FINISHING HIV: An EHE model for Latinos Integrating One-Stop-Shop PrEP Services, a Social Network Support Program and a National Pharmacy Chain

完成艾滋病毒：针对拉丁裔的 EHE 模式，整合一站式 PrEP 服务、社交网络支持计划和全国药房连锁店

• 批准号: 10652529
• 负责人: Mariano Juan Kanamori Nishimura
• 金额: $ 71.01万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-23 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10652529
• 关键词: Address; Adherence; Affect; Area; Attitude; Awareness; Blood; Caring; Charge; Client; Collaborations; Collection; Communities; Consolidated Framework for Implementation Research; Consultations; Counseling; County; Diffusion; Diphosphates; Dryness; Effectiveness; Emotional; Enrollment; Environment; Epidemic; Event; Evolution; Florida; Fostering; Frequencies; Friends; Friendships; Funding; Gays; HIV; HIV diagnosis; Health; Health Promotion; Health behavior; Hearing; Hybrids; Information Services; Infrastructure; Insurance; Intervention; Knowledge; Latino; Latino Population; Logic; Mediator; Methods; Modeling; Network-based; Newly Diagnosed; Participant; Penetration; Pharmacy facility; Population; Prevention; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reaction; Research; Respondent; Risk Reduction; Running; Sampling; Science; Services; Social Environment; Social Network; Social support; Spottings; Tenofovir; Visit; Visualization; Work; bilingualism; community engagement; compare effectiveness; contagion; contextual factors; design; effectiveness evaluation; effectiveness-implementation RCT; empowerment; epidemic preparedness; evidence base; high risk population; implementation science; implementation strategy; improved; innovation; intervention effect; male; men who have sex with men; patient assistance; peer; personalized approach; pre-exposure prophylaxis; preference; primary outcome; programs; rapid testing; recruit; secondary outcome; sex; social; social cohesion; social culture; support network; telehealth; theories; transmission process

Project Summary/Abstract Overview and Background. This is a proposal for a hybrid 2 implementation-effectiveness randomized controlled trial (RCT) of FINISHING HIV, an implementation strategy bundle of a social network support component and a one-stop-shop PrEP component to improve PrEP initiation of Latino men who have sex with men (LMSM). PrEP can reduce HIV transmission by up to 99%,1 however, PrEP services are not being sufficiently accessed by Latinos in Miami, the epicenter of the HIV epidemic in the US.2 Further, LMSM who do not self-identify as gay have lower PrEP awareness than LMSM who self-identify as gay.3 To prepare for this study, we have developed an innovative approach that tailors LMSM engagement based on sexual self-identity using community-based social events and pharmacies. Preliminary work. The trial is a direct next step from our “Ending the HIV Epidemic” (EHE) planning supplements, where we conducted the needed preliminary study to launch this hybrid trial, and with ISCI3 support, the team jointly assessed feasibility, refined strategies and built a logic model informed by local context needs and preferences. Over the past two years, the PI has built partnerships with Latinos Salud (a local HIV agency for LMSM) and CVS Health. Design. We will use an innovative network-based approach informed by the PI’s K99/R00 funded research and Social Contagion Theory,4 which states that health behavior preferences, including PrEP initiation, are affected by opinions and attitudes prevailing in one’s social environment, and spread through friendship networks.5 Penetration at pharmacies and social events will lead to random assignment of the participants to either FINISHING HIV (social network support component + one-stop-shop PrEP component; N=24 seeds and 288 LMSM friends) or to standard health promotion (N=312). Participants will be assessed at baseline, and receive follow ups and dried blood spots collection at 6 and 12 months to quantify tenofovir diphosphate concentrations. For implementation (Aim 1), we will use RE-AIM framework6 to evaluate Reach (the extent to which high risk persons initiate participation in the program), and Implementation (the extent to which implementation strategies are delivered as designed) of FINISHING HIV. We will also use Consolidated Framework for Implementation Science Research7 to examine contextual factors associated with Reach and Implementation (e.g., facilitators and challenges or barriers to reach and implementation; participants reaction to these strategies). We will compare effectiveness (Aim 2) of the strategies in PrEP initiation (primary outcome), as well as PrEP knowledge, retention, and adherence (secondary outcomes). We will identify theory-based moderators (e.g., recruitment at social events vs. pharmacies) and social network mediators of intervention effects. We will also assess how friendship network structural evolutions contribute to increasing PrEP initiation. Implications. Our use of a social network support, one-stop-shop PrEP, and community and national pharmacy chain partners is a promising model that can be replicated in other EHE priority areas nationwide.

项目摘要/摘要 概述和背景。这是混合2实施效应随机的建议 艾滋病毒的对照试验（RCT）是社交网络支持的实施策略捆绑 组件和一站式准备工作组件，以改善与与之发生性关系的拉丁美洲人的准备计划 男人（LMSM）。 PREP可以将HIV传播降低多达99％，1但是，PREP服务没有 拉丁美洲人在迈阿密的足够访问迈阿密，是美国艾滋病毒流行病的中心。2此外，LMSM 与自我认同为同性恋的LMSM相比，没有自我认同为同性恋的意识。3为此做准备 研究，我们开发了一种创新的方法，可以根据性自我认同调整LMSM参与度 使用基于社区的社交活动和药房。初步工作。试验是下一步 我们的“结束艾滋病毒流行病”（EHE）计划补充剂，我们进行了必要的初步 启动该混合动力试验的研究，并在ISCI3支持下，团队共同评估了可行性，精致的策略 并建立了一个逻辑模型，该模型以当地上下文的需求和偏好为信息。在过去的两年中，PI有 与Latinos Salud（LMSM当地的HIV机构）和CVS Health建立了合作伙伴关系。设计。我们将使用 PI的K99/R00资助研究和社会传染性的基于创新的网络方法 理论4指出，健康行为偏好（包括准备计划）受意见和 态度在一个人的社会环境中盛行，并通过友谊网络传播。5 药房和社交活动将导致参与者随机分配要么完成艾滋病毒 （社交网络支持组件 +一站式准备组件； n = 24种种子和288个LMSM朋友）或 标准健康促进（n = 312）。参与者将在基准时进行评估，并接受随访和 在6个月和12个月的时间收集干血点，以量化替诺福韦双磷酸盐浓度。为了 实施（AIM 1），我们将使用Re-Aim Framework6评估覆盖范围（高风险的程度 人们启动参与计划）和实施（实施的程度 策略是按照完成艾滋病毒的设计而交付的。我们还将使用合并框架进行 实施科学研究7旨在检查与覆盖范围和实施相关的上下文因素 （例如，促进者以及触及和实施的挑战或障碍；参与者对这些的反应 策略）。我们将比较准备倡议（主要结果）的效率（目标2）， 以及准备知识，保留和依从性（次要结果）。我们将确定基于理论的 主持人（例如，社交活动与药房招聘）和社交网络调解人 效果。我们还将评估友谊网络结构发展如何有助于增加准备 引发。含义。我们使用社交网络支持，一站式预备以及社区和国家 药房连锁合作伙伴是一个有望模型，可以在全国其他优先领域进行复制。