Promoting linkage to PrEP after HIV self-testing through a peer-led intervention for MSM

通过同伴主导的 MSM 干预措施，促进 HIV 自我检测后与 PrEP 的联系

• 批准号: 10700283
• 负责人: Cedric Howshan Bien-Gund
• 金额: $ 19.44万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-05 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700283
• 关键词: AIDS prevention; Address; Adherence; Adopted; Affect; Behavior; Behavior Therapy; Behavioral; COVID-19; COVID-19 pandemic; Caring; Clinical Trials Design; Collaborations; Complement; County; Cross-Sectional Studies; Data; Decentralization; Development; Epidemic; Evaluation; Feedback; Goals; HIV; HIV Infections; HIV diagnosis; HIV/STD; Health Professional; Health behavior; Health system; Human immunodeficiency virus test; Hybrids; Individual; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Life Experience; Link; Measures; Mentors; Methodology; Methods; Motivation; Persons; Philadelphia; Population; Prevention; Preventive care; Public Health; Questionnaires; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Risk; Risk Reduction; Self Efficacy; Services; Social support; Target Populations; Testing; Training; Treatment Efficacy; Underserved Population; antiretroviral therapy; behavior change; career; design; effectiveness-implementation RCT; effectiveness/implementation hybrid; effectiveness/implementation trial; evidence base; high risk men; implementation measures; implementation outcomes; implementation science; implementation strategy; innovation; intervention mapping; intervention refinement; men who have sex with men; novel; novel strategies; patient oriented; peer; pilot test; pre-exposure prophylaxis; prevent; remote health care; self testing; service delivery; skills; social stigma; testing uptake; theories; therapy design; tool; uptake

Project Summary Ending the HIV epidemic will require novel strategies to expand the HIV prevention continuum among men who have sex with men (MSM), who are disproportionately affected by HIV. The COVID-19 pandemic has underscored the need for remote care approaches such as HIV self-testing (HIVST) to sustain access to HIV services. However, the benefits of self-testing are limited if they do not spur behavioral change or linkage to care, yet only 1 in 10 MSM who self-test obtain preventive care afterwards, and the majority of MSM with indications for PrEP have never used it. Interventions to support linkage from HIVST, the first key step in the HIV “status neutral” continuum, are needed. To maximize the impact of HIVST, linkage to care is a critical practice gap that needs to be addressed, a gap that can potentially be bridged by a peer intervention to support linkage and PrEP uptake. To expand the HIV prevention continuum among MSM, this research will leverage HIVST and evaluate a peer-led intervention to support engagement in care and PrEP uptake through peer linkage after self-testing. The overall goal of this career development award is to provide Dr. Cedric Bien- Gund with the necessary research skills to become an independent clinician-investigator in the development, evaluation, and implementation of behavioral interventions to prevent HIV infections. To achieve this goal, we have assembled a mentoring team and proposed a rigorous training plan to develop his skills in 1) mixed methods for behavioral interventions, 2) intervention design and mapping for implementation, and 3) advanced clinical trial design, including implementation science designs. These training objectives complement a research plan to develop and pilot a behavioral intervention to increase linkage to PrEP among MSM through integration of HIVST distribution and peer-led linkage to PrEP. The specific aims are: 1) identify barriers and facilitators to PrEP linkage after HIV self-testing among MSM, 2) develop a peer-led linkage intervention for HIVST, and 3) test the acceptability, feasibility, and preliminary efficacy of the intervention on PrEP linkage and uptake among MSM by conducting a pilot randomized controlled trial. This project will leverage an ongoing collaboration with the Philadelphia Department of Public Health to expand HIVST and PrEP uptake. The proposed research addresses the first steps in the HIV prevention continuum and will support Dr. Bien-Gund's goal of becoming an independent investigator with expertise in behavioral interventions to end the HIV epidemic. This research will provide preliminary data for an R01 application to test the intervention in a hybrid type I effectiveness-implementation trial, with the goal of optimizing the impact of HIVST by closing the linkage gap after testing.

项目摘要 结束艾滋病毒流行将需要新的策略来扩大男性的艾滋病毒预防连续性 与男性发生性关系的人（MSM），受艾滋病毒影响不成比例。 COVID-19大流行有 强调了诸如艾滋病毒自我测试（HIVST）之类的远程护理方法的需求，以维持艾滋病毒的机会 服务。但是，如果自我测试不刺激行为改变或与 护理，但只有十分之一的MSM自我测试后来获得预防性护理，而大多数MSM都带有 预备指示从未使用过。支持HIVST的链接的干预措施，这是该链接的第一个关键步骤 需要艾滋病毒“地位中立”。为了最大化HIVST的影响，与Care的联系是关键 需要解决的练习差距，这一差距有可能通过同伴干预弥补 支持联系和准备吸收。为了扩大MSM的HIV预防连续性，这项研究将 利用HIVST并评估由同伴主导的干预措施，以支持参与护理和预备通过 自我测试后的同伴链接。该职业发展奖的总体目标是为Cedric Bien-博士提供 Gund具有必要的研究技能，成为开发中独立的临床评估者， 评估和实施行为干预措施以防止艾滋病毒感染。为了实现这一目标，我们 已经组建了一个心理团队，并提出了一项严格的培训计划，以在1）混合 行为干预措施的方法，2）干预设计和实施的映射； 3）高级 临床试验设计，包括实施科学设计。这些培训目标完成 研究计划制定和试行行为干预以通过 HIVST分布和同行指定的链接与PREP的集成。具体目的是：1）确定障碍和 在MSM之间进行艾滋病毒自我测试后的促进者准备链接，2） HIVST和3）测试干预措施的可接受性，可行性和初步效率 通过进行飞行员随机对照试验，在MSM中吸收。该项目将利用持续的 与费城公共卫生部合作，扩大HIVST和PREP吸收。这 拟议的研究介绍了预防HIV的第一步，并将支持Bien-Gund博士 成为具有行为干预措施专业知识以结束艾滋病毒的独立研究者的目标 流行性。这项研究将为R01应用提供初步数据，以测试混合动力的干预措施 I型有效性实施试验，目的是通过关闭联系来优化HIVST的影响 测试后的差距。