Effectiveness and implementation of text messaging to improve HIV testing in sexual and gender minority adolescents

短信改善性少数青少年艾滋病毒检测的有效性和实施

基本信息

批准号：
10403150
负责人：
Kathryn Rose Macapagal
金额：
$ 79.95万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-05 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10403150
关键词：
AIDS prevention Accounting Address Adolescent Adoption Adult Affect Age Attention Behavioral Bisexual Caring Centers for Disease Control and Prevention (U.S.)Clinic Communities Computer software Consensus Consolidated Framework for Implementation Research Continuity of Patient Care Development Devices Effectiveness Ensure Eye Focus Groups Gays Gender Generations Goals HIV HIV Infections HIV Seropositivity HIV risk Health Personnel Human immunodeficiency virus test Hybrids Incidence Infection Intervention Intervention Trial Interview Left Mediator of activation protein Minority Modeling Modernization Motivation Outcome Population Prevention Prevention Research Prevention program Process Provider Public Health Randomized Randomized Controlled Trials Recommendation Reporting Research Resources Risk Risk Reduction Behavior Science Self Efficacy Service provision Sexual and Gender Minorities Strategic Planning Surveys Technology Teenagers Test Result Testing Text Messaging Time Unsafe Sex Update Youth active method age group aged antiretroviral therapy arm base behavior change behavior test boys cisgender design digital digital health digital intervention effective intervention effectiveness outcome effectiveness testing follow-up girls group intervention healthy lifestyle high school hybrid type 1 trial implementation barriers implementation science improved innovation minority children pre-exposure prophylaxis preference prevent preventive intervention primary outcome programs prospective recruit scale up screening secondary outcome sexual minority male sexual minority youth sexually active adolescent skills social media software development success therapy design tool transgender transmission process treatment arm uptake

项目摘要

Project Summary Adolescent sexual minority males, transgender girls, and gender diverse teens (ASMM/TGD; ages 13-18) are disproportionately affected by HIV, accounting for 79% of new infections among this age group. Although CDC and USPTF recommend HIV screening among teens, testing rates among ASMM/TGD are very low (1 in 4 ASMM; <1 in 10 TGD). Increasing HIV testing in ASMM/TGD is critical in mitigating transmission rates and in linkage to care for those who test positive. Despite this alarming public health issue, few developmentally tailored HIV prevention interventions exist for ASMM/TGD, and to date, no CDC best-evidence interventions for this group are focused on increasing HIV testing as a primary outcome. G2G was a 6-week text message-based HIV risk behavior reduction program originally designed for ASMM. Active treatment arm content focused on providing HIV prevention information, increasing HIV prevention motivation, and increasing HIV prevention self- efficacy relative to an information-only healthy lifestyle control arm. The G2G pilot RCT showed adolescents in the active treatment arm were >3x more likely to report being tested for HIV at follow-up versus those in the control arm, even though only a minority of messages focused on testing. We propose to update G2G with the latest HIV prevention and testing science, make content inclusive of TGD, and test its effectiveness on the outcome of validated HIV testing (e.g., photo of test result). Moreover, widespread adoption of digital HIV prevention programs has lagged due to lack of attention to implementation throughout software development, intervention design, and testing. For instance, who should implement digital HIV prevention/testing interventions for teens (e.g., direct-to-consumer, clinics) remains an open question, and involving potential implementers in the development process can ensure intervention success; best practices for updating content and technology for digital HIV prevention/testing programs to prevent their obsolescence are lacking; and there is a lack of consensus on how best to reach SGM adolescents for such programs. We propose a Hybrid Type 1 trial that will establish G2G effectiveness and identify best practices for implementing digital HIV prevention/testing for teens via three specific aims. In Aim 1 we will collaborate with a youth advisory council to add content reflecting our increased emphasis on HIV testing and update gender inclusivity and cultural relevance of existing content. With prospective implementers’ input, we will also modernize the G2G software platform with an eye toward implementation. In Aim 2 we will test G2G effectiveness on HIV testing in a nationwide randomized controlled trial with 360 ASMM/TGD aged 13-18. Finally, Aim 3 will convene a experts in ASMM/TGD youth research and service provision to identify and achieve consensus in processes of, requirements for, and barriers/facilitators to reaching and engaging ASMM/TGD for HIV testing/prevention. The goal of Aim 3 is to inform, develop, and disseminate concrete tools to ensure HIV prevention programs reach ASMM/TGD. The panel will also recommend potential implementation models and adaptations needed to scale up G2G in real world settings.

项目概要青少年性少数男性、变性女孩和性别多样化青少年（ASMM/TGD；13-18 岁）尽管 CDC 指出，该年龄组中受 HIV 影响的比例不成比例，占新感染病例的 79%。 USPTF 建议对青少年进行 HIV 筛查，但 ASMM/TGD 的检测率非常低（四分之一 ASMM；< 10 TGD 中的 1 人）增加 ASMM/TGD 中的 HIV 检测对于降低传播率和尽管存在这一令人担忧的公共卫生问题，但很少有针对检测结果呈阳性的人进行针对性治疗的联系。 ASMM/TGD 存在 HIV 预防干预措施，但迄今为止，CDC 尚无针对此的最佳证据干预措施小组重点关注增加 HIV 检测作为主要成果，G2G 是为期 6 周的基于短信的 HIV 检测。风险行为减少计划最初是为 ASMM 设计的，其内容重点关注主动治疗组。提供艾滋病预防信息，提高艾滋病预防积极性，提高艾滋病预防自我意识相对于仅提供信息的健康生活方式对照组的疗效 G2G 试点随机对照试验显示青少年与对照组相比，积极治疗组报告在随访中接受 HIV 检测的可能性高出 3 倍以上控制臂，尽管只有少数消息集中于测试。最新的艾滋病预防和检测科学，将内容纳入TGD，并测试其有效性经验证的艾滋病毒检测结果（例如检测结果的照片）此外，数字艾滋病毒的广泛采用。由于在整个软件开发过程中缺乏对实施的关注，预防计划已经滞后，例如，谁应该实施数字艾滋病毒预防/检测干预措施。对于青少年（例如，直接面向消费者、诊所）仍然是一个悬而未决的问题，并涉及潜在的实施者开发过程可以确保更新内容和技术的最佳实践；缺乏防止其过时的数字艾滋病毒预防/检测计划；就如何最好地让 SGM 青少年参与此类项目达成共识，我们提出了一项混合 1 型试验。建立 G2G 有效性并确定为青少年实施数字艾滋病毒预防/检测的最佳实践通过三个具体目标，我们将与青年咨询委员会合作，添加反映我们的内容。更加重视艾滋病毒检测并更新现有内容的性别包容性和文化相关性。根据潜在实施者的意见，我们还将对 G2G 软件平台进行现代化改造，着眼于在目标 2 中，我们将在全国随机对照中测试 G2G 在 HIV 检测方面的有效性。最后，Aim 3 将召集 ASMM/TGD 青少年研究专家和 360 名 13-18 岁的 ASMM/TGD 进行试验。提供服务，以确定过程、要求和障碍/促进因素并达成共识达到并参与 ASMM/TGD 进行 HIV 检测/预防目标 3 的目标是提供信息、制定和预防艾滋病毒。该小组还将传播具体工具，确保艾滋病毒预防计划落实到 ASMM/TGD。推荐在现实世界环境中扩大 G2G 所需的潜在实施模型和调整。