Onboarding Positives and PrEP users to Engage Negatives (OPPEN): peer-driven education to link YMSM of color to PrEP

100.7项目概要/摘要 接触前预防（PrEP）在男男性行为者（YMSM）中的吸收缓慢， 特别是那些在美国新感染艾滋病毒的有色人种。有限PrEP 知识，不熟悉如何获得PrEP，医疗不信任以及围绕艾滋病毒和性行为的耻辱感， YMSM之间PrEP护理参与的障碍，包括有色人种。同伴驱动的社会网络 采取干预措施，将个人培训为同伴教育者，以传播有关预防艾滋病毒的信息， 在他们的社交网络内实施治疗，以解决类似的障碍， 在难以触及的人群中取得成果。从事艾滋病毒/PrEP护理的YMSM经常采用弹性 （c）开展各种进程，克服艾滋病毒预防和护理方面的社会结构障碍。因此，培训YMSM的颜色 从事艾滋病毒/PrEP护理的同伴PrEP教育工作者可能会将他们定位为PrEP信息的可靠来源 谁可以影响行为改变（即，PrEP护理参与）之间的YMSM同行的颜色在他们的 社交网络通过他们的能力，传播文化能力的PrEP信息的背景下， 使用这些弹性过程来导航医疗保健系统，医疗不信任， 和耻辱。利用现有的同行驱动的社会网络干预措施，传播创新， 信息-动机-行为技能模型，哈珀等人。的弹性框架，以及我们的数据 最近的焦点小组，拟议的R34将开发和试点Onboarding Positive和PrEP用户参与 消极（OPPEN），一个同伴驱动的PrEP教育社交网络干预，在YMSM的颜色（拉丁美洲人） 或黑色）在圣地亚哥，加州。通过三个小组和两个一对一的会议，OPPEN将培训 YMSM的颜色从事艾滋病毒/PrEP护理是同伴PrEP教育者在他们的社交网络。在第一阶段， OPPEN将通过一个迭代过程进行开发、预测试和改进，该过程将整合来自 YMSM的颜色和采访艾滋病毒阳性和PrEP使用YMSM的颜色通过OPPEN和YMSM培训 在他们的社交网络中的有色人种同伴（AIM 1）。在第二阶段，OPPEN将在一个随机 对70名从事HIV/PrEP护理的有色人种YMSM进行对照试验（即，指标; 50% HIV阳性） 分配到OPPEN（n=35）或时间和注意力匹配的控制条件（n=35）。所有指数将收到 优惠券招募YMSM同龄人的颜色在他们的社交网络的研究。出席会议的同行 研究地点（即，（3）将接受艾滋病毒检测。对PrEP感兴趣的艾滋病毒阴性同伴招募将 预约PrEP诊所就诊通过调查（基线和3个月研究访视）和医学检查收集的数据 记录将用于评估OPPEN对PrEP兴趣，联系和吸收的初步影响， 同伴新兵（AIM 2）和OPPEN在指标和同伴新兵中针对的理论机制 (AIM 3）。将使用混合方法（AIM 4）评价OPPEN的可接受性和可行性。 研究结果将用于进一步完善OPPEN，并为未来的R 01疗效试验提供信息。

100.7 PROJECT SUMMARY/ABSTRACT Pre-exposure prophylaxis (PrEP) uptake has been slow among young men who have sex with men (YMSM), particularly those of color who experience a high rate of new HIV infections in the United States. Limited PrEP knowledge, unfamiliarity with how to access PrEP, medical mistrust, and stigma around HIV and sexuality are barriers to PrEP care engagement among YMSM, including those of color. Peer-driven social network interventions that train individuals as peer educators to disseminate information about HIV prevention and treatment within their social networks have been implemented to address similar barriers and improve HIV outcomes within hard to reach populations. YMSM of color engaged in HIV/PrEP care often employ resilience processes to overcome socio-structural barriers to HIV prevention and care. As such, training YMSM of color engaged in HIV/PrEP care as peer PrEP educators may position them as credible sources of PrEP information who can influence behavior change (i.e., PrEP care engagement) among YMSM peers of color within their social networks via their ability to disseminate culturally competent PrEP messages in the context of their personal experiences using these resilience processes to navigate the healthcare system, medical mistrust, and stigma. Drawing on existing peer-driven social network interventions, the diffusion of innovations and information-motivation-behavioral skills models, Harper et al.'s resilience framework, as well as data from our recent focus groups, the proposed R34 will develop and pilot Onboarding Positives and PrEP users to Engage Negatives (OPPEN), a peer-driven PrEP education social network intervention, among YMSM of color (Latino or Black) in San Diego, California. Through three small-group and two one-on-one sessions, OPPEN will train YMSM of color engaged in HIV/PrEP care to be peer PrEP educators within their social networks. In Phase I, OPPEN will be developed, pretested, and refined using an iterative process that integrates feedback from YMSM of color and interviews with HIV-positive and PrEP-using YMSM of color trained via OPPEN and YMSM peers of color within their social networks (AIM 1). In Phase II, OPPEN will be piloted in a randomized controlled trial with 70 YMSM of color engaged in HIV/PrEP care (i.e., indexes; 50% HIV-positive) randomly assigned to OPPEN (n=35) or a time- and attention-matched control condition (n=35). All indexes will receive coupons to recruit YMSM peers of color within their social networks to the study. Peers who present at the study site (i.e., peer-recruits) will undergo HIV testing. HIV-negative peer-recruits interested in PrEP will be scheduled for a PrEP clinic visit. Data collected via surveys (baseline and 3-month study visits) and medical records will be used to evaluate the preliminary effect of OPPEN on PrEP interest, linkage, and uptake among peer-recruits (AIM 2) and theory-based mechanisms targeted by OPPEN among indexes and peer-recruits (AIM 3). OPPEN acceptability and feasibility will be evaluated using a mixed-methods approach (AIM 4). Findings will be used to further refine OPPEN and inform a future R01 efficacy trial.