Feasibility of Short-Term PrEP Uptake for MSM with Episodic High-Risk for HIV

具有偶发性 HIV 高风险的 MSM 短期接受 PrEP 的可行性

• 批准号: 8845287
• 负责人: KENNETH H MAYER
• 金额: $ 25.59万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8845287
• 关键词: AIDS prevention; Accounting; Address; Adherence; Alcohol or Other Drugs use; Biological Markers; Boston; Cities; Clinic; Data; Development; Dose; Effectiveness; Ensure; Ethnic Origin; Evaluation; HIV; HIV Infections; Health; Home environment; Incidence; Internet; Intervention; Interview; Measures; Methods; Minority Groups; Patient Self-Report; Pharmaceutical Preparations; Phase; Pilot Projects; Plasma Cells; Prevalence; Prevention strategy; Prophylactic treatment; Public Health; Race; Regimen; Reporting; Research; Research Activity; Risk; Risk Behaviors; Schedule; Site; Social Environment; Surveys; Time; Unsafe Sex; base; biobehavior; design; drug testing; effectiveness trial; efficacy trial; experience; high risk; men; men who have sex with men; prevent; programs; psychosocial; public health relevance; success; therapy design; tool; transmission process; uptake; willingness

 DESCRIPTION (provided by applicant): This proposed study is designed to investigate the acceptability, perceived need and uptake of short-term episodic Pre-Exposure Prophylaxis for HIV prevention among men who have sex with men (MSM). Long-term PrEP may be unnecessary for the many HIV-uninfected men who have episodic contextually defined high-risk periods, particularly when away from their home setting. Alternative dosing strategies, such as short-term fixed-interval episodic PrEP (Epi-PrEP), may be a more realistic, feasible, acceptable, and useful option with high public health impact for the majority of MSM. PrEP has the potential to dramatically raise the effectiveness of current HIV prevention efforts if it is correctly used and disseminated. This application is designed to investigate several questions essential to the development of efficacious Epi-PrEP uptake and adherence programs. The specific aims of the proposed two-city (Pittsburgh and Boston) study are to: (1) characterize and assess the prevalence of MSM who have high-risk but short-term periods when episodic PrEP may be an optimal HIV prevention strategy with a particular focus on low SES men; (2) determine the feasibility of clinic- based Epi-PrEP implementation pilot project for MSM who report occasional unprotected sex and who anticipate that they will have at defined high-risk time during the study period; and (3) Identify specific adherence-related contexts and problems, as well as resiliencies that will inform the intervention design of a larger scale trial of the effcacy of Epi-PrEP. Findings from this study will provide the empirical platform necessary to supporting the design, implementation and evaluation of an Epi-PrEP adherence intervention in a larger scale effectiveness trial. By basing the creation of new intervention strategies on data that measure both uptake and adherence of Epi-PrEP use among high-risk MSM, we can help ensure that PrEP strategies will reduce HIV transmission among the risk group that accounts for nearly two-thirds of all new HIV infections in the U.S.

 描述（由申请人提供）：本拟议研究旨在调查男男性行为者 (MSM) 短期偶发性暴露前预防治疗艾滋病毒预防的可接受性、感知需求和采用情况。对于许多未感染 HIV 的男性来说，长期 PrEP 可能是不必要的，因为他们有间歇性的高风险期，特别是在远离家庭环境时。替代剂量策略，例如短期固定间隔间歇性 PrEP (Epi-PrEP)，可能是一种更现实、可行、可接受和有用的选择，对大多数 MSM 具有较高的公共卫生影响。如果正确使用和传播，PrEP 有可能显着提高当前艾滋病毒预防工作的有效性。该应用程序旨在调查对于制定有效的 Epi-PrEP 摄取和依从计划至关重要的几个问题。拟议的两个城市（匹兹堡和波士顿）研究的具体目标是：（1）描述和评估具有高风险但短期时期的 MSM 患病率，此时间歇性 PrEP 可能是最佳的 HIV 预防策略，特别关注低社会经济地位男性； (2) 确定针对报告偶尔发生无保护性行为并预计在研究期间将在规定的高风险时间发生性行为的 MSM 实施基于临床的 Epi-PrEP 试点项目的可行性； (3) 确定与依从性相关的具体背景和问题，以及弹性，为更大规模 Epi-PrEP 功效试验的干预设计提供信息。这项研究的结果将为支持在更大规模的有效性试验中设计、实施和评估 Epi-PrEP 依从性干预措施提供必要的实证平台。通过根据测量高危 MSM 中 Epi-PrEP 使用情况和依从性的数据制定新的干预策略，我们可以帮助确保 PrEP 策略将减少高危人群中的 HIV 传播，该人群占美国所有新发 HIV 感染者的近三分之二。