RP7 Impact

RP7 影响

• 批准号: 10595907
• 负责人: Lisa B Hightow-Weidman
• 金额: $ 70.1万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-25 至 2029-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595907
• 关键词: AIDS prevention; Address; Adherence; Administrator; Adolescent Medicine Trials Network; Adolescent and Young Adult; Adoption; Age; Behavior; Behavior Therapy; Behavioral; Biological Markers; Bisexual; Caring; Characteristics; Clinic; Clinical; Cocaine; Cognitive; Cognitive Therapy; Communities; Competence; Consultations; Counseling; Depressed mood; Development; Distress; Educational workshop; Effectiveness; Evidence based intervention; Feedback; Feeling; Funding; Gays; Geography; HIV; HIV risk; HIV/AIDS; HIV/STD; Health; Heterosexuals; Hybrids; Individual; Intervention; Interview; Leadership; Maintenance; Manuals; Measures; Mediating; Mediator; Mental Depression; Methamphetamine; Methods; Modeling; Motivation; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Prevalence; Primary Care; Professional counselor; Psychological reinforcement; Public Health; Quality-Adjusted Life Years; Random Allocation; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reporting; Research; Resources; Risk; Risk Reduction; Secure; Sex Behavior; Sexual Transmission; Site; Stimulant; Structure; Testing; Training; Training Activity; Translations; United States; United States National Institutes of Health; Unsafe Sex; Urinalysis; Viral; Viral Load result; antiretroviral therapy; arm; behavioral disinhibition; cisgender; condomless anal sex; cost effectiveness; cost estimate; depressive symptoms; design; economic impact; ecstasy; effectiveness evaluation; effectiveness outcome; effectiveness/implementation trial; evidence base; experience; field study; implementation evaluation; implementation strategy; improved; intervention delivery; intervention effect; life time cost; men who have sex with men; multidisciplinary; non-drug; pilot trial; pleasure; pre-exposure prophylaxis; prevention service; primary outcome; psychosocial; relapse prevention; response; satisfaction; secondary outcome; sex; sexual risk behavior; sexually active; skills; standard of care; stimulant use; substance use; substance use treatment; therapy adherence; translational impact; transmission process; treatment as prevention; treatment services; uptake; virtual

Stimulant drug (e.g., crystal methamphetamine, cocaine, ecstasy, MDMA) use is a substantial public health problem among young gay, bisexual and other men who have sex with men (YGBMSM) in the United States (US). Stimulant use is associated with increased engagement in sexual risk behaviors and decreased use of HIV prevention and treatment services, and as such leads to increased HIV acquisition/transmission. There are currently no evidence-based interventions to reduce stimulant use and concurrent HIV risk among YGBMSM; in response to this urgent need and building of over a decade of NIH-funded formative and pilot research, the proposed hybrid type 2 effectiveness-implementation trial is designed to assess the effectiveness and implementation strategies of Project IMPACT—a HIV status neutral, modular behavioral intervention to reduce HIV risk in YGBMSM who use stimulants in the context of high-risk sex. The intervention incorporates HIV risk reduction counseling (including supporting PrEP and ART use) with behavioral activation (BA)—an evidence-based, easy to administer, cognitive behavioral approach to treat depression that focuses on helping individuals re-engage in activities that generate feelings of enjoyment. Our conceptual model posits that BA will re-engage YGBMSM in pleasurable non-drug use activities that will serve as a natural reinforcement for functional behavior, improve depressed mood when not on stimulants by experiencing increases in pleasure, and decrease overall distress so that YGBMSM who use stimulants can better benefit from HIV risk reduction counseling. The initial pilot trials of Project IMPACT resulted in significant reductions in sexual risk, stimulant use and depressive symptoms. Research Plan Overview: By harnessing the resources, geographic and site diversity, and multidisciplinary expertise of the Adolescent Trials Network (ATN), the current proposal aims to efficiently and rigorously prepare Project IMPACT for rapid translation into real-world practice. Following the RE-AIM Framework, we will test the reach and effectiveness of Project IMPACT (compared to an enhanced Standard of Care condition) in a two-arm, multi-site and multi-format (i.e., in-person and virtual) randomized controlled trial of 360 cisgender YGBMSM who use stimulants in the context of high-risk sex. Participants will be followed for 12 months, and primary outcomes include number of condomless anal sex acts while not protected by PrEP (HIV- YGBMSM) or while not virally suppressed (HIV+ YGBMSM) and stimulant use (via urinalysis). We will also test our multi-faceted implementation strategy by assessing adoption/ accessibility and implementation using mixed-methods assessments that describe and examine characteristics of successful implementation (including differences by intervention delivery format). Finally, we will assess the feasibility of maintenance and sustainment of Project IMPACT by using the well-established CEPAC-AYA model to project its cost effectiveness on HIV transmissions, QALYs, and per person lifetime costs.

兴奋剂（如水晶甲基苯丙胺、可卡因、摇头丸、摇头丸）的使用是相当普遍的