Adapting effective mhealth interventions to improve uptake and adherence of the HIV pre- exposure prophylaxis (PrEP) in Thai young MSM

采用有效的移动健康干预措施，以提高泰国年轻 MSM 的 HIV 暴露前预防 (PrEP) 的接受度和依从性

• 批准号: 10258607
• 负责人: NITTAYA PHANUPHAK
• 金额: $ 26.62万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258607
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; Advisory Committees; Asia; Asthma; Awareness; Behavioral; Biological Markers; Car Phone; Centers for Disease Control and Prevention (U.S.); Chronic; Clinic; Computers; Counseling; Country; Development; Drug usage; Enrollment; Epidemic; General Population; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV Seroprevalence; HIV/STD; Health; Health behavior; Health system; Incidence; Individual; Intervention; Interview; Literature; Massage; Methods; Modeling; Monitor; Motivation; Nature; Oral; Participant; Patient Recruitments; Pattern; Persons; Pharmaceutical Preparations; Phase; Population; Prevalence; Prevention strategy; Preventive service; Process; Protocols documentation; Randomized; Randomized Controlled Trials; Recommendation; Regimen; Reporting; Risk; Risk-Taking; System; Technology; Testing; Text; Text Messaging; Thailand; Time; Treatment Efficacy; Work; Youth; acceptability and feasibility; aged; antiretroviral therapy; base; behavior change; digital; effective intervention; efficacy testing; efficacy trial; feasibility research; follow-up; high risk population; improved; infection rate; innovation; mHealth; men; men who have sex with men; mobile computing; motivational enhancement therapy; motivational intervention; participant retention; post intervention; pre-exposure prophylaxis; prevent; programs; recruit; response; satisfaction; scale up; sex; side effect; skills; social stigma; success; transmission process; uptake; usability; young man; young men who have sex with men

Young men having sex with men (YMSM) are the fastest growing HIV+ population worldwide. Thailand has the highest adult HIV seroprevalence in Asia; 28.6% of men having sex with men in Bangkok are HIV+. The HIV incidence rate among YMSM in Bangkok is 12.2 per 100 person-years. Effective prevention strategies are urgently needed to prevent HIV transmission in this high-risk population. Pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention strategy recommended by the CDC and WHO for all at-risk individuals, including HIV-negative MSM. PrEP is highly effective when taken as prescribed, but PrEP utilization has been low and adherence is often inadequate. To address these challenges among Thai YMSM, we propose to develop a technology facilitated intervention combining Motivational Enhancement System for PrEP Uptake and Adherence (MES-PrEP) and Motivational Interactive Text Messaging (MTM) to increase uptake of and sustained adherence to PrEP among HIV-negative, Thai YMSM. MTM will be programmed and tested to send two-way motivational messages to promote PrEP uptake and adherence. Our primary aim is to develop and pilot test MES-PrEP and MTM and associated protocols and to assess preliminary evidence of the effect of the technology facilitated intervention. The proposed study includes 3 phases. Phase I includes in-depth interviews with 30 HIV-negative Thai YMSM to explore barriers and facilitators of PrEP initiation and adherence to inform intervention content. Phase II consists of adapting and beta testing MES-PrEP and MTM for functionality and feasibility using 10 HIV-negative Thai YMSM. In Phase III, we will conduct a pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary efficacy of MAS-PrEP and MTM to increase PrEP uptake and adherence among Thai YMSM. We will enroll 60 HIV-negative Thai YMSM who have not started PrEP and 60 YMSM who are on PrEP but not adherent to it. Participants will be randomized 2:1 to received MES-PrEP and MTM (n=40) or Standard PrEP Counseling (n=20). Feasibility and acceptability of the intervention will be assessed through paradata of usage patterns and the System Usability Scale. Preliminary impact will be assessed by evaluating the proportion of PrEP initiation and level of adherence to PrEP. Participants will complete the assessments at baseline and 1, 3, and 6 months post- intervention. Biomarkers of adherence to PrEP and HIV/STI will be collected. Upon project completion, we shall have developed a highly innovative mHealth intervention to support MSM using PrEP which will be ready for testing in a larger efficacy trial.

男男性行为者 (YMSM) 是全球增长最快的艾滋病病毒感染者群体。泰国有 亚洲成人艾滋病毒血清流行率最高；在曼谷，28.6% 的男男性行为者感染艾滋病毒。这 曼谷 YMSM 的艾滋病毒发病率为每 100 人年 12.2 人。有效的预防策略是 迫切需要预防艾滋病毒在这一高危人群中的传播。暴露前预防 (PrEP) 是 疾病预防控制中心和世界卫生组织为所有高危人群推荐的有效艾滋病毒预防策略， 包括 HIV 阴性 MSM。按处方服用 PrEP 非常有效，但 PrEP 的使用率一直很低 低且依从性往往不足。为了应对泰国 YMSM 面临的这些挑战，我们建议制定 一种技术促进的干预措施，结合了 PrEP 吸收的动机增强系统和 坚持 (MES-PrEP) 和激励性交互式短信 (MTM)，以提高对药物的吸收和使用 HIV 阴性的泰国 YMSM 持续坚持 PrEP。 MTM将被编程和测试以发送 促进 PrEP 的采用和坚持的双向激励信息。我们的首要目标是开发和 试点测试 MES-PrEP 和 MTM 及相关协议，并评估初步效果的证据 技术促进了干预。拟议的研究包括 3 个阶段。第一阶段包括深入 采访了 30 名 HIV 阴性的泰国 YMSM，探讨 PrEP 启动和实施的障碍和促进因素 坚持告知干预内容。第二阶段包括适应和 beta 测试 MES-PrEP 和 MTM 使用 10 HIV 阴性泰国 YMSM 的功能和可行性。第三阶段，我们将进行试点 评估 MAS-PrEP 和 MAS-PrEP 的可行性、可接受性和初步疗效的随机对照试验 MTM 旨在提高泰国 YMSM 中 PrEP 的采用率和依从性。我们将招募 60 名 HIV 阴性的泰国 YMSM 尚未开始 PrEP 的人以及正在接受 PrEP 但未遵守的 60 YMSM。参加者将是 以 2:1 的比例随机分配接受 MES-PrEP 和 MTM (n=40) 或标准 PrEP 咨询 (n=20)。可行性和 干预的可接受性将通过使用模式的参数数据和系统可用性进行评估 规模。将通过评估 PrEP 启动的比例和水平来评估初步影响 坚持 PrEP。参与者将在基线以及术后 1、3 和 6 个月完成评估 干涉。将收集坚持 PrEP 和 HIV/STI 的生物标志物。项目完成后，我们 应开发出高度创新的移动医疗干预措施，以支持使用 PrEP 的 MSM，该干预措施已准备就绪 用于在更大规模的功效试验中进行测试。