Using behavioral economics to improve the uptake of and persistence on pre-exposure prophylaxis in men who have sex with men to prevent HIV infection

利用行为经济学提高男男性行为者对暴露前预防的接受度和持久性，以预防艾滋病毒感染

• 批准号: 10012296
• 负责人: Lawrence Camdon Long
• 金额: $ 17.32万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-03 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10012296
• 关键词: AIDS prevention; Address; Adherence; Affect; Africa; Anti-Retroviral Agents; Applications Grants; Behavior; Behavior Therapy; Behavioral; Behavioral Sciences; Belief; Boston; Cognitive; Data; Decision Making; Development; Development Plans; Effectiveness; Effectiveness of Interventions; Epidemic; Failure; Focus Groups; Funding; Future; Goals; Government; HIV; HIV Infections; HIV Seronegativity; HIV risk; Health; Health Personnel; Health behavior; Human; Human immunodeficiency virus test; Incidence; Individual; Infection; Institutes; Intervention; Interview; Knowledge; Learning; Medical Records; Mentored Research Scientist Development Award; Mentorship; Methods; Participant; Patients; Pharmaceutical Preparations; Pilot Projects; Play; Population; Prevention; Prevention program; Preventive therapy; Process; Psychology; Qualitative Research; Questionnaires; Randomized; Recording of previous events; Reporting; Research; Research Assistant; Research Methodology; Research Personnel; Risk; Risk Behaviors; Role; Service provision; Site; Socioeconomic Status; South Africa; South African; Structure; Surveys; Testing; Training; Training Activity; Universities; Vulnerable Populations; Work; antiretroviral therapy; base; behavior change; behavioral economics; career; career development; cohort; control trial; cost; data format; design; health care service; health care service utilization; health goals; high risk; high risk men; high risk population; improved; infection risk; informant; innovation; lens; men who have sex with men; novel; pre-exposure prophylaxis; predictive modeling; prevent; professor; programs; social health determinants; theories; tool; treatment program; uptake

PROJECT SUMMARY / ABSTRACT This is an application for a five-year K01 award for Dr. Lawrence Long, a Research Assistant Professor at Boston University. The K01 award will support a complementary set of training activities and research aims aimed at establishing Dr. Long as an independent researcher in the field of HIV prevention and behavioral economics. This will allow Dr. Long to reach his long-term career goal of leading HIV research that guides the design of health delivery programs (treatment and prevention) which encourages optimal health behavior and decision making. The K01 will provide the support necessary to accomplish the following training goals: 1) to obtain expert technical knowledge in the use of pre-exposure prophylaxis (PrEP) in men who have sex with men; 2) to learn, master and apply the theory of human decision making; 3) to become skilled in the design and implementation of behavior change interventions and 4) to successfully apply for independent research funding. In order to achieve these training goals Dr. Long has proposed a career development plan centered around strong mentorship supported by didactic training in behavioral economics, qualitative research methods, and research approaches for working with vulnerable populations. Despite the largest HIV treatment program in the world South Africa’s HIV incidence remains high, in particular amongst key populations such as men who have sex with men (MSM). The recent inclusion of HIV pre-exposure prophylaxis (PrEP) as part of the national prevention package in South Africa is considered key to reducing incidence in these populations, yet pilot studies show sub optimal uptake and poor persistence amongst those most at risk. Dr. Long’s research will focus on understanding why PrEP uptake and persistence amongst MSM in South Africa is low and how the delivery of PrEP to this population could be altered to encourage those most at risk to start treatment. The research will aim to: 1) identify predictors of PrEP initiation and persistence amongst South African MSM testing negative at PREP pilot sites; 2) qualitatively examine the role of cognitive bias in the decision to request, offer, accept and continue on PrEP from a health care provider and patient perspective; and 3) develop and pilot a simple intervention to increase the uptake of and persistence on PrEP in MSM using behavioral economic theory to improve decision making. In order to accomplish these aims Dr. Long has access to the two pilot sites currently offering PrEP to MSM in South Africa. Before the completion of the K01 award Dr. Long will use this research as the basis for an R01 grant application which would aim to conduct a randomized control trial to establish the effectiveness of behavioral economic interventions in improving PrEP uptake amongst various key populations.

项目概要/摘要 这是劳伦斯·朗 (Lawrence Long) 博士的五年 K01 奖申请，他是该大学的研究助理教授。 波士顿大学。K01 奖项将支持一套互补的培训活动和研究目标。 旨在使龙博士成为艾滋病毒预防和行为领域的独立研究员 这将使龙博士能够实现他领导艾滋病毒研究的长期职业目标，从而指导艾滋病毒的研究。 设计健康服务计划（治疗和预防），鼓励最佳的健康行为和 K01 将提供实现以下培训目标所需的支持：1) 获得对与男性发生性关系的男性使用暴露前预防 (PrEP) 的专业技术知识 男性；2）学习、掌握和应用人类决策理论；3）熟练掌握设计； 和实施行为改变干预措施以及 4) 成功申请独立研究 为了实现这些培训目标，龙博士提出了一个以资金为中心的职业发展计划。 围绕行为经济学、定性研究方面的教学培训支持的强有力的指导 尽管艾滋病毒治疗规模最大，但仍存在与弱势群体合作的方法和研究方法。 南非的艾滋病毒发病率仍然很高，特别是在重点人群中，例如 最近将 HIV 暴露前预防 (PrEP) 纳入了男男性行为者 (MSM) 的一部分。 南非的国家预防方案被认为是减少这些人群发病率的关键， 然而初步研究表明，龙博士的风险最高的人群的吸收率和持久性较差。 研究重点是了解为什么南非 MSM 的 PrEP 吸收率和持久性较低 以及如何鼓励高危人群开始向该人群提供 PrEP 该研究的目的是：1）确定南方人群 PrEP 启动和持续的预测因素。 非洲 MSM 在 PREP 试点地点检测呈阴性；2) 定性研究认知偏差在 从医疗保健提供者和患者的角度决定请求、提供、接受和继续 PrEP； 3) 制定并试点一项简单的干预措施，以提高 MSM 中 PrEP 的采用率和持久性，使用 为了实现这些目标，龙博士采用了行为经济学理论来改善决策。 在 K01 完成之前，可以访问目前在南非向 MSM 提供 PrEP 的两个试点地点。 Long 博士将利用这项研究作为 R01 拨款申请的基础，该申请旨在开展 随机对照试验以确定行为经济干预措施在改善 PrEP 方面的有效性 各个重点人群的吸收情况。