Integration of Electronic SBI(RT) into an HIV Testing Program to Reduce Substance Use and HIV risk Behavior among MSM in Argentina

将电子 SBI(RT) 纳入 HIV 检测计划，以减少阿根廷 MSM 的药物使用和 HIV 风险行为

• 批准号: 10402058
• 负责人: Ivan C Balan
• 金额: $ 18.86万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10402058
• 关键词: AIDS prevention; Acute; Address; Affect; Alcohol consumption; Alcohols; Argentina; Caring; Client; Cocaine; Collaborations; Communities; Dependence; Development; Drug usage; Early Intervention; Effectiveness; Europe; Evidence based intervention; Feeling; Funding; Future; Gays; General Population; Glare; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Human immunodeficiency virus test; Incidence; Individual; Infection; Infrastructure; Intervention; Latin America; Lesbian Gay Bisexual Transgender; Link; Measures; Mental Health; Motivation; Outcome; Participant; Persons; Population; Postpartum Period; Prevalence; Process; Professional counselor; Randomized; Reporting; Research Infrastructure; Resources; Risk; Risk Behaviors; Risk Reduction; Substance Addiction; Substance Use Disorder; Substance abuse problem; Sulfate; Tablets; Testing; Time; Training; Tranquilizing Agents; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; acceptability and feasibility; aged; base; brief intervention; condomless anal sex; efficacy trial; evidence base; high risk; illicit drug use; implementation barriers; implementation intervention; male health; marijuana user; men; men who have sex with men; motivational enhancement therapy; pilot trial; preventive intervention; programs; prospective; recruit; reduced substance use; retention rate; screening; screening guidelines; screening, brief intervention, referral, and treatment; sexual risk behavior; substance abuse treatment; substance use; uptake; young man; young men who have sex with men

Men who have sex with men (MSM) are disproportionally affected by HIV and substance abuse in the U.S., Europe, and Latin America. However, as in the general population, identifying and engaging MSM with problematic substance use (PSU) into treatment is a significant challenge, which results in the great majority of MSM with PSU never receiving treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends Screening (S), Brief Intervention (BI), and Referral to Treatment (RT; SBIRT) as an early intervention for non-treatment-seeking individuals with risky alcohol and drug use, as well as the timely referral to more intensive substance abuse treatment for those with substance use disorders. The need for such an intervention is particularly acute in Argentina and Latin America, where there is little implementation of evidence-based interventions for MSM with PSU. The proposed study seeks to address this glaring gap by developing and piloting an electronic-SBI program tailored for MSM awaiting their HIV test at Nexo Asociacion Civil, our community partners in Buenos Aires. The tablet-based e-SBI will integrate substance use and sexual risk behavior screeners and individually tailored Motivational Interviewing (MI) as the BI. We will also adapt and pilot the implementation of the Young Men’s Health Project (YMHP, now MHP since it will not be limited to young MSM), a four-session MI-based intervention that effectively reduced substance use and condomless anal intercourse among substance using MSM, as a brief treatment provided at Nexo for participants with moderate or high-risk substance use. The Specific Aims of this R34 study are to: 1) develop a tailored e-SBI intervention for MSM in an HIV testing context aimed at reducing substance use and HIV risk behavior (Primary); 2) assess the feasibility and acceptability of integrating e-SBI into the HIV testing process at Nexo as measured by a) percent of MSM testing clients at Nexo who accept entry into the study; b) percent of participants who complete e-SBI; c) e-SBI acceptability ratings (Primary); 3) assess the feasibility and acceptability of implementing adapted YMHP at Nexo, as measured by a) the percent of MSM with moderate or high-risk substance use who enter and/or complete MHP; b) acceptability of MHP among those who received it; and c) percentage of sessions conducted by each MHP counselor that meets criteria for MI fidelity (Secondary). In Stage 1 (Development) we will develop e-SBI, adapt YMHP into MHP, train MHP counselors, and pilot e-SBI with 50 MSM coming to Nexo for HIV testing. In Stage 2 (RCT Pilot), we will randomize 200 MSM coming to Nexo for HIV testing at a 3:1 ratio (eSBI: Screening Assessments Only-SA) to assess the feasibility and acceptability of e-SBI among MSM coming to Nexo for HIV testing and establish and pilot the RCT process for a future trial. As a secondary aim, we will assess uptake, acceptability, and feasibility of delivering MHP to participants with low or moderate risk substance use and subsequent referrals to substance abuse treatment among participants with high-risk substance use or dependence. Lastly, we will explore preliminary findings on substance use and sexual risk reduction outcomes.

