Male Access to Sexual Health Services and PrEP

男性获得性健康服务和 PrEP 的机会

• 批准号: 10538658
• 负责人: Philip John Smith
• 金额: $ 10.66万
• 依托单位: DESMOND TUTU HIV FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538658
• 关键词: AIDS prevention; Address; Adherence; Adolescent and Young Adult; Age; Alcohol consumption; Award; Behavioral; Behavioral Sciences; Blood; Caring; Cause of Death; Cessation of life; Child health care; Clinic; Clinical Management; Clinical Trials; Communities; Commuting; Data; Diphosphates; Education; Educational workshop; Enrollment; Epidemiology; Evidence based intervention; Female; Foundations; Gender; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; Health; Health Services; Health behavior; Healthcare; Heterosexuals; Human immunodeficiency virus test; Improve Access; Individual; Intervention; Interview; Location; Measures; Mentors; Mentorship; Methods; Modeling; Outcome; Outcome Assessment; Patients; Pattern; Population; Prevalence; Province; Public Health; Qualitative Methods; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Research Personnel; Resource-limited setting; Science; Scientist; Services; Sexual Health; Sexual Partners; Socioeconomic Status; South Africa; South African; Spottings; Surveys; Tenofovir; Training; Treatment outcome; United States National Institutes of Health; Viral; Visit; Wait Time; Woman; acceptability and feasibility; adverse outcome; age group; aged; antiretroviral therapy; base; behavioral economics; behavioral study; burden of illness; care delivery; cohort; community burden; contextual factors; design; evidence base; experience; girls; health care service; health seeking behavior; high risk; high risk men; human old age (65+); implementation science; improved; innovation; insight; low and middle-income countries; male; male health; men; mortality; multidisciplinary; pre-exposure prophylaxis; preference; premature; prevention service; preventive intervention; prototype; response; sexual health intervention; social stigma; theories; therapy design; transmission process; treatment as prevention; uptake; young man

PROJECT SUMMARY Global HIV prevention efforts have conventionally focused on supporting women and key populations through treatment as prevention resulting in viral suppression (Undetectable = Untransmittable, U=U). This presents the opportunity to develop interventions that support HIV prevention in heterosexual men, aged 15-49 years. Since there are no interventions that address PrEP uptake among HIV seronegative heterosexual men, the scientific goal of this K43 is to develop and prototype an evidence-based intervention to curb HIV acquisition in South African men at high risk of HIV acquisition. Behavioral economics (BE) theory posits that contextual and individual factors influence health behavior. BE will be used to understand these factors associated with pre- exposure prophylaxis (PrEP) uptake in South African men. Candidate: I am a South African behavioral scientist with a background in HIV research in HIV endemic communities in South Africa I am committed to improve health seeking in this population. This K43 will support my training, mentorship, and research towards becoming an independent investigator. Mentoring: I have assembled a multi-disciplinary team with globally recognized expertise in their fields, committed to HIV research in South Africa. My primary mentors are Dr. Alison Buttenheim (U.S. based, behavioral economics intervention design, evidence-based HIV care delivery, mixed methods research), Dr. Linda-Gail Bekker (S.A.-based, clinical trials, PrEP, research in key populations). My co- mentorship team includes: Dr. Joseph Daniels (U.S.-based, qualitative research, HIV prevention and treatment), Dr. Andrew Medina-Marino (S.A.-based, epidemiology, men’s health, implementation science). Training: The K43 will support mentoring and rigorous training to support me to develop expertise in 1) behavioral economics intervention design, 2) cohort design and managing clinical trials, 3) mixed methods research design and analysis. These aims will be supported by mentors who are global leaders in HIV prevention in limited resource communities. Research: HIV prevalence peaks in South African males (45-49 years) later than their female (35- 39 years) counterparts and males tend to choose younger female sexual partners. Reducing HIV acquisition among men living in LMICs is central to breaking this cycle of transmission. The specific research aims of this award are to: 1) investigate the influence of contextual factors on PrEP uptake, 2) describe factors associated with attrition and sustained PrEP use 3) to use BE to develop and prototype an intervention to support PrEP uptake among men. This research is nested in the existing mobile clinic services operating in the Klipfontein district in Cape Town, which was recently awarded a PrEP implementation grant (Bill and Melinda Gates Foundation, PI Bekker) to assess community-based PrEP uptake. This study will advance NIH science on HIV prevention in men in high HIV disease burden communities. The evidence will be used to design a BE informed intervention for a larger clinical trial investigating the impact on reducing HIV acquisition and transmission in men.

项目摘要 全球艾滋病毒预防工作通常侧重于通过以下方式支持妇女和重点人群： 治疗作为预防，导致病毒抑制（不可检测=不可传播，U=U）。这就提出了 有机会制定干预措施，支持在15-49岁的异性恋男子中预防艾滋病毒。以来 没有干预措施可以解决艾滋病毒血清阴性异性恋男性中PrEP的摄入，科学 K43的目标是开发和原型化一种基于证据的干预措施，以遏制南苏丹的艾滋病毒感染。 非洲男性感染艾滋病毒的风险很高。行为经济学（BE）理论认为， 个体因素影响健康行为。BE将用于了解这些与预处理相关的因素， 暴露预防（PrEP）在南非男性中的应用。候选人：我是南非的行为科学家 我在南非艾滋病流行社区从事艾滋病研究，我致力于改善健康状况， 在这个人群中寻找。这个K43将支持我的培训，指导和研究，成为一个 独立调查员指导：我组建了一个多学科团队， 他们在各自领域的专业知识，致力于南非的艾滋病毒研究。我的主要导师是艾莉森·布滕汉姆博士 (U.S.基于行为经济学的干预设计，基于证据的艾滋病护理服务，混合方法 Linda-Gail Bekker博士（S.A.-基于临床试验、PrEP、关键人群研究）。我的同事 导师团队包括：约瑟夫·丹尼尔斯博士（美国-基于定性研究的艾滋病毒预防和治疗）， 博士Andrew Medina-Marino（S.A.-基础、流行病学、男性健康、实施科学）。训练：The K43将支持指导和严格的培训，以支持我发展行为经济学方面的专业知识 干预设计，2）队列设计和管理临床试验，3）混合方法研究设计和 分析.这些目标将得到在资源有限的情况下在艾滋病毒预防方面处于全球领先地位的导师的支持 社区.研究：南非男性（45-49岁）的艾滋病毒感染率峰值晚于女性（35 -49岁）。 39岁）的同行和男性倾向于选择年轻的女性性伴侣。减少艾滋病毒感染 在生活在中低收入国家的男性中传播艾滋病毒是打破这种传播循环的关键。本文的具体研究目的 奖励是：1）调查背景因素对PrEP摄取的影响，2）描述相关因素 3）使用BE开发和原型化干预措施，以支持PrEP 男人之间的吸引力。这项研究是嵌套在现有的移动的诊所服务经营的克利方丹 开普敦的一个地区，最近获得了PrEP实施补助金（比尔和梅林达盖茨 基金会，PI Bekker），以评估基于社区的PrEP吸收。这项研究将推动NIH在艾滋病毒方面的科学研究 在艾滋病毒疾病高负担社区的男性中开展预防工作。这些证据将被用于设计一个被告知的BE 一项大型临床试验的干预措施，调查对减少艾滋病毒感染和传播的影响， 男人