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.

项目摘要/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)经历了显著的健康差距 与酒精使用和艾滋病毒有关。大量饮酒是对坚持使用抗逆转录病毒药物的重大威胁(例如， 抗逆转录病毒疗法[抗逆转录病毒疗法])。然而，目前还不清楚饮酒是否会影响服药依从性 接触前预防(PrEP)预防艾滋病毒。美国35%的GBM使用PREP，可以使用 每天或在性事件周围按顺序进行(即，事件驱动的PrEP)。Prep是一种高效的口服液 抗逆转录病毒，但研究表明，两种PrEP方案的依从性都不佳。酗酒 与酒精和PrEP混合有关的特定信念可能会导致次优依从性。例如, 有兴趣服用PrEP的GBM中有60%错误地认为酒精与PrEP混合会导致中毒 组合(即，交互毒性信念)。像其他错误的信念(例如，艾滋病毒是人为的)一样，交互的 毒性信念可能会在社交网络中传播，并随后影响依从性。建议数 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) 检查大量饮酒和PrEP依从性之间的关系，以及(2)测试酒精相互作用的毒性 信念和社会网络特征是PrEP不坚持的危险因素。GBM(N=100) PREP将通过实体实体(例如，LGBTQ+中心和酒吧)、当地医疗诊所和 德克萨斯州哈里斯县(即大休斯顿地区)的在线广告。在基线上，参与者将完成 交互毒性信念的人口统计学和测量。参与者还将完成以自我为中心的社交活动 网络面谈旨在获得最多20个改变的信息(即，社交网络中的人)。这个 访谈将捕捉交互毒性信念、PrEP和酒精使用、亲密程度、信任 整体连接性、人口统计数据和规范。然后参与者将完成为期五周的半周 评估酒精使用、PrEP使用和艾滋病毒危险行为的日记。这项研究可以为未来的PrEP相关研究提供参考 旨在纠正PrEP误解和提高遵从性的咨询技术和干预。 该项目通过推进两个领域的研究来支持NIAAA 2017-2021年战略计划。第一，项目 的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 准备(目标1C)。其次，该项目可能通过以下方式加强NIAAA支持的研究对公共健康的影响 关注酒精对酒精相关人群的次优PrEP依从性的影响 差距(目标5)。此外，该项目还有助于研究少数群体的健康差距， 这是一个交叉的NIAAA研究主题。通过这个项目，我将获得知识、技能和 要发展成为专注于性少数群体的尖端酒精和艾滋病毒研究人员，需要有经验。