Training in mHealth Prevention with MSM

MSM 移动健康预防培训

基本信息

批准号：
10082827
负责人：
Roman Shrestha
金额：
$ 3.9万
依托单位：
YALE UNIVERSITY
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 2020-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10082827
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Age Alcohol or Other Drugs use Amphetamines Area Asia Biometry Career Choice Caring Cellular Phone Clinic Communication Competence Country Coupled Decision Making Development Diffusion Discrimination Drug usage Ensure Environment Epidemic Equilibrium Fostering Foundations Fright Funding Future Goals Guide prevention HIV HIV Infections Health Health Communication Health Professional Health Promotion Health Services Healthcare Homosexuality Human immunodeficiency virus test Incidence Income International Agencies Intervention Interview Judgment Laws Lead Link Malaysia Malaysian Mentors Mentorship Methods Mobile Health Application Motivation Muslim population group Patient Preferences Patients Persons Pharmaceutical Preparations Phase Physicians Population Prevalence Prevention Prevention strategy Preventive Intervention Productivity Provider Recommendation Research Research Activity Research Personnel Research Project Grants Risk Risk Behaviors Science Services Sexual Health Sexual Transmission Sexuality Social Discrimination Statutes and Laws Stigmatization Strategic Planning Study models Substance Use Disorder Surveys Technology Testing Training Translating Unsafe Sex Ursidae Family Vulnerable Populations Work amphetamine use base biobehavior career comparative effectiveness trial experience high risk improved innovation interest mHealth men men who have sex with men mobile computing pre-exposure prophylaxis preference prevention service programs public health research scale up service delivery sex skills smartphone Application social stigma stimulant use therapy design therapy development transmission process uptake virtual

项目摘要

Abstract Malaysia's HIV epidemic is rapidly expanding with recent evidence suggesting accelerated sexual transmission, especially among men who have sex with men (MSM): 10% in 2008 to 54% in 2016. Biobehavioral surveys suggest high HIV prevalence in MSM being nationally (21.6%) and in Kuala Lumpur (43%). This growing epidemic in MSM is associated with condomless sex (CS), STIs, and high usage of substance (particularly amphetamine-type stimulants; ATS). In Malaysia, both substance use and homosexuality are criminalized, making MSM dually bear the burden of social stigma and discrimination, including in healthcare. Consequently, they are marginalized from traditional, venue-based HIV prevention services, which undermines recommendations by international agencies. To address stigma and discrimination, mHealth (mobile technology to promote health) strategies can deliver prevention messages and guide health decisions anonymously, and thus hold great promise for MSM, especially those using ATS. They can overcome barriers along the HIV prevention cascade that now includes pre-exposure prophylaxis (PrEP). Combined with strong training and mentoring, the proposed projects directly address this need through the conduct of two formative studies. First, information about MSM's preferences of various attributes of PrEP delivery programs, including segmentation of ATS-using MSM, will be assessed. Then, building on the first study, the candidate will develop and test an mHealth-based intervention to overcome barriers along the prevention continuum, including HIV testing, co-occurring sexual and drug risk behaviors and PrEP uptake among Malaysian MSM. Findings from these related projects will provide the candidate with the necessary skills and competencies to develop and test an innovative and tailored primary HIV prevention intervention for MSM. This K01 application for Dr. Shrestha is well-suited to advance the career of the candidate by virtue of his training in intervention design, delivery, and placement, his high productivity in public health research, and his evolving experience with research in the Malaysian context. Over 5 years, he will achieve new skills and experiences to achieve his professional goals and objectives to: 1) gain experience in decision science with advanced quantitative and qualitative skills to become an independent investigator in HIV, substance use, and mHealth intervention for vulnerable populations; 2) develop expertise in mHealth intervention development, testing, implementation, and dissemination that will address specific barriers to HIV prevention services in MSM, especially those with substance use disorders; and 3) develop an independent career path focusing on HIV prevention in MSM using mHealth strategies. To achieve these goals, he has assembled a stellar interdisciplinary team of mentors with expertise in HIV, substance use, intervention design, decision science, advanced biostatistics, and mHealth research. Under their guidance, he will complete relevant didactic work and attend seminars and conduct research to apply the skills needed to become an independent researcher in mHealth-based HIV prevention among MSM.

抽象的马来西亚的艾滋病毒流行正在迅速扩大，最近的证据表明性行为加速传播，尤其是男男性行为者 (MSM) 中的传播：2008 年为 10%，2016 年为 54%。调查显示，全国（21.6%）和吉隆坡（43%）的男男性行为者的艾滋病毒感染率很高。这种不断增长的 MSM 中的流行病与无套性行为 (CS)、性传播感染和大量使用物质（特别是安非他明类兴奋剂；苯丙胺类兴奋剂）。在马来西亚，药物滥用和同性恋均被定为犯罪，使男男性行为者双重承受社会耻辱和歧视的负担，包括在医疗保健方面。最后，他们在传统的、基于场所的艾滋病毒预防服务中被边缘化，这损害了国际机构的建议。为了解决耻辱和歧视问题，移动医疗（移动技术促进健康）策略可以匿名传递预防信息并指导健康决策，从而对于 MSM，尤其是那些使用 ATS 的 MSM 来说，前景广阔。他们可以克服艾滋病毒预防过程中的障碍现在包括暴露前预防 (PrEP) 的级联反应。结合强有力的培训和指导，拟议项目通过进行两项形成性研究直接满足这一需求。一、信息关于 MSM 对 PrEP 实施方案各种属性的偏好，包括 ATS 使用的细分 MSM，将被评估。然后，在第一项研究的基础上，候选人将开发并测试基于移动医疗的克服预防连续过程中的障碍的干预措施，包括艾滋病毒检测、同时发生的性行为马来西亚 MSM 中的药物风险行为和 PrEP 吸收情况。这些相关项目的调查结果将为候选人提供必要的技能和能力来开发和测试创新和定制的 MSM 的初级艾滋病毒预防干预。 Shrestha 博士的 K01 申请非常适合推进候选人的职业生涯取决于他在干预设计、实施和安置方面的培训，他的高公共卫生研究的生产力，以及他在马来西亚背景下不断发展的研究经验。超过 5年内，他将获得新的技能和经验，以实现他的职业目标和目的：1）获得拥有先进的定量和定性技能的决策科学经验，成为独立的决策者艾滋病毒、药物滥用和弱势群体移动健康干预领域的调查员； 2）发展专业知识移动医疗干预措施的开发、测试、实施和传播，将解决特定问题 MSM 中艾滋病毒预防服务的障碍，特别是那些患有物质使用障碍的人； 3）开发一个独立的职业道路，重点是使用移动医疗策略预防男男性行为者的艾滋病毒。为了实现这些目标，他组建了一支出色的跨学科导师团队，拥有艾滋病毒、药物滥用、干预方面的专业知识设计、决策科学、先进生物统计学和移动医疗研究。在他们的指导下，他将完成相关的教学工作，参加研讨会和进行研究，以应用成为一名男男性接触者中基于移动医疗的艾滋病毒预防的独立研究员。