究性协议的性质及其影响 与物质使用和艾滋病毒传播风险行为之间的关联他得到了一项研究的支持。 团队成员包括 Jeffrey Parsons 博士，他是针对性行为的多项干预研究的 PI 生物学专家莫妮卡·甘地博士也加入了他的行列。 评估 PrEP 依从性，他在之前的 NIH 中率先使用了新型基质 该团队在行为干预研究方面拥有丰富的经验， 关系研究和生物医学评估。