The Collaborative Care PrTNER (Prevention, Treatment, Navigation, Engagement, Resource) Project

协作护理 PrTNER（预防、治疗、导航、参与、资源）项目

• 批准号: 10743133
• 负责人: Oluwaseun Falade-Nwulia
• 金额: $ 63.14万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10743133
• 关键词: AIDS prevention; Address; Adherence; Adolescent; Alcohol consumption; Alcohols; Anal Sex; Anti-Retroviral Agents; Baltimore; Black race; Cannabis; Caring; Communication impairment; County; Decision Making; Eligibility Determination; Epidemic; Feedback; Geography; Goals; HIV; HIV Infections; HIV risk; HIV/AIDS; Health; Hispanic; Illicit Drugs; Individual; Intervention; Latino; Link; Marijuana; Modeling; Participant; Pattern; Philadelphia; Population; Prevalence; Prevention; Psychiatrist; Randomized, Controlled Trials; Reporting; Research; Resources; Risk; Risk Factors; Substance Use Disorder; Time; Unsafe Sex; Viral; Viral Load result; Work; aged; antiretroviral therapy; arm; black men who have sex with men; care delivery; collaborative care; condomless anal sex; condoms; effective intervention; ethnic disparity; experience; falls; illicit drug use; integrated care; marijuana use; medication nonadherence; member; men who have sex with men; multi-component intervention; peer coaching; polysubstance use; pre-exposure prophylaxis; pressure; primary care services; racial disparity; randomized trial; reduced substance use; sex; sexual minority men; standard of care; substance use; substance use treatment; uptake

Project Summary/Abstract To end the HIV epidemic, we need integrated care models that address HIV and PrEP care, and co-existing substance use (SU) disorders that disrupt uptake and consistent use of effective interventions. The overarching goal of this R01 proposal is to conduct a randomized controlled trial to assess the ability of a Collaborative Care Prevention, Treatment, Navigation, Engagement, Resource (PrTNER) intervention to increase initiation of preexposure prophylaxis (PrEP) (for those at-risk for HIV) and decrease viral load (for those living with HIV) among young Black and Latino men who have sex with men (YBLMSM) through engagement in SU treatment. The Collaborative Care (CC) PrTNER is a multi-component intervention developed by members of our research team specifically for YBLMSM aged 15 to 24 who are at-risk for or living with HIV. This model moves beyond the individual to consider the broader context in which, substance use, and HIV risk are (re)produced. Enhanced models that integrate SU treatment into HIV and PrEP primary care services (using a collaborative care approach that incorporates feedback from a psychiatrist and support from a peer coach) are needed to address the nuance of substance use in this population. We, therefore, are proposing to conduct a randomized trial to evaluate an integrated collaborative care model (CC PrTNER) using the following aims: Specific Aim 1: To compare the proportion of YBLMSM with co-existing SU at risk for HIV infection who initiate (start or restart) PrEP over the 12 months in the CC PrTNER arm versus standard of care (SOC). Specific Aim 2: To compare the proportion of YBLMSM with co-existing SU living with HIV infection who are HIV virally suppressed at 12 months in the Collaborative Care PrTNER arm versus SOC. Specific Aim 3: To compare the effect of CC PrTNER versus SOC on non-tobacco SU in YLBMSM with co- existing SU and examine the effect of change in SU on PrEP uptake and HIV viral suppression. This proposal directly addresses goals 1, 2, and 4 of the 2022 National HIV/AIDS Strategy to End the HIV Epidemic through: prevention, treatment, and addressing co-existing SU disorders through comprehensive integrated care delivery. It further can transform the adolescent, health department and Ryan White care settings serving YBLMSM through harmonization of PrEP, HIV and SU treatment care delivery and implementation of a collaborative care model to address the multi-level barriers that impede uptake and adherence.

项目摘要/摘要 为了结束艾滋病毒的流行，我们需要综合护理模型来解决艾滋病毒和准备护理，并共存 药物使用（SU）疾病破坏摄取并持续使用有效干预措施。总体 该R01提案的目标是进行一项随机对照试验，以评估 协作护理预防，治疗，导航，参与，资源（PRTNER）干预 增加预防预防的起始（PREP）（对于艾滋病毒危险的人），并减少病毒载量 （对于患有艾滋病毒的人）在与男人发生性关系的年轻黑人和拉丁裔男人中 参与SU治疗。协作护理（CC）PRTNER是一种多组分干预 由我们的研究团队的成员专门针对15至24岁的YBLMMSM开发 与艾滋病毒。该模型超越了个体，以考虑更广泛的环境，在这种情况下，物质使用和 艾滋病毒风险是（重新）。 增强的模型，将SU治疗整合到艾滋病毒和准备初级保健服务中（使用协作 需要从精神科医生的反馈和同伴教练的支持中进行反馈的护理方法） 解决该人群中物质使用的细微差别。因此，我们正在提议进行随机 使用以下目的评估综合协作护理模型（CC PRTNER）的试验： 特定目的1：将YBLMMM的比例与启动HIV感染风险的共存SU的比例进行比较 （开始或重新启动）在CC Prtner组与护理标准（SOC）的12个月中进行准备。 具体目的2：将YBLMMM的比例与与HIV感染的共存SU相提并论 艾滋病毒在12个月的合作护理中被抑制了Prtner ARM与SoC的抑制作用。 特定目标3：比较CC Prtner与SOC对YLBMSM中非烟草SU的影响 现有的SU并检查SU变化对PrEP摄取和HIV病毒抑制的影响。 该提案直接解决了2022年国家艾滋病毒/艾滋病战略的目标1、2和4 流行病：预防，治疗和通过全面解决共存的SU疾病 综合护理交付。它可以进一步改变青少年，卫生部门和瑞安·怀特护理环境 通过统一准备，艾滋病毒和苏治疗护理提供和实施YBLMSM 协作护理模型，以解决阻碍吸收和依从性的多层次障碍。