Building mobile HIV prevention and mental health support in low-resource settings

在资源匮乏的地区建立流动艾滋病毒预防和心理健康支持

基本信息

批准号：
10632778
负责人：
Corina Lelutiu-Weinberger
金额：
$ 76.83万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-05 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10632778
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Affect Alcohol abuse Alcohol consumption Appalachian Region Attention Automobile Driving Behavior Therapy Behavioral Biological Bisexual Bypass Cognitive Collaborations Communities Conscious Country Dangerousness Data Discrimination Eastern Europe Education Ensure Epidemic Europe European European Union Evaluation Face Gays HIV HIV Infections HIV Seropositivity HIV risk HIV/STD Health Health Personnel Health Services Healthcare High Prevalence Homophobia Income Infection International Intervention Interview Investments Knowledge Learning Module Locales Mediating Mental Depression Mental Health Modeling Motivation Nature Nongovernmental Organizations Outcome Measure Persons Phase Plant Roots Population Prevalence Prevention Preventive service Professional counselor Provider Randomized Randomized Controlled Trials Reporting Research Resource-limited setting Resources Risk Romania Route Rural Appalachia STI prevention Sampling Self Administration Self Efficacy Services Site Symptoms Testing Training Translating Travel Treatment Efficacy United States National Institutes of Health Vulnerable Populations alcohol testing attentional control base comparison intervention condomless anal sex condoms coping mechanism cost cost effective cost effectiveness cost estimate design efficacy testing follow-up future implementation high risk population improved mHealth male male health member men men who have sex with men minority stress motivational enhancement therapy physical conditioning pilot test pre-exposure prophylaxis prevent prevention service primary outcome psychosocial recruit response screening secondary outcome self esteem sex skills skills training social stigma stem syndemic theories tool transmission process treatment as usual

项目摘要

Project Summary This project is designed to remedy unaddressed and interlocking HIV-prevention and mental health needs among gay and bisexual men (GBM) in the Central Eastern European country of Romania, and their underpinning stigma-related mechanisms. Rampant stigma contributes to the increasing prevalence of HIV among Romanian GBM (from under 10% in 2009 to close to 20% in 2014, by best available estimates) and keeps GBM out-of-reach of HIV-prevention services. Our mHealth pilot intervention (titled “Despre Mine. Despre Noi.” [DMDN] translated as “About Me. About Us.”), which reduced US and Romanian GBM’s risk for HIV infection while also reducing depression and alcohol abuse in initial pre-post trials, is now ready for testing in a randomized controlled trial with a large national sample. The DMDN intervention entails eight 60-minute live chat sessions delivered by trained counselors on our mobile study platform using motivational interviewing (MI) and cognitive-behavioral skills training (CBST). First, during pre-trial (mos 1-5), in collaboration with a community advisory board consisting of GBM community members, GBM-affirmative physical and mental health providers, and our technical developer, we will fine-tune the DMDN intervention based on our pilot findings and evaluation interviews, and expand the original DMDN education materials for an education attention condition (EAC) that will serve as our control. Second, during the intervention phase (mos 6-45), we will recruit, screen, assess, and randomize GBM at risk for HIV infection and alcohol abuse to either the DMDN intervention (n=163) or EAC (n=163). The conditions are content matched, and both are hosted on our study platform. While DMDN will consist of eight weekly mHealth live chat sessions, EAC will consist of eight self- administered educational modules. Third, during the follow-up phase (mos 8-55), we will assess at 4, 8, and 12 months post-baseline, in a mobile fashion identical to the baseline, the primary outcome of condomless anal sex with male partners and secondary outcomes of alcohol abuse, depression, biologic HIV/STI infection, HIV/STI testing, and psychosocial mechanisms rooted in the Information-Motivation-Behavioral Skills (IMB) model (e.g., HIV/STI knowledge, condom use self-efficacy) and minority stress theory (e.g., identity concealment, internalized homophobia). We hypothesize that 1) compared to GBM randomized to EAC, those randomized to the mHealth DMDN condition will report significant reductions in condomless anal sex across the 12-month follow-up, 2) IMB and minority stress mechanisms will statistically mediate intervention efficacy, and 3) compared to EAC, the DMDN intervention will prove cost-effective in terms of HIV infections averted and reduced depression and alcohol abuse. If efficacious and cost-effective, DMDN presents a highly disseminable intervention that could significantly prevent HIV infection among GBM in high-stigma, low- resource areas, where GBM are disproportionately affected by HIV, yet kept out-of-reach of brick-and-mortar prevention services.

