The impact of alcohol use and alcohol-interactive toxicity beliefs on pre-exposure prophylaxis (PrEP) adherence among gay, bisexual, and other men who have sex with men: A social network approach

饮酒和酒精相互作用毒性信念对同性恋、双性恋和其他男男性行为者的暴露前预防 (PrEP) 依从性的影响：社交网络方法

• 批准号: 10538253
• 负责人: Jace DeWayne Pierce
• 金额: $ 3.74万
• 依托单位: UNIVERSITY OF HOUSTON
• 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 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10538253
• 关键词: AIDS prevention; Accounting; Adherence; Advertising; Affect; Alcohol consumption; Alcohol dependence; Alcohols; Anti-Retroviral Agents; Area; Behavior; Belief; Bisexual; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Code; Coitus; Contracts; Counseling; County; Diffuse; Dose; Ego; Event; Exposure to; Future; Gays; Goals; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Heterosexuals; Hour; Individual; Intervention; Interview; Knowledge; Lesbian Gay Bisexual Transgender Queer; Measures; Medicine; Minority Groups; National Institute on Alcohol Abuse and Alcoholism; Oral; Participant; Perception; Persons; Pharmaceutical Preparations; Phase; Poison; Population; Public Health; Regimen; Reporting; Research; Research Personnel; Research Support; Risk; Risk Behaviors; Risk Factors; Risk-Taking; Schedule; Social Network; Strategic Planning; Tablets; Techniques; Time; Toxic effect; Trust; alcohol risk; alcohol testing; antiretroviral therapy; base; binge drinking; condomless anal sex; demographics; design; diaries; drinking; experience; hazardous drinking; health disparity; high risk; interest; men; men who have sex with men; minority health disparity; pill; pre-exposure prophylaxis; prevent; recruit; sexual minority; skills; therapy adherence; trustworthiness; truvada

PROJECT SUMMARY/ABSTRACT Gay, bisexual, and other men who have sex with men (GBM) in the U.S. experience striking health disparities related to alcohol use and HIV. Heavy alcohol use is a significant threat to adherence to antiretrovirals (e.g., antiretroviral therapy [ART]) among GBM managing HIV. However, it is unclear if alcohol use impacts adherence to Pre-Exposure Prophylaxis (PrEP) for preventing HIV. PrEP is used by >35% of U.S. GBM and can be taken either daily or taken in sequence around a sexual event (i.e., event-driven PrEP). PrEP is a highly effective oral antiretroviral but studies have demonstrated suboptimal adherence for both PrEP regimens. Heavy alcohol use and specific beliefs related to mixing alcohol and PrEP may contribute to suboptimal adherence. For instance, >60% of GBM interested in taking PrEP falsely believe that mixing alcohol with PrEP results in a toxic combination (i.e., interactive toxicity beliefs). Like other erroneous beliefs (e.g., HIV is manmade), interactive toxicity beliefs may diffuse across the social network and, subsequently, influence adherence. The proposed study will employ an egocentric social network interview and a semi-weekly diary phase over five weeks to (1) examine associations between heavy alcohol use and PrEP adherence, and (2) to test alcohol-interactive toxicity beliefs and social network characteristics as risk factors for PrEP non-adherence. GBM (N=100) who are taking PrEP will be recruited via brick-and-mortar entities (e.g., LGBTQ+ centers and bars), local health clinics, and online advertising in Harris County, TX (i.e., the greater Houston area). At baseline, participants will complete demographics and measures of interactive toxicity beliefs. Participants will also complete an egocentric social network interview designed to obtain information on up to 20 alters (i.e., people in the social network). The interview will capture alter expression of interactive toxicity beliefs, PrEP and alcohol use, closeness, trust, overall connectedness, demographics, and norms. Participants will then complete five weeks of semi-weekly diaries that assess alcohol use, PrEP use, and HIV risk behaviors. This research can inform future PrEP-related counseling techniques and interventions aimed at correcting PrEP misconceptions and increasing adherence. The project supports the 2017-2021 strategic plan of NIAAA by advancing research in two areas. First, the project has the goal of identifying ways in which alcohol can influence the use of HIV-related medications, specifically PrEP (Goal 1C). Second, the project may enhance the public health impact of NIAAA-supported research, by focusing on how alcohol contributes to suboptimal PrEP adherence among a population with alcohol-related disparities (Goal 5). Moreover, the project contributes to research on health disparities of minority populations, which is a cross-cutting NIAAA research theme. Through this project, I will obtain the knowledge, skills, and experience needed to develop into a cutting-edge alcohol and HIV researcher that focuses on sexual minorities.

项目总结/摘要 在美国，同性恋、双性恋和其他与男性发生性关系的男性（GBM）经历着惊人的健康差距 与酗酒和艾滋病有关。大量饮酒是坚持抗逆转录病毒药物的一个重大威胁（例如， 抗逆转录病毒疗法[ART]）。然而，目前还不清楚饮酒是否会影响依从性。 暴露前预防（Pre-Exposure Prephylaxis，PrEP）是预防艾滋病的一种方法。PrEP被>35%的美国GBM使用，可以服用 每天服用或在性事件前后依次服用（即，事件驱动的PrEP）。PrEP是一种高效的口服 抗逆转录病毒药物，但研究表明，两种PrEP方案的依从性均不理想。重度酒精使用 与酒精和PrEP混合相关的特定信念可能导致次优依从性。比如说， >60%对服用PrEP感兴趣的GBM错误地认为，将酒精与PrEP混合会导致有毒物质。 组合（即，交互毒性信念）。就像其他错误的信念一样（例如，艾滋病毒是人造的），互动的 毒性信念可能会在整个社会网络中扩散，并随后影响遵守。拟议 研究将采用以自我为中心的社交网络访谈和为期五周的半周日记阶段，以（1） 检查重度酒精使用和PrEP依从性之间的关联，以及（2）测试酒精相互作用毒性 信仰和社会网络特征作为PrEP不依从的风险因素。GBM（N=100），正在服用 PrEP将通过实体招募（例如，LGBTQ+中心和酒吧），当地诊所，以及 德克萨斯州哈里斯县的在线广告（即，休斯敦地区）。在基线时，参与者将完成 人口统计学和相互作用毒性信念的措施。参与者还将完成一个以自我为中心的社会 设计用于获得关于多达20个改变的信息的网络访谈（即，社交网络中的人）。的 访谈将捕捉交互毒性信念、PrEP和酒精使用、亲密度、信任 整体连通性、人口统计学和规范。然后，参与者将完成为期五周的半周 评估酒精使用，PrEP使用和HIV风险行为的日记。这项研究可以为未来的PrEP相关 咨询技术和干预措施，旨在纠正PrEP误解和增加坚持。 该项目通过推进两个领域的研究来支持NIAAA的2017-2021战略计划。一是项目 目标是确定酒精如何影响艾滋病毒相关药物的使用，特别是 PrEP（目标1C）。第二，该项目可以通过以下方式增强NIAAA支持的研究对公共卫生的影响： 关注酒精如何有助于酒精相关人群中的次优PrEP依从性 不平等（目标5）。此外，该项目还有助于研究少数民族人口的健康差异， 这是一个跨学科的NIAAA研究主题。通过这个项目，我将获得知识，技能， 需要发展成为一个尖端的酒精和艾滋病毒研究人员，重点是性少数群体的经验。