Identifying preferences for receiving HIV prevention services among GBMSMs and for providing HIV prevention services among HCPs who are active-duty service members

确定 GBMSM 中接受艾滋病毒预防服务的偏好以及现役军人 HCP 中提供艾滋病毒预防服务的偏好

• 批准号: 10838943
• 负责人: Christofer Alfredo Rodriguez
• 金额: $ 3.83万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-12-16 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10838943
• 关键词: AIDS prevention; Address; Affect; Authorization documentation; Behavior; Behavioral Model; Bisexual; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Coin; Congresses; Data; Department of Defense; Diagnosis; Epidemic; Future; Gays; Geography; Goals; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV/AIDS; HIV/STD; Health; Health Personnel; Health Services; Health behavior; Healthcare; Healthcare Systems; Healthy People 2020; Human immunodeficiency virus test; Individual; Infection; Injections; Interview; Lesbian Gay Bisexual; Measures; Medical; Mentorship; Methods; Military Personnel; Oral; Pathway interactions; Patients; Pharmaceutical Preparations; Policies; Population; Populations at Risk; Prevention program; Prevention strategy; Preventive service; Provider; Recommendation; Reporting; Research; Research Project Grants; Residual state; Respondent; Risk; Services; Sex Behavior; Sexual Health; Sexual Partners; Side; Surveys; Testing; Time; United States Dept. of Health and Human Services; active duty; authority; condoms; cost; doctoral student; evidence base; experience; experimental study; health care delivery; high risk; improved; innovation; men who have sex with men; military health system; patient oriented; pre-exposure prophylaxis; preference; prevention service; programs; psychosocial; response; same sex behavior; service delivery; service member; sex; sexual minority men; sexually active; social stigma; sound; therapy development; transgender; uptake; willingness

PROJECT SUMMARY The proposed research project addresses an important gap in HIV prevention by applying innovative methods to help bolster uptake of HIV Pre-Exposure Prophylaxis (PrEP), as well as identify ways to improve the delivery of sexual health services among active-duty service members in the US military who are at most risk for HIV acquisition: gay, bisexual, and other men who have sex with men (GBMSM). Annually, the military diagnoses approximately 350 new HIV infections, with 236 new HIV infections occurring in 2020, and another 433 new infections diagnosed between January 1, 2021, through June 30, 2022. HIV PrEP is a highly effective prevention strategy, currently underutilized by active-duty service members. When taken as directed, PrEP is ~99% effective at reducing HIV-seroconversion in at-risk populations, such as GBMSM. Despite authorization to provide PrEP and related care free of cost, PrEP uptake among active-duty service members is low. Prior research has noted psychosocial barriers, such as stigma, may exist from residuals of the ‘Don’t Ask, Don’t Tell’ policy era that emphasized hiding one’s identity as a lesbian, gay, bisexual, or transgender (LGBT) and engagement in same-sex behaviors. Other factors may impede uptake-provision of PrEP, such as one’s comfort level of discussing sex-related topics and identifying whether someone is a candidate for PrEP. Currently, there is limited data describing what factors affect active-duty service members’ demand for PrEP and what factors influence providers’ willingness to prescribe it. The proposed project – from a promising doctoral student with a strong mentorship team – will apply an exploratory sequential mixed-method preference-based study to identify how best to bolster the uptake-delivery of sexual health and HIV prevention, including PrEP, among GBMSM and healthcare providers (HCP) who are active-duty service members in the US military. The integrated behavioral model (IBM) will guide the study to accomplish the proposed Specific Aims: (1) Qualitatively explore preferences for receiving sexual health services, including PrEP, among active-duty GBMSM and explore preferences for receiving sexual health services, including PrEP, among active-duty HCP service members. (2) Quantitatively identify, describe, and compare HIV/STI prevention program preferences among active-duty GBMSM and active-duty HCPs using Choice-Based Conjoint and MaxDiff preference-based methods. Findings from this timely, innovative project will identify ways to tailor sexual health services to the individual’s risk profile, merge overlapping concepts from the patient and provider perspective, facilitate more patient-centered provision of sexual health services, and optimize PrEP uptake among GBMSM service members, and PrEP provision among HCPs in the military.

项目概要 拟议的研究项目通过应用创新方法来帮助解决艾滋病毒预防方面的一个重要差距 促进艾滋病毒暴露前预防 (PrEP) 的采用，并找出改善性健康的方法 美国军队现役军人中最容易感染艾滋病毒的人：同性恋、双性恋、 每年，军队会诊断出大约 350 例新的艾滋病毒感染者。 感染人数，2020 年新增 236 例艾滋病毒感染者，1 月 1 日期间又诊断出 433 例新感染者， 2021 年至 2022 年 6 月 30 日。HIV PrEP 是一种高效的预防策略，目前现役军人尚未充分利用 当按照指示服用时，PrEP 在减少高危人群中的 HIV 血清转化方面有约 99% 的有效性， 尽管获得免费提供 PrEP 和相关护理的授权，但现役军人对 PrEP 的采用率很高。 先前的研究已经指出，服役人员的残余可能存在心理社会障碍，例如耻辱感。 “不问、不说”政策时代强调隐藏自己的女同性恋、男同性恋、双性恋或变性者身份 （LGBT）和同性行为的参与可能会阻碍 PrEP 的提供，例如个人的情况。 讨论与性相关的话题并确定某人是否适合 PrEP 的舒适度 目前，存在以下问题： 描述哪些因素影响现役军人对 PrEP 的需求以及哪些因素影响的数据有限 提议的项目——来自一位有前途的博士生，并得到了强有力的指导。 团队 - 将应用基于偏好的探索性序贯混合方法研究来确定如何最好地支持 GBMSM 和医疗保健提供者 (HCP) 接受并提供性健康和艾滋病毒预防，包括 PrEP 综合行为模型 (IBM) 将指导该研究 实现拟议的具体目标： (1) 定性探索接受性健康服务的偏好， 包括 PrEP，在现役 GBMSM 中，并探索接受性健康服务的偏好，包括 PrEP， (2) 定量识别、描述和比较 HIV/STI 预防 使用基于选择的联合和 MaxDiff 在现役 GBMSM 和现役 HCP 之间进行程序偏好 这个及时的创新项目的研究结果将确定定制性健康服务的方法。 根据个人的风险状况，从患者和提供者的角度合并重叠的概念，促进更多 提供以患者为中心的性健康服务，并优化 GBMSM 服务成员对 PrEP 的采用，以及 军队 HCP 中的 PrEP 规定。