Effectiveness of combination HIV preventive interventions for young Thai MSM

泰国年轻男男性接触者联合艾滋病毒预防干预措施的有效性

基本信息

批准号：
10084364
负责人：
Christopher C. Beyrer
金额：
$ 38.23万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10084364
关键词：
AIDS prevention Acute Address Adherence Asia Awareness Car Phone Caring Centers for Disease Control and Prevention (U.S.)Cohort Studies Collaborations Communities Cost Analysis Cost Measures Cost Savings Counseling Data Effectiveness Enrollment Epidemic Foundations Goals HIV HIV Infections HIV Seropositivity Health Promotion Human immunodeficiency virus test Incidence Individual Infection Intervention LGBT Health Lubricants Methods Oral Participant Persons Phase Population Prevention Prevention strategy Preventive Intervention Procedures Process Prostitution Qualitative Methods Recording of previous events Reporting Research Research Design Rights Risk Risk Reduction Scoring Method Service provision Services Structural Models Tenofovir Testing Thailand Time Treatment Cost Universities Work acute infection aged base behavior change community clinic community consultation condoms cost cost effective cost effectiveness density design disability-adjusted life years effectiveness testing effectiveness trial empowerment emtricitabine experience high risk male male sex worker member men men who have sex with men open label pre-exposure prophylaxis public health relevance sex sexual risk taking truvada uptake young man young men who have sex with men

项目摘要

DESCRIPTION (provided by applicant): This Thai-US collaborative application seeks to develop and conduct a non-randomized effectiveness and cost-effectiveness study of a multi-level combination HIV preventive intervention with and without daily oral Tenofovir/Emtricitabine (Truvada) pre-exposure prophylaxis (PrEP) with mobile phone-based SMS adherence support among young men who have sex with men (YMSM) in Bangkok, Thailand. The current epidemic of HIV among Thai YMSM (men aged 18-26) is marked by high HIV incidence (5-12/100py) despite current prevention and treatment efforts, and rates are highest among the youngest men, aged 18-21, and among the subset of YMSM who sell sex. The proposed combination intervention will include individual level components: frequent HIV testing, risk reduction counseling, condom and lubricant distribution, and behavior change counseling; community awareness and mobilization; and an open label offer of PrEP with SMS (FrontlineSMS) adherence support. Participants will include Thai YMSM engaged in sex work or with a history of recent (in the previous 12 months) selling sex. The proposed study will be conducted by Johns Hopkins, Mahidol, and Emory Universities; The Thai MOPH-US CDC Collaboration (TUC) and its Silom Community Clinic @ Trop Med (SCC); and community partners including SWING, a sex worker empowerment and health promotion group; Rainbow Sky, an LGBT health and rights group; and APCOM, the Asia-Pacific Community of MSM. This group combines unique expertise, access, and experience in working with YMSM in this hyper-epidemic context. The study will include a formative phase using qualitative and community engagement methods to refine the intervention; a pilot; the open label intervention assessing effectiveness of combination interventions with and without PrEP and SMS adherence support with an HIV infection endpoint; and a costing and cost-effectiveness assessment which will measure the costs associated with the combined intervention, the number of infections averted through PrEP use, discounted treatment costs save, and assess whether the intervention packages are cost- saving, cost effective, or not cost-effective. The effectiveness study has been powered on the comparison of person time on PrEP versus not on PrEP and will employ propensity score methods to reduce the potential bias inherent in the self-selection design. In all the study proposes to enroll 1240 YMSM, 620 who choose PrEP and 620 who do not choose PrEP.

描述（由申请人提供）：这项泰国-美国合作申请旨在开发和开展一项非随机有效性和成本效益研究，研究多层次联合艾滋病毒预防干预措施，无论是否每天口服替诺福韦/恩曲他滨（Truvada）。在泰国曼谷，针对男男性行为者 (YMSM) 的年轻男性进行暴露预防 (PrEP)，并提供基于手机短信的依从性支持。尽管目前采取了预防和治疗措施，但目前泰国 YMSM（18-26 岁男性）中艾滋病毒流行的特点是艾滋病毒发病率较高（5-12/100py），并且在最年轻的男性（18-21 岁）和属于 YMSM 中卖性的子集。拟议的组合干预措施将包括个人层面的组成部分：频繁的艾滋病毒检测、降低风险咨询、安全套和润滑剂分发以及行为改变咨询；社区意识和动员；以及带有 SMS (FrontlineSMS) 依从性支持的 PrEP 开放标签产品。参与者将包括从事性工作或最近（过去 12 个月）有卖淫历史的泰国 YMSM。拟议的研究将由约翰·霍普金斯大学、玛希隆大学和埃默里大学进行；泰国卫生部-美国疾病预防控制中心合作组织 (TUC) 及其隆社区诊所 @ Trop Med (SCC)；以及社区合作伙伴，包括性工作者赋权和健康促进组织 SWING； Rainbow Sky，LGBT 健康和权利组织；以及 APCOM（MSM 亚太社区）。该团队结合了在疫情背景下与 YMSM 合作的独特专业知识、渠道和经验。该研究将包括一个形成阶段，使用定性和社区参与方法来完善干预措施；飞行员；开放标签干预评估有或没有 PrEP 和 SMS 依从性支持以及 HIV 感染终点的组合干预措施的有效性；成本核算和成本效益评估，将衡量与联合干预措施相关的成本、通过使用 PrEP 避免的感染数量、节省的折扣治疗成本，并评估干预方案是否节省成本、具有成本效益或不成本-有效的。有效性研究以进行 PrEP 与未进行 PrEP 的人员时间比较为基础，并将采用倾向评分方法来减少自我选择设计中固有的潜在偏差。总共该研究建议招募 1240 名 YMSM，其中 620 名选择 PrEP 的人，620 名不选择 PrEP 的人。