Intervention to reduce drug use and HIV incidence among high PrEP priority partnered YMSM

项目摘要 CDC建议识别非一夫一妻制关系中的MSM和 与艾滋病毒阳性伴侣的关系作为PrEP的候选人。 年轻男男性行为者（YMSM; 18-29岁）中79%的新艾滋病毒感染是在 主要合作伙伴。吸毒是艾滋病毒传播风险的一个既定相关因素。对于有伴侣的男人来说， 相关因素（例如，性协议）的背景下使用毒品和吸毒， 性协议预测对PrEP的接受性。总之，这些发现表明需要 综合干预服务-针对吸毒和性健康-为合作伙伴量身定制 YMSM。这些服务对于解决美国的艾滋病毒流行至关重要。 作为回应，我们的团队开发了一种针对PrEP的4节基于MI的干预措施 艾滋病毒感染率/依从性，艾滋病毒TRB和药物使用之间的合作伙伴YMSM。合作伙伴（预防 和风险：治疗与关系的新重点）是交付给个人YMSM在 关系（而不是夫妇），这增强了拟议干预的可扩展性。我们 初步试点工作已确定PARTNER可被接受和可行。主 本研究的目的是测试PARTNER相对于注意力匹配的 教育控制条件用于先前资助的NIH研究与艾滋病毒阴性YMSM。 我们建议招募240名HIV阴性的YMSM伴侣，他们报告最近使用毒品， 性行为符合CDC对PrEP候选人资格的指导，纳入随机对照 审判作为次要目标的一部分，该项目旨在增强生物学的范围 目前可用的PrEP依从性措施。替诺福韦的现场评价标准 代谢物是干血斑试验;然而，指甲试验具有高可接受性， 更低的成本我们建议通过关联结果来验证指甲样本的PrEP依从性 从指甲样品中获得的干血斑数据。 该研究小组由Tyrel J. Starks博士（PI）领导，他是一位具有丰富经验的新研究者 在研究与性健康和男男性接触者的关系因素。他 在许多项目上进行了合作，研究性协议的性质及其 与物质使用和艾滋病毒传播风险行为的关系。他的研究支持了 团队，其中包括杰弗里帕森斯博士，PI的多个干预研究，针对性 健康和物质使用。与他一起出席会议的还有生物医学专家莫妮卡·甘地博士。 评估PrEP依从性，他在以前的NIH中率先使用了新型基质- 资助的研究。该团队在行为干预研究方面拥有丰富的经验， 关系研究和生物医学评估。

Project Summary CDC recommendations identify MSM in non-monogamous relationships and those in relationships with an HIV positive partner as candidates for PrEP. Estimates suggest as many as 79% of new HIV infections among young MSM (YMSM; ages 18-29) are transmitted between main partners. Drug use is an established correlate of HIV transmission risk. For partnered men, relational factors (e.g., sexual agreements) contextualize drug use and both drug use and sexual agreements predict receptivity to PrEP. Together, these findings point to the need for integrated intervention services – targeting drug use and sexual health –tailored for partnered YMSM. Such services are essential to addressing the HIV epidemic in the US. In response, our team has developed a 4-session MI-based intervention targeting PrEP uptake/adherence, HIV TRB, and drug use among partnered YMSM. PARTNER (Prevention And Risk: Treatment with a New Emphasis on Relationships) is delivered to individual YMSM in relationships (not couples), which enhances the scalability of the proposed intervention. Our preliminary pilot work has established the acceptability and feasibility of PARTNER. The primary goal of the current study is to test the efficacy of PARTNER relative to an attention-matched educational control condition used in previously funded NIH studies with HIV-negative YMSM. We propose to recruit 240 HIV-negative partnered YMSM who report recent drug use and sexual behavior consistent with CDC guidance for PrEP candidacy into a randomized control trial. As part of a secondary aim, this project seeks to enhance the range of biological measures for PrEP adherence currently available. The field standard for assessing tenofovir metabolites is dried blood spot assay; however, fingernail assay has high acceptability and lower cost. We propose to validate fingernail samples for PrEP adherence by correlating results obtained from fingernail samples with dried blood spot data. The study team is led by Dr. Tyrel J. Starks (PI), a new investigator with substantial experience in the study of relationship factors associated with sexual health and MSM in relationships. He has collaborated on numerous projects examining the nature of sexual agreements and their association with substance use and HIV transmission risk behavior. He is supported by a study team which includes Dr. Jeffrey Parsons, the PI of multiple intervention studies targeting sexual health and substance use. He is also joined by Dr. Monica Gandhi, an expert in biological assessment for PrEP adherence who has pioneered the use of novel matrices in previous NIH- funded studies. The team brings extensive experience in behavioral intervention research, relationship research, and biomedical assessment.