mHealth Peer Support to Reduce Rates of STIs in Black MSM PrEP Users

mHealth 同行支持可降低黑人 MSM PrEP 用户的性传播感染率

• 批准号: 10462604
• 负责人: Meredith Edwards Clement
• 金额: $ 14.67万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-03 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10462604
• 关键词: AIDS prevention; Address; Adherence; Affect; Anti-Retroviral Agents; Attention; Automobile Driving; Behavioral; Behavioral Sciences; Biometry; Caring; Centers for Disease Control and Prevention (U.S.); Chlamydia; Chlamydia Infections; Clinic; Clinical; Clinical Investigator; Collaborations; County; Data; Diagnosis; Feasibility Studies; Feedback; Financial compensation; Focus Groups; Fumarates; Future; Goals; Gonorrhea; HIV; HIV Infections; Health Technology; Health behavior; Hepatitis C; Homophobia; Housing; Incidence; Income; Individual; Intervention; Interview; Investigation; Knowledge; Medical; Mentorship; Mobile Health Application; Patients; Pharmaceutical Preparations; Physician Executives; Play; Population; Prospective cohort; Protocols documentation; Psychologist; Public Health; Randomized; Recording of previous events; Research; Research Personnel; Risk; Risk Factors; Risk Reduction; Role; STI prevention; Sampling Studies; Science; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Social isolation; Statistical Methods; Syphilis; Technology; Tenofovir; Testing; Time; Training; United States; Work; aged; base; behavior influence; black men; black men who have sex with men; care delivery; experience; follow-up; health application; health care availability; health disparity; high risk; improved; infection rate; infection risk; insight; knowledge base; lifetime risk; mHealth; men; men who have sex with men; mobile application; mobile computing; peer support; pre-exposure prophylaxis; primary outcome; public health research; racial disparity; randomized trial; screening; sexual HIV transmission; sexual risk taking; skills; social; social factors; transmission process; young men who have sex with men

PROEJECT SUMMARY Pre-exposure prophylaxis (PrEP) with emtricitibine/tenofovir disoproxyl fumarate (FTC/TDF) has been shown to dramatically reduce transmission of HIV in men who have sex with men (MSM). However, as an antiretroviral medication, it does not protect against other sexually transmitted infections (STIs). Currently in the US, STI rates are at an “unprecedented high,” according to the Centers for Disease Control and Prevention. These elevated rates are especially pronounced in MSM prescribed PrEP and represent a crucial public health problem that requires immediate attention. Dr. Clement's K23 proposal will focus on addressing this problem through the use of mobile health (mHealth) technology in a critically important population with profound health disparities, Black MSM in the South. First, to understand predictors of STIs, she will explore the relationship between social factors (e.g. social isolation) and STI incidence; these relationships will inform research efforts to focus on those at highest risk for STIs. Second, she will investigate facilitators and barriers to STI risk reduction practices through in-depth interviews (IDIs) with Black MSM PrEP users. She will specifically inquire about peer support as a facilitator to STI risk reduction practices, and gather initial feedback on the peer support features of the mSMART application (“app”). Data will be used to adapt the app, which will be further assessed in focus groups. These qualitative studies will give valuable insight into factors driving sexual risk taking that the mSMART app will then target. Third, in a pilot investigation of Black MSM PrEP users with predictive STI risk factors, as identified in the first aim, she will conduct a randomized study to determine the feasibility and preliminary impact of the adapted mSMART app in reducing STI incidence. Through this proposal, Dr. Clement will build upon her experience in STIs with continued pursuit of critical public health research, and as a result be prepared to become a national leader in the field of HIV/STI prevention. Didactic coursework will bolster Dr. Clement's quantitative analytic skills and solidify her knowledge base. Additionally, she will gain training and experience in mHealth technology, a growing field with broad applications for health care access and delivery. She will also gain an appreciation for the application of qualitative science that will serve fruitful in future investigations. The mentorship team, led by Dr. Susanna Naggie, an experienced HIV investigator, will include experts in behavioral science related to PrEP (Dr. Amy Corneli), the use of mHealth technology in Black MSM (Dr. Sara LeGrand), and biostatistics (Dr. Cliburn Chan). Also included as collaborators are Dr. Arlene Seña, an expert in STIs who is Medical Director of the Durham County Department of Public Health, Dr. Mehri McKellar, the Medical Director of the Duke PrEP clinic, Dr. John Mitchell, a clinical psychologist who has pioneered the mobile app mSMART in PrEP users, Dr. Lisa Hightow-Weidman, a recognized leader in the field of technology based interventions aimed at HIV/STI prevention in young MSM, and Dr. Kenneth Mayer, a world expert in biomedical HIV prevention and the intersection of STIs and PrEP. The proposed aims and accompanying training plan will allow Dr. Clement to mature into an independent researcher in HIV/STI prevention and provide a basis for an R01 to implement her mobile technology intervention for STI prevention in Black MSM PrEP users.

