Optimizing PrEP Utilization among Alcohol and Other Drug (AOD) Using Women of Color

使用有色人种女性优化酒精和其他药物 (AOD) 的 PrEP 使用

• 批准号: 10053581
• 负责人: JESSY G DEVIEUX
• 金额: $ 14.35万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-11-14 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10053581
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Advocacy; Affect; African American; Alcohol consumption; Alcohols; Area; Assessment tool; Awareness; Biological; Biological Markers; Caring; Centers for Disease Control and Prevention (U.S.); Color; Communities; Community Participation; Continuity of Patient Care; Country; County; Data; Dependence; Development; Disadvantaged; Drug usage; Economics; Educational workshop; Epidemic; Evidence based intervention; FDA approved; Face; Feasibility Studies; Female; Florida; Funding; Future; Gender; Goals; HIV; HIV Seronegativity; HIV diagnosis; Haitian; Health Personnel; High Prevalence; Individual; Institutes; Instruction; Intervention; Label; Latina; Latino; Lead; Male Condoms; Manuals; Measures; Mediation; Methods; Modeling; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Oral; Outcome; Participant; Patient Self-Report; Pattern; Pharmaceutical Preparations; Pharmacy facility; Policies; Population; Predisposition; Prevention program; Prevention strategy; Procedures; Provider; Recommendation; Research; Research Personnel; Risk; Rural; Safe Sex; Shapes; Source; Structure; Surveys; Testing; Training; Update; Ursidae Family; Voice; Woman; Work; alcohol and other drug; alcohol research; base; biobehavior; collaborative care; community based participatory research; comorbidity; comparison group; design; education access; ethnic minority population; experience; fight against; gender difference; health disparity; implementation research; improved; instrument; intervention program; meetings; member; men who have sex with men; multi-component intervention; pre-exposure prophylaxis; programs; public health relevance; racial and ethnic disparities; screening; sex; social; symposium; theories; therapy development; uptake; working group

Project Summary As we edge closer to the half century mark of the HIV epidemic, the disproportionate effect on women of color in the U.S. continues to be jolting. Women overall have been at a disadvantage in the epidemic due to gender differences and norms that shape biological, social and economic vulnerability. Racial and ethnic disparities magnify the risk. Co-factors such as alcohol and other drug (AOD) use intersect and reinforce other comorbidities. Living in a high prevalence area significantly hardens the risk and makes it tougher to overcome. Options to help women stay HIV negative have been limited. However, this obstacle shifted several years ago with FDA approval and CDC endorsement of oral pre-exposure prophylaxis (PrEP). Yet, the majority of U.S. women do not know that PrEP can be a female-controlled strategy or that it applies to them—and backup has not been forthcoming from providers or their communities. What is most disturbing, however, is the absence of PrEP as an accessible strategy among women of color in high impact regions of the country. This developmental U34 responds to RFA-AA-17-013, which prioritizes community based participatory research (CBPR) to develop implementation models for women that address alcohol and HIV in high impact regions and communities. The proposed study will produce an evidence- and CBPR-driven PrEP implementation intervention to enhance uptake and optimize use among women of color in South Florida, which is currently the highest impact region of the U.S. with HIV rates recently determined by the CDC to be the highest in the nation. The study builds upon the team’s experience in alcohol/HIV intervention and CBPR in South Florida and preliminary work with stakeholders from the greater Miami and Fort Lauderdale areas to develop a multi- level PrEP intervention program for African American, Latina, and Haitian women who engage in risky sex and AOD use. The study includes researchers from the Southern HIV and Alcohol Research Consortium (SHARC) and will inform the design of target and comparison groups and other features of a U01 for further study within the NIAAA CHAART Consortia. Guided by the social ecological framework, the study will: identify needs, priorities, and community strengths and develop a PrEP continuum during a summit to engage stakeholders (Aim 1); produce a replicable implementation program, including manuals, materials, instruments, and procedures, through the formation of a Community Advisory and Advocacy Board (Aim 2); and conduct an exploratory pilot among 120 multi-ethnic women of color in Broward and Miami-Dade counties to test fidelity, feasibility and acceptability and measure PrEP uptake and adherence and retention in care over a 6 month period. The study will utilize biomarkers in a subsample to compare with self-reports and pharmacy refill measures. It will be among the first to develop a PrEP intervention in the South for women of color, and is thus in line with the specific high funding priorities of the Office of AIDS Research on cross-cutting research to reduce health disparities in developing implementation approaches for bio-behavioral strategies such as PrEP.

项目概要 随着艾滋病毒流行已接近半个世纪，有色人种女性受到的影响尤为严重 在美国，由于性别原因，女性总体上在疫情中处于不利地位。 造成生物、社会和经济脆弱性的差异和规范。 酒精和其他药物 (AOD) 的使用等辅助因素会相互交叉并强化其他因素。 生活在高发病率地区会显着增加风险并使其更难发生。 帮助女性保持艾滋病毒阴性的选择非常有限，但是这一障碍已经发生了一些变化。 几年前，FDA 批准并 CDC 认可口服暴露前预防 (PrEP)。 的美国女性不知道 PrEP 可以是女性控制的策略，也不知道它适用于她们，并且 然而，最令人不安的是提供商或其社区尚未提供备份。 该国高影响地区的有色人种女性缺乏 PrEP 作为一项可行的战略。 发展 U34 响应 RFA-AA-17-013，优先考虑基于社区的参与性研究 (CBPR) 为妇女制定实施模型，解决高影响地区的酒精和艾滋病毒问题 拟议的研究将产生证据和 CBPR 驱动的 PrEP 实施。 旨在提高南佛罗里达州有色人种女性的接受度和优化使用的干预措施，这是目前 美国疾病预防控制中心 (CDC) 最近确定，该地区是美国影响最严重的艾滋病毒感染率地区 该研究建立在该团队在南佛罗里达州酒精/艾滋病毒干预和 CBPR 的经验基础上。 并与大迈阿密和劳德代尔堡地区的利益相关者进行初步合作，开发一个多 针对从事危险性行为和行为的非裔美国人、拉丁裔和海地妇女的 PrEP 水平干预计划 AOD 的使用包括来自南方艾滋病毒和酒精研究联盟 (SHARC) 的研究人员。 并将为 U01 的目标组和对照组的设计以及其他特征提供信息，以供进一步研究 NIAAA CHAART 联盟以社会生态框架为指导，该研究将：确定需求， 优先事项和社区优势，并在峰会期间制定 PrEP 连续体以吸引利益相关者参与 （目标 1）；制定可复制的实施方案，包括手册、材料、仪器和 程序，通过成立社区咨询和宣传委员会（目标 2）并开展 在布劳沃德县和迈阿密戴德县 120 名多种族有色人种女性中进行探索性试点，以测试忠诚度， 可行性和可接受性，并衡量 6 个月内 PrEP 的吸收率、依从性和护理保留率 该研究将利用子样本中的生物标志物与自我报告和药房补充进行比较。 它将是首批在南方为有色人种女性制定 PrEP 干预措施的国家之一，因此正在采取行动。 根据艾滋病研究办公室关于跨领域研究的具体高资助优先事项， 在制定生物行为策略（例如 PrEP）的实施方法时减少健康差异。