Increasing PrEP Use in High-Risk Social Networks of African American MSM in Underserved Low-Uptake Cities

在服务不足、使用率低的城市中，增加非洲裔美国男男性接触者高风险社交网络中 PrEP 的使用

基本信息

批准号：
10200891
负责人：
Yuri A Amirkhanian
金额：
$ 66.05万
依托单位：
MEDICAL COLLEGE OF WISCONSIN
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-21 至 2023-06-30
项目状态：
已结题

项目摘要

Abstract PrEP is a powerful and potentially groundbreaking HIV prevention strategy, but its public health impact will depend on widescale adoption by persons at greatest risk for contracting HIV infection. PrEP awareness and use remain especially low among African American MSM in mid-sized cities across the center of the country, and very little research has tested interventions that can increase PrEP awareness, benefit perception, and normative support—and decrease PrEP stigma and concerns—among African American MSM in these cities. PrEP can achieve its full public health potential only when its uptake among racial minority MSM in neglected mid-sized American cities is increased. In prior research, our team established that network-level interventions can reach and be used to deliver effective HIV risk reduction interventions to Black MSM in the industrial Midwest, including hard-to-reach men hidden in the community. The planned mixed- methods research will now evaluate a network intervention to increase PrEP uptake among high-risk African American MSM in Milwaukee and Cleveland, cities where HIV racial disparities are profound but PrEP use is low. In a formative research phase, in-depth interviews will be conducted with African American MSM, PrEP providers, and other key informants in each city to identify understandings, concerns, barriers, and facilitators of PrEP use. In the main intervention trial phase, 36 social networks of high-risk racial minority MSM (expected n=504 participants) will be enrolled, 18 networks per city, by recruiting high-risk initial “seeds,” members of each seed's MSM friendship network, and then two outward successive rings of their friends. All study participants will receive baseline counseling for PrEP and risk reduction. The 36 networks will then be randomized in equal numbers to intervention and comparison conditions. In each intervention condition network, a cadre of network leaders open to PrEP, trusted for advice, and highly interconnected with others will attend an intervention that educates and then provides training and guidance in diffusing messages to friends to encourage PrEP uptake, correcting PrEP misconceptions and stigma, and instilling positive PrEP norms and benefit perceptions. At baseline and 6- and 15-month followup points, participants will complete measures of PrEP use corroborated by the testing of dried blood spot specimens for tenofovir; measures of PrEP related knowledge, attitudes, perceived norms, and stage of change readiness; sexual risk practices; and substance use. We hypothesize that the network intervention will produce greater PrEP adoption by HIV- participants than that found in comparison networks. PrEP knowledge, attitudes, intentions, peer norms, and stage of change readiness will be explored as both mediators and as secondary outcomes. Intervention effects on HIV incidence will be mathematically modeled to determine its public health impact. This research will test a novel approach for increasing PrEP use among neglected racial minority MSM in mid-sized American cities who can best—and can perhaps only—be reached through their social network connections.

抽象的 PrEP 是一种强大且具有潜在突破性的 HIV 预防策略，但其对公共卫生的影响将取决于感染艾滋病毒风险最大的人群的广泛采用。在中部城市的非裔美国男男性接触者中，使用率仍然特别低国家，很少有研究测试了可以提高 PrEP 意识、受益的干预措施非裔美国人 MSM 的认知和规范支持，并减少 PrEP 耻辱和担忧只有在少数族裔中接受 PrEP 后，PrEP 才能充分发挥其公共卫生潜力。在之前的研究中，我们的团队确定，被忽视的美国中型城市的男男性接触者有所增加。网络级干预措施可以覆盖并用于向黑人提供有效的降低艾滋病毒风险的干预措施中西部工业区的男男性行为者，包括隐藏在社区中难以接触到的男性。方法研究现在将评估网络干预措施，以提高高危非洲人对 PrEP 的吸收密尔沃基和克利夫兰的美国 MSM，这些城市的艾滋病毒种族差异很大，但 PrEP 的使用却很少在形成性研究阶段，将与非裔美国人 MSM、PrEP 进行深入访谈。每个城市的提供者和其他关键信息提供者，以确定理解、关注、障碍和促进因素在主要干预试验阶段，36 个高危少数族裔 MSM 的社交网络。（预计 n = 504 名参与者）将通过招募高风险的初始“种子”来注册，每个城市 18 个网络，每个种子的 MSM 友谊网络的成员，然后是他们的朋友的两个连续环。研究参与者将接受 PrEP 和风险降低的基线咨询，然后将在 36 个网络中进行。随机分配相同数量的干预和比较条件。网络中，一群对 PrEP 持开放态度、值得信赖并与其他人高度互联的网络领导者将参加教育干预活动，然后提供向朋友传播信息的培训和指导鼓励 PrEP 的采用，纠正 PrEP 误解和耻辱，并灌输积极的 PrEP 规范和在基线以及 6 个月和 15 个月的随访点，参与者将完成以下方面的测量：通过测试干燥血斑标本中替诺福韦相关指标来证实 PrEP 的使用；知识、态度、认知规范以及改变性风险做法和实质内容的阶段；我们率先提出网络干预将提高 HIV 参与者对 PrEP 的采用率。比比较网络中发现的 PrEP 知识、态度、意图、同伴规范和阶段。将探讨变革准备情况作为对艾滋病毒的中介因素和次要结果。将对发病率进行数学建模，以确定其对公共健康的影响。这项研究将测试一项新颖的研究。增加美国中型城市中被忽视的少数族裔男男性接触者中 PrEP 使用的方法，他们可以最好的——或许也只能——通过他们的社交网络联系来联系。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Calibration of an Adaptive Genetic Algorithm for Modeling Opinion Diffusion.

用于模拟意见扩散的自适应遗传算法的校准。

DOI：
发表时间：
2022-02
期刊：
影响因子：
2.3
作者：
Johnson, Kara Layne;Carnegie, Nicole Bohme
通讯作者：
Carnegie, Nicole Bohme

Performance of a Genetic Algorithm for Estimating DeGroot Opinion Diffusion Model Parameters for Health Behavior Interventions.

用于估计健康行为干预的德格鲁特意见扩散模型参数的遗传算法的性能。

DOI：
发表时间：
2021-12-20
期刊：
影响因子：
0
作者：
Johnson, Kara Layne;Walsh, Jennifer L;Amirkhanian, Yuri A;Carnegie, Nicole Bohme
通讯作者：
Carnegie, Nicole Bohme

Using a novel genetic algorithm to assess peer influence on willingness to use pre-exposure prophylaxis in networks of Black men who have sex with men.

使用一种新颖的遗传算法来评估同伴对在男男性行为的黑人网络中使用暴露前预防的意愿的影响。

DOI：
发表时间：
2021
期刊：
影响因子：
2.2
作者：
Johnson, Kara Layne;Walsh, Jennifer L;Amirkhanian, Yuri A;Borkowski, John J;Carnegie, Nicole Bohme
通讯作者：
Carnegie, Nicole Bohme