The impact of alcohol use and alcohol-interactive toxicity beliefs on pre-exposure prophylaxis (PrEP) adherence among gay, bisexual, and other men who have sex with men: A social network approach

饮酒和酒精相互作用毒性信念对同性恋、双性恋和其他男男性行为者的暴露前预防 (PrEP) 依从性的影响：社交网络方法

• 批准号: 10707934
• 负责人: Jace DeWayne Pierce
• 金额: $ 3.84万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10707934
• 关键词: AIDS prevention; Adherence; Advertising; Affect; Alcohol consumption; Alcohol dependence; Alcohols; Anti-Retroviral Agents; Area; Behavior; Belief; Bisexual; Characteristics; Clinic; Code; Coitus; Contracts; Counseling; County; Diffuse; Disparity; Dose; Ego; Event; Exposure to; Future; Gays; Goals; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Heterosexuals; Hour; Individual; Intervention; Interview; Knowledge; Lesbian Gay Bisexual Transgender Queer; Measures; Medicine; Minority Groups; National Institute on Alcohol Abuse and Alcoholism; Oral; Participant; Perception; Persons; Pharmaceutical Preparations; Phase; Poison; Population; Public Health; Regimen; Reporting; Research; Research Personnel; Research Support; Risk; Risk Behaviors; Risk Factors; Risk Taking; Schedule; Social Network; Strategic Planning; Tablets; Techniques; Toxic effect; Trust; alcohol risk; alcohol testing; antiretroviral therapy; binge drinking; condomless anal sex; demographics; design; diaries; drinking; experience; hazardous drinking; health disparity; high risk; interest; man; men; men who have sex with men; minority health disparity; pill; pre-exposure prophylaxis; prevent; recruit; sexual minority; skills; therapy adherence; trustworthiness; truvada

PROJECT SUMMARY/ABSTRACT Gay, bisexual, and other men who have sex with men (GBM) in the U.S. experience striking health disparities related to alcohol use and HIV. Heavy alcohol use is a significant threat to adherence to antiretrovirals (e.g., antiretroviral therapy [ART]) among GBM managing HIV. However, it is unclear if alcohol use impacts adherence to Pre-Exposure Prophylaxis (PrEP) for preventing HIV. PrEP is used by >35% of U.S. GBM and can be taken either daily or taken in sequence around a sexual event (i.e., event-driven PrEP). PrEP is a highly effective oral antiretroviral but studies have demonstrated suboptimal adherence for both PrEP regimens. Heavy alcohol use and specific beliefs related to mixing alcohol and PrEP may contribute to suboptimal adherence. For instance, >60% of GBM interested in taking PrEP falsely believe that mixing alcohol with PrEP results in a toxic combination (i.e., interactive toxicity beliefs). Like other erroneous beliefs (e.g., HIV is manmade), interactive toxicity beliefs may diffuse across the social network and, subsequently, influence adherence. The proposed study will employ an egocentric social network interview and a semi-weekly diary phase over five weeks to (1) examine associations between heavy alcohol use and PrEP adherence, and (2) to test alcohol-interactive toxicity beliefs and social network characteristics as risk factors for PrEP non-adherence. GBM (N=100) who are taking PrEP will be recruited via brick-and-mortar entities (e.g., LGBTQ+ centers and bars), local health clinics, and online advertising in Harris County, TX (i.e., the greater Houston area). At baseline, participants will complete demographics and measures of interactive toxicity beliefs. Participants will also complete an egocentric social network interview designed to obtain information on up to 20 alters (i.e., people in the social network). The interview will capture alter expression of interactive toxicity beliefs, PrEP and alcohol use, closeness, trust, overall connectedness, demographics, and norms. Participants will then complete five weeks of semi-weekly diaries that assess alcohol use, PrEP use, and HIV risk behaviors. This research can inform future PrEP-related counseling techniques and interventions aimed at correcting PrEP misconceptions and increasing adherence. The project supports the 2017-2021 strategic plan of NIAAA by advancing research in two areas. First, the project has the goal of identifying ways in which alcohol can influence the use of HIV-related medications, specifically PrEP (Goal 1C). Second, the project may enhance the public health impact of NIAAA-supported research, by focusing on how alcohol contributes to suboptimal PrEP adherence among a population with alcohol-related disparities (Goal 5). Moreover, the project contributes to research on health disparities of minority populations, which is a cross-cutting NIAAA research theme. Through this project, I will obtain the knowledge, skills, and experience needed to develop into a cutting-edge alcohol and HIV researcher that focuses on sexual minorities.

项目概要/摘要 在美国，同性恋、双性恋和其他男男性行为者 (GBM) 面临着巨大的健康差异 与饮酒和艾滋病毒有关。大量饮酒对坚持抗逆转录病毒药物（例如， 抗逆转录病毒治疗 [ART]）在治疗 HIV 的 GBM 中进行。然而，尚不清楚饮酒是否会影响依从性 暴露前预防（PrEP）以预防艾滋病毒。 PrEP 被超过 35% 的美国 GBM 使用，并且可以采取 每天或围绕性事件依次进行（即事件驱动的 PrEP）。 PrEP 是一种高效的口服药物 抗逆转录病毒药物，但研究表明两种 PrEP 方案的依从性均不理想。大量饮酒 与混合酒精和 PrEP 相关的特定信念可能会导致依从性不佳。例如， >60% 对 PrEP 感兴趣的 GBM 错误地认为酒精与 PrEP 混合会产生有毒物质 组合（即交互毒性信念）。与其他错误信念一样（例如，艾滋病毒是人造的），互动 毒性信念可能会在社交网络中传播，从而影响依从性。拟议的 研究将采用以自我为中心的社交网络访谈和为期五周的半周日记阶段，以（1） 检查大量饮酒和 PrEP 依从性之间的关联，以及 (2) 测试酒精相互作用毒性 信念和社交网络特征是不遵守 PrEP 的风险因素。正在服用 GBM (N=100) PrEP 将通过实体实体（例如 LGBTQ+ 中心和酒吧）、当地卫生诊所和 德克萨斯州哈里斯县（即大休斯顿地区）的在线广告。在基线时，参与者将完成 人口统计学和交互毒性信念的测量。参与者还将完成一个以自我为中心的社交活动 网络访谈旨在获取最多 20 个替代者（即社交网络中的人）的信息。这 访谈将捕捉互动毒性信念、PrEP 和酒精使用、亲密程度、信任、 整体连通性、人口统计和规范。然后，参与者将完成五周的半周课程 评估饮酒、PrEP 使用和 HIV 风险行为的日记。这项研究可以为未来 PrEP 相关的研究提供信息 旨在纠正 PrEP 误解并提高依从性的咨询技术和干预措施。 该项目通过推进两个领域的研究来支持 NIAAA 2017-2021 年战略计划。一、项目 目标是确定酒精影响艾滋病毒相关药物使用的方式，特别是 PrEP（目标 1C）。其次，该项目可以通过以下方式增强 NIAAA 支持的研究对公共卫生的影响： 重点关注酒精如何导致酒精相关人群中 PrEP 依从性不佳 差异（目标 5）。此外，该项目有助于研究少数民族人口的健康差异， 这是 NIAAA 的一个跨领域研究主题。通过这个项目，我将获得知识、技能和 发展成为专注于性少数群体的尖端酒精和艾滋病毒研究人员所需的经验。