在美国，男男性行为者 (MSM) 受到艾滋病毒和药物滥用的影响尤为严重， 然而，与一般人群一样，识别并接触 MSM 治疗中有问题的物质使用（PSU）是一项重大挑战，这导致绝大多数 PSU 的 MSM 从未接受过药物滥用和心理健康服务管理局的治疗。 (SAMHSA) 建议将筛查 (S)、简短干预 (BI) 和转诊治疗 (RT; SBIRT) 作为 对有酗酒和吸毒风险的非寻求治疗个体进行早期干预，并及时采取预防措施 对患有药物滥用障碍的患者转介接受更强化的药物滥用治疗。 阿根廷和拉丁美洲的干预尤为严重，这些国家几乎没有实施 针对 MSM 与 PSU 的循证干预措施 拟议的研究旨在通过以下方式解决这一明显差距。 开发并试点为 Nexo Asociacion 等待 HIV 检测的 MSM 量身定制的电子 SBI 计划 Civil，我们在布宜诺斯艾利斯的社区合作伙伴，基于平板电脑的 e-SBI 将整合药物使用和性行为。 我们还将调整和调整风险行为筛选器和个性化的动机访谈 (MI)。 试点实施青年男性健康项目（YMHP，现为MHP），因为该项目不仅限于青年 MSM），一项为期四次的基于 MI 的干预措施，可有效减少药物使用和无套肛交 使用 MSM 进行物质间的交流，作为 Nexo 为中度参与者提供的简短治疗 该 R34 研究的具体目标是： 1) 制定量身定制的 e-SBI 干预措施。 针对旨在减少物质使用和艾滋病毒风险行为的艾滋病毒检测中的男同性恋者（主要）2) 评估； 将 e-SBI 整合到 Nexo 的 HIV 检测流程中的可行性和可接受性（通过 a) 衡量） Nexo 接受参与研究的 MSM 测试客户的百分比 b) 完成研究的参与者的百分比； e-SBI； c) e-SBI 可接受性评级（主要）； 3) 评估实施改编的可行性和可接受性 Nexo 的 YMHP，通过 a) 进入中度或高风险物质使用的 MSM 的百分比来衡量 和/或完整的 MHP；b) 接受者对 MHP 的接受程度；以及 c) 课程百分比； 由符合 MI 保真度标准的每位 MHP 顾问进行（中学） 在第 1 阶段（发展），我们。 将开发 e-SBI、将 YMHP 改编为 MHP、培训 MHP 顾问并试点 e-SBI，其中 50 名 MSM 来到 Nexo 在第 2 阶段（RCT 试点），我们将以 3:1 的比例随机抽取 200 名 MSM 来 Nexo 进行 HIV 检测。 （eSBI：仅筛选评估-SA）评估 e-SBI 在即将到来的 MSM 中的可行性和可接受性 作为次要目标，我们将向 Nexo 进行 HIV 检测并建立和试点 RCT 流程以进行未来的试验。 评估向具有低或中风险物质的参与者提供 MHP 的接受度、可接受性和可行性 在高危药物使用参与者中使用药物并随后转介接受药物滥用治疗，或 最后，我们将探讨有关物质使用和性风险降低结果的初步发现。