项目概要 恩曲西他滨/富马酸替诺福韦酯（FTC/TDF）暴露前预防（PrEP）已被 显示出显著减少艾滋病毒在男男性行为者（MSM）中的传播。然而，在这方面， 作为一种抗逆转录病毒药物，它不能预防其他性传播感染。 根据疾病中心的数据，目前在美国， 控制和预防。这些升高的比率在MSM规定的PrEP中尤其明显 这是一个需要立即关注的重要公共卫生问题。克莱门特博士的K23 一项提案将侧重于通过使用移动的医疗技术来解决这一问题 在一个非常重要的人口与深刻的健康差距，黑人男男性行为者在南方。一是 了解性传播感染的预测因素，她将探讨社会因素（如社会 隔离）和性传播感染发病率之间的关系;这些关系将为研究工作提供信息， 性传播感染的最高风险。其次，她将调查减少性传播感染风险的促进者和障碍 通过与黑人MSM PrEP用户的深入访谈（IDIs）进行实践。她会特别询问 关于同行支持作为减少性传播感染风险做法的促进者，并收集关于 mSMART应用程序（“app”）的对等支持功能。数据将用于调整应用程序， 将在焦点小组中进一步评估。这些定性研究将提供宝贵的见解， 推动性风险的因素，mSMART应用程序将针对这些因素。三是在试点调查中 对于第一个目标中确定的具有预测性性传播感染风险因素的黑人MSM PrEP使用者，她将 进行随机研究，以确定适应的可行性和初步影响， mSMART应用程序在降低性传播感染发病率方面的作用。通过这个提议，克莱门特博士将在她的基础上 在性传播感染方面的经验，并继续追求关键的公共卫生研究，因此， 准备成为艾滋病毒/性传播感染预防领域的国家领导者。教学课程将 加强克莱门特博士的定量分析技能，巩固她的知识基础。此外，她将 获得移动医疗技术方面的培训和经验，这是一个不断发展的领域，在健康领域有着广泛的应用 护理的获取和提供。她还将获得定性科学应用的赞赏 这将有助于在未来的调查中取得成果。导师团队由苏珊娜·纳吉博士领导， 经验丰富的艾滋病毒调查员，将包括与PrEP相关的行为科学专家（Amy博士 Corneli），在黑人MSM中使用移动健康技术（Sara LeGrand博士）和生物统计学（Sara LeGrand博士）。 Cliburn Chan）.合作者还包括Arlene Seña博士，她是一位性病专家， 达勒姆县公共卫生部主任，医疗主任Mehri McKellar博士 杜克大学PrEP诊所的临床心理学家约翰·米切尔博士是移动的应用程序的先驱 mSMART在PrEP用户，博士丽莎Hightow-Weidman，在技术领域公认的领导者 针对年轻男男性行为者艾滋病毒/性传播感染预防的干预措施，以及世界卫生组织 专家在生物医学艾滋病毒预防和交叉性传播感染和准备。拟议的目标和 伴随的培训计划将使克莱门特博士成熟为一个独立的研究人员， 艾滋病毒/性传播感染预防，并为R 01实施其移动的技术干预提供基础 在黑人MSM PrEP用户中进行STI预防。

项目成果

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study.

• DOI: 10.2196/43019
• 发表时间: 2023-02-27
• 期刊: JMIR FORMATIVE RESEARCH
• 影响因子: 2.2
• 作者: Clement, Meredith Edwards;Lovett, Aish;Caldwell, Sylvia;Beckford, Jeremy;Hilgart, Michelle;Corneli, Amy;Flickinger, Tabor;Dillingham, Rebecca;Ingersoll, Karen
• 通讯作者: Ingersoll, Karen

Evaluation of an HIV Pre-Exposure Prophylaxis Referral System: From Sexual Health Center to Federally Qualified Health Center Pre-Exposure Prophylaxis Clinic.

HIV 暴露前预防转诊系统的评估：从性健康中心到联邦合格的健康中心暴露前预防诊所。

• DOI: 10.1089/apc.2021.0050
• 发表时间: 2021
• 期刊: AIDS patient care and STDs
• 影响因子: 4.9
• 作者: Lillis,Rebecca;Beckford,Jeremy;Fegley,Joshua;Siren,Julia;Hinton,Bruce;Gomez,Samuel;Taylor,StephanieN;Butler,Isolde;Halperin,Jason;Clement,MeredithEdwards
• 通讯作者: Clement,MeredithEdwards

Preexposure Prophylaxis Outcomes in an Urban Community in North Carolina: Discontinuation of Care and Sexually Transmitted Infections.

• DOI: 10.1097/olq.0000000000001288
• 发表时间: 2021-03-01
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Clement ME;Nicchitta M;Sun Y;Ellis A;Chakraborty H;McGee K;Eagle C;Frye J;Taylor D;Okeke NL;Johnston B;Seña AC;McKellar M
• 通讯作者: McKellar M

Characteristics of Mpox Infections in Louisiana in the 2022 Outbreak.

路易斯安那州 2022 年爆发的 Mpox 感染特征。

• DOI: 10.1089/aid.2023.0011
• 发表时间: 2023
• 期刊: AIDS research and human retroviruses
• 影响因子: 1.5
• 作者: Essajee,NabilM;Oddo-Moise,Hope;Hagensee,MichaelE;Lillis,RebeccaA;Maffei,Joanne;Butler,Isolde;Lovett,Aish;Sokol,Theresa;Clement,MeredithE
• 通讯作者: Clement,MeredithE