项目摘要该项目旨在记住未解决的和互锁的艾滋病毒预防和心理健康需求在东欧国家罗马尼亚的同性恋和双性恋男子（GBM）中，基础与污名相关机制。猖ramp的污名导致艾滋病毒的患病率提高在罗马尼亚GBM中（根据最佳估计，从2009年的10％到2014年接近20％）和保留GBM的艾滋病毒预防服务。我们的MHealth Pilot干预（标题为“ Perstre Mine”。诺伊（Noi）。” [dmdn]翻译为“关于我。关于我们。”），这降低了我们和罗马尼亚GBM的风险艾滋病毒感染同时还减少了初始前试验中的抑郁和酗酒，现在已经准备好进行测试在一项大型国家样本的随机对照试验中。 DMDN干预需要八个60分钟通过激励访谈在我们的移动学习平台上训练有素的优惠券提供的实时聊天会议（MI）和认知行为技能培训（CBST）。首先，在预审期间（MOS 1-5），与社区咨询委员会由GBM社区成员，GBM务实的身心健康组成健康提供商和我们的技术开发人员，我们将根据我们的飞行员微调DMDN干预措施调查结果和评估访谈，并扩展原始的DMDN教育材料注意条件（EAC）将作为我们的控制。第二，在干预阶段（MOS 6-45），我们将招募，屏幕，评估和随机将艾滋病毒感染和酗酒风险的GBM随机招募到DMDN 干预（n = 163）或EAC（n = 163）。条件是满足的，并且两者都在我们的研究中托管平台。虽然DMDN将包括八个每周的MHealth实时聊天课程，但EAC将由八个自我组成管理教育模块。第三，在随访阶段（MOS 8-55），我们将在4、8和12评估基线后的月份，以与基线相同的移动方式，无避孕套肛门的主要结果与男性伴侣的性行为以及酒精滥用，抑郁，生物艾滋病毒/STI感染的次要结果，艾滋病毒/STI测试以及植根于信息动机行为技能（IMB）的社会心理机制模型（例如，艾滋病毒/STI知识，避孕套使用自我有效）和少数族裔压力理论（例如身份隐藏，内部同性恋恐惧症）。我们假设这是1）与随机分配给EAC的GBM相比随机分配到MHealth DMDN条件将报告遍布整个避孕套肛交的大幅减少 12个月的随访2）IMB和少数族裔压力机制将从统计学上培养基干预效率， 3）与EAC相比，DMDN干预将在避免HIV感染方面证明具有成本效益减少抑郁和酗酒。如果有效且具有成本效益，DMDN会呈现高度可以明显防止GBM中高污名，低 - 资源领域，GBM受艾滋病毒的影响不成比例，但要保持实体范围预防服务。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A randomized controlled trial of an mHealth intervention for gay and bisexual men's mental, behavioral, and sexual health in a high-stigma, low-resource context: Project Comunică protocol.

一项在高耻辱、低资源背景下对男同性恋和双性恋男性的心理、行为和性健康进行 mHealth 干预的随机对照试验：Project Comunicä 协议。

DOI：
10.21203/rs.3.rs-3008174/v1
发表时间：
2023
期刊：
Research square
影响因子：
0
作者：
Lelutiu-Weinberger,Corina;Filimon,Mircea;Hoover,Donald;Lixandru,Mihai;Hanu,Lucian;Dogaru,Bogdan;Kovaks,Tudor;Fierbinteanu,Cristina;Ionescu,Florentina;Manu,Monica;Maris,Alexandra;Pana,Elena;Dorobantescu,Cristian;Streinu-Cercel,Ad
通讯作者：
Streinu-Cercel,Ad