PrEParados: A Multi-Level Social Network Model to Increase PrEP Enrollment by Latino MSM Self-Identified as Gay, Bisexual

项目摘要 PrEParados是一项为期三年的发展R 01研究，将确定社交网络如何影响PrEP 与男性发生性关系的拉丁裔男性（LMSM）的吸收和坚持，无论是那些自我认同为 同性恋，以及自我认同为双性恋/异性恋的LMSM未研究组。这项研究将在 迈阿密-戴德县（迈阿密），美国艾滋病流行的中心。在种族/族裔群体中 迈阿密，LMSM的艾滋病发病率最高。尽管PrEP是最有效的艾滋病毒预防措施， 目前，迈阿密很少有符合条件的LMSM参加PrEP计划（2018年只有6%）。我们 初步研究（N=130）表明，社会网络结构可能有助于LMSM的低PrEP 使用.在对LMSM自我认定为同性恋的研究中，我们发现很大比例的性接触 涉及双性恋/异性恋LMSM自我认同的双性恋/异性恋LMSM是MSM之间的桥梁， 艾滋病的流行集中在迈阿密的普通人群中。在制定干预措施之前，我们 我需要实施R 01，它研究更大的样本以识别网络配置和动态 影响LMSM中的艾滋病毒风险，通过他们的性自我认同（同性恋或双性恋/异性恋）。为了告知未来 干预，我们的研究将探讨社会网络结构因素如何抑制或促进访问， 鼓励，吸收和坚持PrEP。这些发现将允许更好地部署准确的 信息和干预措施，导致LMSM中PrEP的启动和遵守增加。 PrEParados将研究三个社交网络：1）友谊网络--识别社会网络机制 在迈阿密的LMSM朋友中推广PrEP的使用。2)性网络-区分同性恋和 与性伴侣之间的PrEP沟通相关的二元特征和动态。3)会场 网络，以确定与地理和在线场所，可以增加PrEP知识的隶属关系。 我们与拉丁裔健康，迈阿密-戴德县卫生局PrEP诊所和 迈阿密大学的移动的PrEP诊所和快速访问健康诊所将提供8,000多个 LMSM，包括1，500 + PrEP用户和500+自我认同为双性恋/异性恋者。本R 01研究将 提供新的信息，使PrEP干预措施包括社交网络组件， 根据LMSM的性别自我认同度身定制这些新的干预措施可以作为模式， PrEP计划针对来自其他难以接触的人群的男性。

PROJECT SUMMARY PrEParados is a three-year developmental R01 study that will determine how social networks impact PrEP uptake and adherence among Latino men who have sex with men (LMSM), both those who self-identify as gay, and the unstudied group of LMSM who self-identify as bisexual/straight. This study will be implemented in Miami-Dade County (Miami), the epicenter of the HIV epidemic in the US. Among racial/ethnic groups in Miami, LMSM have the highest HIV incidence. Despite PrEP being the most effective HIV prevention measure currently available, few eligible LMSM in Miami are enrolled in a PrEP program (only 6% in 2018). Our preliminary study (N=130) suggests that social network structures may be contributing to LMSM’s low PrEP use. In that study of LMSM self-identified as gay, we discovered a large proportion of sexual encounters involved bisexual/straight LMSM. Self-identified bisexual/straight LMSM are a bridge between MSM—in whom the HIV epidemic is concentrated—and the general population in Miami. Before developing interventions, we need to implement this R01, which studies a larger sample to identify network configurations and dynamics impacting HIV risk among LMSM by their sexual self-identification (gay or bisexual/straight). To inform future interventions, our study will examine how social network structural factors suppress or promote access, encouragement, uptake, and adherence to PrEP. These findings will allow better deployment of accurate information and interventions, resulting in increased PrEP initiation and adherence amongst LMSM. PrEParados will study three social networks: 1) Friendship Networks—to identify social network mechanisms that promote PrEP use among LMSM friends in Miami. 2) Sexual Networks—to distinguish homophily and dyadic characteristics and dynamics associated with PrEP communication between sexual partners. 3) Venue Networks—to determine affiliations with geographic and online venues that could increase PrEP knowledge. Our established partnerships with Latinos Salud, Miami-Dade County Health Department PrEP Clinic, and the University of Miami’s Mobile PrEP Clinic and Rapid Access Wellness Clinic will provide access to 8,000+ LMSM, including 1,500+ PrEP users and 500+ who self-identify as bisexual/straight. This R01 study will provide new information that will allow PrEP interventions to include social network components and be tailored based on LMSM’s sexual self-identification. These new interventions could then serve as models for PrEP programs targeting males from other hard to reach populations.