A Skills-Based HIV Serostatus Disclosure Intervention for Sexual Minority Men in South Africa: Protocol for Intervention Adaptation and a Pilot Randomized Controlled Trial.
A Skills-Based HIV Serostatus Disclosure Intervention for Sexual Minority Men in South Africa: Protocol for Intervention Adaptation and a Pilot Randomized Controlled Trial.
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DOI：
10.2196/36845
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发表时间：
2022-05-16
影响因子：
1.7
通讯作者：
Stephenson, Rob
中科院分区：
文献类型：
--
作者：
Daniels, Joseph;Peters, Remco P. H.;Medina-Marino, Andrew;Bongo, Cikizwa;Stephenson, Rob
关键词：
在南非，同性恋、双性恋和其他男男性行为者（GBMSM）感染艾滋病毒的抗逆转录病毒治疗依从性较低，原因是他们在管理与性伴侣和浪漫伴侣的披露和预防行为方面的技能有限。因此，在艾滋病毒不和谐的伙伴关系中存在很高的艾滋病毒传播风险，但如果有效调整，现有的干预措施可能会解决这些问题。健康关系（HR）是一种行为干预，最初以小组和个人形式提供，超过5次会议，以发展应对艾滋病毒相关压力和性风险情况的应对技能，提高向伴侣披露艾滋病毒的决策技能，并建立和保持与伴侣的安全性行为。人力资源有效地改善了预防行为，但尚未针对非美国的情况进行调整。我们的目标是适应人力资源到一个新的文化接地干预，名为GBMSM说出来和结盟关系，然后评估其在南非东开普省的可行性。这项研究将有两个目标。对于目标1-适应性-我们将使用以人为本的设计方法。初步干预措施的调整将涉及整合不可检测=不可传播和接触前预防教育，为视频会议格式开发干预内容，并根据初步数据设计角色扮演和电影，以培养技能。之后，将对GBMSM进行访谈和调查，以评估干预偏好，并将与卫生保健提供者和信息技术专家组成一个焦点小组，以评估干预的设计。最后，将进行可用性测试，以确定功能和内容理解。参与者将是与艾滋病毒感染者有关系的GBMSM（n=15）和从事艾滋病毒护理和规划工作的卫生保健提供者和信息技术专家（n=7）。对于目标2，我们将通过使用试点随机对照设计来检查适应性干预的可行性。每组将有60人。将对干预组进行可行性调查和访谈，并收集两组的关系和治疗依从性结局的行为和生物医学评估。所有参与者将是感染艾滋病毒的GBMSM，他们与艾滋病毒阴性或身份不明的伴侣有关系。2021年8月开始干预适应。GBMSM干预偏好的初步定制和完善已于2021年12月完成。可用性和可行性评估将分别于2022年3月和2024年2月完成。GBMSM需要有效的干预措施，以解决伙伴关系的动态，艾滋病毒预防和治疗结果的抗逆转录病毒治疗依从性和病毒抑制在南非。利用社交网络（如视频会议）的日常技术使用，不可检测=不可传播的教育和暴露前预防，以更新南非GBMSM的现有干预措施，有可能加强有关艾滋病毒治疗和预防的关系沟通，从而改善结果。DERR1-10.2196/36845
Gay, bisexual, and other men who have sex with men (GBMSM) living with HIV have low antiretroviral treatment adherence in South Africa due to limited skills in managing disclosure and prevention behaviors with sexual and romantic partners. As a result, there is a high HIV transmission risk within HIV-discordant partnerships, but an existing intervention may address these outcomes, if adapted effectively. Healthy Relationships (HR) is a behavioral intervention that was originally delivered in groups and in person over 5 sessions to develop coping skills for managing HIV-related stress and sexually risky situations, enhance decision-making skills for HIV disclosure to partners, and establish and maintain safer sex practices with partners. HR effectively improves prevention behaviors but has yet to be tailored to a non-US context. We aim to adapt HR into a new culturally grounded intervention entitled Speaking Out & Allying Relationships for GBMSM and then assess its feasibility in Eastern Cape, South Africa. The study will have 2 aims. For aim 1—adaptation—we will use a human-centered design approach. Initial intervention tailoring will involve integrating Undetectable=Untransmittable and pre-exposure prophylaxis education, developing intervention content for a videoconference format, and designing role-plays and movies for skill building based on preliminary data. Afterward, interviews and surveys will be administered to GBMSM to assess intervention preferences, and a focus group will be conducted with health care providers and information technology experts to assess the intervention’s design. Finally, a usability test will be performed to determine functionality and content understanding. Participants will be GBMSM living with HIV (n=15) who are in a relationship and health care providers and information technology (n=7) experts working in HIV care and programming with this population. For aim 2, we will examine the feasibility of the adapted intervention by using a pilot randomized control design. There will be 60 individuals per arm. Feasibility surveys and interviews will be conducted with the intervention arm, and behavioral and biomedical assessments for relationship and treatment adherence outcomes will be collected for both arms. All participants will be GBMSM living with HIV who are in a relationship with an HIV-negative or unknown status partner. Intervention adaptation began in August 2021. Initial tailoring and the refining of GBMSM intervention preferences were completed in December 2021. Usability and feasibility assessments are due to be completed by March 2022 and February 2024, respectively. GBMSM need efficacious interventions that tackle partnership dynamics, HIV prevention, and treatment outcomes for antiretroviral treatment adherence and viral suppression in South Africa. Harnessing everyday technology use for social networking (eg, videoconferences), Undetectable=Untransmittable education, and pre-exposure prophylaxis to update an existing intervention for South African GBMSM has the potential to strengthen relationship communication about HIV treatment and prevention and, in turn, improve outcomes. DERR1-10.2196/36845
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期刊：
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