Expanding the potential of couples HIV testing: Adjunct modules to reduce drug use among vulnerable male couples

扩大夫妇艾滋病毒检测的潜力：减少弱势男性夫妇吸毒的辅助模块

基本信息

批准号：
10079536
负责人：
Tyrel J Starks
金额：
$ 75.42万
依托单位：
HUNTER COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10079536
关键词：
4-hydroxybutyric acid AIDS prevention Address Age Agreement Alcohol or Other Drugs use Amphetamines Assertiveness Behavioral Biological Assay Biological Markers Chlamydia Chlamydia Infections Clinical Virology Cocaine Communication Counseling Couples Crack Cocaine Data Data Analytics Development Drug usage Enrollment Feedback Funding Funding Agency Future Goals Gonorrhea HIV HIV Infections HIV Seronegativity HIV Seropositivity HIV risk HIV/STD Human immunodeficiency virus test Individual Infection Intervention Interview Investments Joints Ketamine Laboratory Research Link Marijuana Measures Mediating Mediator of activation protein Methodology New York City Nitrates Participant Patient Self-Report Pharmaceutical Preparations Play Prevention Prevention strategy Process Protocols documentation Provider Public Health Randomized Recording of previous events Reporting Research Resources Risk Risk Behaviors Role Sampling Science Services Sexual Partners Site Structure of nail of finger Syphilis Testing Training Treatment Efficacy United States National Institutes of Health Viral Load result Work aged binge drinking club drug condomless anal sex condoms data format design ecstasy effectiveness implementation trial efficacy testing emerging adult ethnic diversity experience follow-up implementation research infection risk innovation intervention effect male men men who have sex with men multi-site trial post intervention pre-exposure prophylaxis racial and ethnic recruit secondary outcome sex sexual HIV transmission skills skills training theories transmission process uptake young men who have sex with men

项目摘要

Project Summary Couples HIV testing and counseling (CHTC) for male couples in the US has emerged as a promising dyadic HIV prevention strategy. Interventions such as CHTC, which address HIV-risk within primary relationships, are an essential component to a comprehensive national prevention strategy. Up to two-thirds of HIV infections among MSM occur within the context of primary partnerships. Rates are particularly pronounced for emerging adult MSM (aged 18-29). Estimates suggest 79% to 84% of HIV infections are transmitted by primary partners5. The current CHTC protocol is limited in two ways. First, CHTC does not incorporate a focus on drug use – a well-established correlate of HIV infection risk among YMSM specifically. Second, CHTC provides limited guidance for formal communication skills training in instances where partners have substantial communication deficits. To address these limitations, our group has developed and pilot-tested the We Test intervention, which includes two adjunct CHTC components. The first is a substance use module (SUM) that elicits the formation of a substance use agreement and a discussion about how partners can support one another in observing drug use limits. The second is an assertive communication training video (ACTV). Results from our recent pilot RCT (DA036419, PI-Starks) suggest these components decrease the odds of drug use and drug-related problems. We now propose a multi-site trial powered to test the efficacy of We Test’s components and evaluate putative moderators and mediators. The proposed RCT builds directly upon the pilot data generated by DA036419. Participants include 240 male couples in which at least one partner is age 18 – 29; HIV negative; and reports recent (past 30 days) drug use; and recent (past 3 months) sexual HIV/STI transmission risk behavior. The study utilizes biological markers for drug use (fingernail assay), HIV testing, and gonorrhea, chlamydia, and syphilis. Viral load testing is conducted with HIV positive participants. To increase generalizability and the feasibility of recruitment, couples be enrolled equally across 2-sites in New York City and Detroit. Participants will be randomized in a factorial design to receive CHTC as usual; CHTC + SUM; CHTC + ACTV; or CHTC+SUM+ACTV. Follow-ups will occur at 3-, 6-, 9-, and 12-months post intervention. Drs. Starks, Stephenson (Co-I), Kahle (Co-I; biostatistician) and Sullivan (Consultant) have substantial experience in the study of male couples. This group completed the pilot RCT which produced the formative data for this proposal. The study is supported by the Emory CFAR Prevention Sciences Core and the Clinical Virology Research Laboratory. The intervention tested is an innovative and highly scalable adaptation of the existing CHTC intervention. In addition, the integration of a substance use intervention into CHTC might facilitate uptake by affording access to additional funding sources and expanding the pool of providers who see the service as relevant. Results would inform the development of a future implementation/effectiveness trial. .

项目摘要夫妻艾滋病毒测试和咨询（CHTC）在美国为男性夫妻夫妇出现作为诺言二元艾滋病毒预防策略。诸如CHTC之类的干预措施，该干预措施解决了主要的艾滋病毒风险关系是全面的国家预防战略的重要组成部分。最多三分之二 MSM之间的艾滋病毒感染发生在主要伙伴关系的背景下。费率特别明显用于新兴的成人MSM（18-29岁）。估计表明79％至84％的艾滋病毒感染是通过主要合作伙伴5。当前的CHTC协议以两种方式受到限制。首先，CHTC不关注吸毒 - 特别是YMSM中艾滋病毒感染风险的公认相关性。第二，CHTC提供有限在合作伙伴有实质性沟通的情况下，正式沟通技巧培训指南缺陷。为了解决这些局限包括两个辅助CHTC组件。第一个是引起编队的物质使用模块（sum）关于毒品使用协议以及关于如何伴侣如何在观察药物方面支持彼此的讨论使用限制。第二个是一个自信的交流培训视频（ACTV）。我们最近的飞行员RCT的结果（DA036419，PI-Starks）建议这些成分减少了药物使用和与药物有关的问题的几率。现在，我们提出了一项多站点试验，该试验旨在测试我们测试组件的效率并评估推定的主持人和调解人。所提出的RCT直接建立在由 DA036419。参与者包括240对男性夫妇，其中至少一个伴侣是18-29岁；艾滋病毒阴性；并报告了最近（过去30天）使用毒品的情况；以及最近（过去3个月）性HIV/STI传播风险行为。该研究利用生物学标记物用于药物使用（指甲测定），HIV测试和淋病，衣原体和梅毒。病毒负荷测试是通过HIV阳性参与者进行的。增加纽约市的2个站点同样会招募夫妇的概括性和招聘的可行性和底特律。参与者将在阶乘设计中随机分配以照常接收CHTC； chtc + sum; CHTC + ACTV;或CHTC+SUM+ACTV。干预后的3-，6，9和12个月的随访。博士。 Starks，Stephenson（Co-I），Kahle（Co-I; Biostatisticians）和Sullivan（顾问）具有实质性研究男性夫妇的经验。该小组完成了产生格式的飞行员RCT 该提案的数据。该研究得到了Emory CFAR预防科学核心和临床的支持病毒学研究实验室。测试的干预措施是对现有的CHTC干预。另外，将药物使用干预措施的整合到CHTC中可能通过提供额外资金来源并扩大看到的提供商池来促进吸收服务是相关的。结果将为未来的实施/有效性试验的发展提供信息。。