Expanding "Safe Spaces 4 Sexual Health," a Mobile Van HIV/STI Testing and Care Linkage Strategy, for Black MSM in online spaces

为在线空间中的黑人 MSM 扩展“安全空间 4 性健康”，这是一项移动货车 HIV/STI 检测和护理联动策略

• 批准号: 10619057
• 负责人: ERROL L FIELDS
• 金额: $ 16.38万
• 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: 2023-02-10 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619057
• 关键词: 18 year old; Advertisements; Affect; Age; Baltimore; Bisexual; Black race; Caring; Clinic; Communication; Communities; Cybersex; Data; Development; Diagnosis; Effectiveness; Ensure; Epidemic; Etiology; Event; Exposure to; Focus Groups; Gays; Goals; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; HIV disparities; Health; Healthcare; Human immunodeficiency virus test; Interruption; Interview; Lesbian Gay Bisexual Transgender Queer; Link; Newly Diagnosed; Outcome; Outcome Measure; Participant; Pilot Projects; Population; Population Surveillance; Prevention; Privatization; Public Health; Quasi-experiment; Race; Reporting; Reproducibility; Research; Risk; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Stigmatization; Surveys; Syphilis; Testing; Time; Translating; Work; acceptability and feasibility; barrier to care; black men who have sex with men; community engagement; community organizations; comorbidity; experience; high risk; high risk men; high risk population; informant; innovation; meetings; member; men; men who have sex with men; participant interview; patient-level barriers; personalized approach; pre-exposure prophylaxis; racial disparity; recruit; satisfaction; standard of care; surveillance data; testing services; transmission process

Project Summary Ending the HIV epidemic (EHE) depends on developing innovative, strategic and tailored approaches to HIV diagnosis, treatment and prevention. While new HIV diagnoses have declined significantly from their peak, progress has stalled, particularly among Black men who have sex with men (MSM) who remain disproportionately affected in the US. In the pilot study, Safe Spaces 4 Sexual Health (SS4SH), we demonstrated the feasibility and acceptability of a status-neutral HIV/STI testing approach which identified at- risk MSM in online spaces and linked them to testing services on a mobile van in Baltimore, MD. Focusing on reaching MSM in online spaces who may be missed by traditional seek-test-treat strategies, our pilot reached 151 MSM over 14 months and demonstrated a significantly higher new HIV diagnosis (7% vs. 0.5%, p<0.001) and syphilis positivity rate (10% vs. 0.5%, p<0.001) compared to the standard of care health department (HD SOC) mobile van strategy. SS4SH pilot did not evaluate participants’ linkage to PrEP or HIV care, which are key pillars of the EHE strategy. The objective of this proposed R21 is to expand the pilot study to integrate PrEP and HIV care linkage, evaluate the acceptability and feasibility of this expanded strategy and in a quasi- experimental design, generate preliminary data on the effectiveness of this strategy compared to the HD SOC mobile van. The specific aims are: 1) Using a community-based participatory approach, expand SS4SH to incorporate linkage to PrEP for Black MSM at high risk for HIV acquisition and linkage to HIV care for those living with undiagnosed/unsuppressed HIV, and 2) Using a quasi-experimental design, pilot the expanded SS4SH testing plus care linkage strategy to (1) evaluate the acceptability and feasibility of adding care linkage and (2) generate preliminary data on effectiveness of the expanded SS4SH compared to the HD SOC mobile van as defined by reach, reproducibility of testing outcomes, and care linkage outcome measures. Aim 1 will involve qualitative formative work including focus groups and in-depth interviews with Black MSM and key informant interviews with care linkage stakeholders to explore environmental and patient level barriers to care linkage and develop community engaged linkage strategies to overcome these barriers. A community advisory board (CAB), composed of Black MSM recruited from focus group and interview participants will provide member-checking of the study team’s interpretations of qualitative data and partner with the study team to develop the expansion of SS4SH for care linkage to be implemented during the Aim 2 pilot. In Aim 2, we will recruit MSM (ages 18-49) for mobile van HIV/STI testing/care linkage over 8 months. We will evaluate outcome measures of feasibility and acceptability of providing care linkage and generate preliminary data on the effectiveness of the SS4SH compared to the HD SOC mobile van strategy. The proposed research has the potential to inform public health strategies prioritizing Black MSM and potentially reduce ongoing HIV disparities by reaching both those at risk for acquisition and transmission and linking them to care.

项目概要 结束艾滋病毒流行 (EHE) 取决于制定创新的、战略性的和量身定制的艾滋病毒治疗方法 虽然新的艾滋病毒诊断、治疗和预防已较高峰期大幅下降， 进展已经停滞，特别是在仍然存在的男男性行为者 (MSM) 中 在安全空间 4 性健康 (SS4SH) 试点研究中，我们受到了不成比例的影响。 证明了状态中立的 HIV/STI 检测方法的可行性和可接受性，该方法确定了 在在线空间中对 MSM 进行风险评估，并将其与马里兰州巴尔的摩的一辆移动货车上的测试服务联系起来。 我们的试点项目达到了在线空间中接触传统寻求-测试-治疗策略可能会错过的 MSM 的目标 14 个月内有 151 名 MSM，并表现出明显更高的新 HIV 诊断率（7% vs. 0.5%，p<0.001） 与卫生部门护理标准 (HD SOC）移动货车策略没有评估参与者与 PrEP 或 HIV 护理的联系，这些是 EHE 战略的关键支柱 拟议 R21 的目标是扩大试点研究以整合。 PrEP 和 HIV 护理联系，评估这一扩展战略的可接受性和可行性，并以准 实验设计，生成初步数据，说明该策略与 HD SOC 相比的有效性 具体目标是： 1) 采用基于社区的参与方式，将 SS4SH 扩展到 将感染艾滋病毒高风险的黑人男男性接触者与 PrEP 联系起来，并将其与艾滋病毒护理联系起来 患有未确诊/未抑制的艾滋病毒，以及 2) 使用准实验设计，试点扩大 SS4SH 测试加护理联动策略 (1) 评估添加护理联动的可接受性和可行性 (2) 生成有关扩展 SS4SH 与 HD SOC 移动设备相比的有效性的初步数据 van 由测试结果的覆盖范围、可重复性和护理联系结果测量来定义。 涉及定性形成工作，包括焦点小组和对黑人 MSM 和关键人物的深入访谈 与护理联系利益相关者进行知情访谈，探讨环境和患者层面的护理障碍 联系并制定社区参与的联系战略以克服这些障碍。 董事会 (CAB)，由从焦点小组招募的黑人 MSM 和访谈参与者组成，将提供 成员检查研究团队对定性数据的解释，并与研究团队合作 制定将在目标 2 试点期间实施的 SS4SH 护理联系扩展 在目标 2 中，我们将实施。 招募 MSM（18-49 岁）进行移动货车 HIV/STI 检测/护理联动，为期 8 个月。我们将评估结果。 衡量提供护理联系的可行性和可接受性，并生成有关护理联系的初步数据 SS4SH 与 HD SOC 移动货车策略相比的有效性所提出的研究具有以下特点。 为优先考虑黑人男男性行为者的公共卫生战略提供信息的潜力，并有可能减少持续的艾滋病毒 通过接触那些有感染和传播风险的人并将他们与护理联系起来来消除差异。