Exploring Real-time ART Adherence Monitoring In Young African American MSM

探索年轻非裔美国 MSM 的实时 ART 依从性监测

• 批准号: 9198162
• 负责人: Mark S Dworkin
• 金额: $ 20.81万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-26 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198162
• 关键词: Accounting; Address; Adherence; African American; Anti-Retroviral Agents; Antiretroviral resistance; Behavior; Behavioral; Caring; Case Manager; Cellular Phone; Communication; Communities; Coupled; Data; Development; Devices; Dose; Drug resistance; Event; Failure; Focus Groups; Future; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Hispanics; Incidence; Intervention; Intervention Trial; Interview; Logistics; Modeling; Monitor; Morbidity - disease rate; Motivation; Neighborhoods; Patients; Persons; Pharmaceutical Preparations; Population; Prevention; Prophylactic treatment; Public Health; Publishing; Race; Reaction Time; Recruitment Activity; Research; Resistance; Resources; Retrospective Studies; Social support; Technology; Text; Time; Treatment Failure; Triage; Viral; Viral Load result; Virus; Wireless Technology; antiretroviral therapy; design; experience; improved; medication compliance; men; men who have sex with men; mortality; patient population; prevent; real time model; response; skills; social; theories; therapy adherence; time use; transmission process

ABSTRACT This exploratory/developmental application proposes to determine the acceptability of a promising new intervention using real-time adherence monitoring and to determine reasons for missed antiretroviral therapy (ART) doses in young AAMSM. Adherence to ART is critical to prevent morbidity, mortality, and emergence of resistant virus. Adherence to Pre-Exposure Prophylaxis (PrEP) with antiretrovirals is critical to prevent HIV transmission. In the US, African American men account for the largest proportion of new HIV infections by race and disproportionately experience associated mortality. Among HIV-positive persons treated with ART, African Americans are significantly less likely than Whites and Hispanics to be virally suppressed. In addition, young MSM have low adherence to PrEP. Guided by the Information Motivation, Behavioral Skills Model, real-time adherence monitoring with a triaged response to missed doses may increase patient information about the consequences of non adherence, motivate medication adherence, and positively influence adherence behavioral skills, resulting in improved behavior that leads to viral suppression and/or more sustained protective PrEP drug levels. The proposed study will recruit young AAMSM from high HIV incidence neighborhoods where improvement in ART adherence has the potential to produce high personal and public health gain, potentially contributing towards lowering HIV incidence rates in these communities. The aims of this study are to: 1) Determine the acceptability of real-time adherence monitoring in young AAMSM by conducting participative formative research with focus groups of young HIV-positive AAMSM patients with detectable viral load in the past 12 months and young AAMSM who are taking PrEP and; 2) Conduct qualitative interviews to determine reasons for missed doses detected in real-time in young HIV-infected AAMSM patients who had a detectable viral load in the past 12 months. We will analyze interview data to identify salient behavioral and/or emergent subpopulation factors that contribute to non adherence. These data will provide a deeper understanding of ART adherence than previous retrospective studies and will inform development of a theory-driven real-time ART adherence intervention including choice of response messages, understanding to what extent perceived social/logistic factors may contribute to these events, and exploring subject's motivation to address reasons for missed doses to prevent future events.

抽象的 该探索性/开发性应用旨在确定有前途的新产品的可接受性 使用实时依从性监测进行干预并确定错过抗逆转录病毒治疗的原因 年轻 AAMSM 的 (ART) 剂量。坚持 ART 对于预防发病、死亡和出现疾病至关重要 耐药病毒。坚持使用抗逆转录病毒药物进行暴露前预防 (PrEP) 对于预防 HIV 至关重要 传播。在美国，按种族划分，非洲裔美国男性在新增艾滋病毒感染者中所占比例最大 并且不成比例地经历相关死亡率。在接受抗逆转录病毒治疗的艾滋病毒阳性者中，非洲 与白人和西班牙裔相比，美国人受到病毒抑制的可能性要小得多。此外，年轻 MSM 对 PrEP 的依从性较低。以信息动机、行为技能模型为指导，实时 通过对错过剂量的分类反应进行依从性监测可能会增加患者关于药物的信息 不依从性的后果，激励药物依从性，并对依从性产生积极影响 行为技能，从而改善行为，从而抑制病毒和/或更持久 保护性 PrEP 药物水平。拟议的研究将从艾滋病毒高发区招募年轻的 AAMSM 提高 ART 依从性有可能产生较高的个人和公共效益的社区 健康增益，可能有助于降低这些社区的艾滋病毒发病率。的目标 本研究的目的是： 1) 通过以下方式确定年轻 AAMSM 实时依从性监测的可接受性： 与年轻 HIV 阳性 AAMSM 患者焦点小组开展参与性形成性研究 过去 12 个月内可检测到的病毒载量以及正在服用 PrEP 的年轻 AAMSM； 2) 行为 定性访谈以确定年轻艾滋病毒感染者实时检测到漏服剂量的原因 过去 12 个月内可检测到病毒载量的 AAMSM 患者。我们将分析采访数据 识别导致不依从的显着行为和/或新兴亚群因素。这些数据 与之前的回顾性研究相比，将提供对 ART 依从性的更深入的了解，并将提供信息 开发理论驱动的实时 ART 依从性干预措施，包括选择响应消息， 了解感知的社会/后勤因素在多大程度上可能促成这些事件，并探索 受试者解决漏服原因以预防未来事件的动机。