TransPrEP: Social Network-Based PrEP Adherence for Transgender Women in Peru

描述（由申请人提供）：暴露前预防（PrEP）减少艾滋病毒传播的有效性强烈依赖于依从性，这受到个人，社会和结构因素的影响。我们提出了一个基于社会网络的干预措施，以促进秘鲁利马变性妇女（TW）的PrEP依从性：1)形成性研究。为了优化PrEP依从性干预的内容，我们将进行半结构化访谈和焦点小组。结果将用于改进PrEP依从性干预。2)对秘鲁基于社交网络的PrEP依从性干预进行公开评估。干预模式将在5-10个TW的小组中进行试点。数据将用于最终确定试验随机对照试验（RCT）的研究设计和评估工具。3)在秘鲁开展一项基于社交网络的PrEP依从性干预的试验RCT。我们计划随机选取8个基于社会网络的TW组，进行基于网络的PrEP依从性干预或标准化的PrEP依从性咨询。主要结果将是PrEP依从性。干预措施将结合个人咨询、小组研讨会、基于社会媒体的网络互动和实际支持工具，以促进同性恋者遵守预防措施。个人咨询：参与者将完成两次关于PrEP使用和艾滋病毒预防的双周咨询会议。个人咨询的目标是介绍PrEP作为艾滋病毒预防工具，并解决PrEP依从性的基本问题，作为全面艾滋病毒预防战略的一部分。小组研讨会。小组研讨会将建立对PrEP作为全面艾滋病毒预防的核心组成部分的共同认识，讨论遵守PrEP的重要性，制定支持遵守PrEP的实际战略，并在同龄人群体中制定和维持艾滋病毒预防和遵守PrEP的规范。两周一次的维护会议将解决与PrEP使用和依从性相关的持续问题。社交网络互动。干预措施的社会网络部分将包括结构化的社会媒体平台，用于教育、激励和促进参与者网络中关于PrEP依从性的讨论，非结构化的参与者生成的互动，用于阐明和加强网络中新形成的社会规范，以及支持日常依从性的实用工具。准备使用。在为期6个月的研究期间，参与者将每天服用特鲁瓦达。评估程序、时间和措施。将有三个主要的评估点：基线，短期结果（3个月）和长期结果（6个月）。干预的主要结果将是比较干预组和对照组的PrEP依从性。研究结果将用于支持美国国立卫生研究院资助的R01提案，该提案使用TW的社交网络和社交媒体技术来产生、实施和加强关于PrEP依从性、性风险行为和艾滋病毒预防的新的社会规范。

DESCRIPTION (provided by applicant): The effectiveness of Pre-Exposure Prophylaxis (PrEP) for reducing HIV transmission is strongly dependent on adherence, which is influenced by individual, social, and structural factors. We propose a social network-based intervention to promote PrEP adherence among transgender women (TW) in Lima, Peru: 1) Formative research. To optimize content for a PrEP adherence intervention, we will conduct semi- structured interviews and focus groups. Results will be used to refine the PrEP adherence intervention. 2) To conduct an open evaluation of a social network-based PrEP adherence intervention for TW in Peru. The intervention model will be piloted with a small group of 5-10 TW. Data will be used to finalize the study design and assessment tools for a pilot randomized controlled trial (RCT). 3) To conduct a pilot RCT of a social network-based PrEP adherence intervention for TW in Peru. We plan to randomize 8 social network-based clusters of TW that to either a network-based PrEP adherence intervention or standardized PrEP adherence counseling. The primary outcome will be PrEP adherence. The intervention will use a combination of individual counseling, group workshops, social media-based network interactions, and practical support tools to promote PrEP adherence among TW. Individual Counseling: Participants will complete two biweekly counseling sessions addressing PrEP use and HIV prevention. The goals of individual counseling are to introduce PrEP as an HIV prevention tool and address basic issues of PrEP adherence as part of a comprehensive HIV prevention strategy. Group Workshops. Group workshops will establish a common understanding of PrEP as a central component of comprehensive HIV prevention, address the importance of PrEP adherence, develop practical strategies to support adherence, and generate and maintain norms of HIV prevention and PrEP adherence within the peer group. Biweekly maintenance meetings will address ongoing issues related to PrEP use and adherence. Social Network Interactions. The social network component of the intervention will include structured social media platforms to educate, motivate, and promote discussions of PrEP adherence within the participant network, unstructured participant-generated interactions to articulate and reinforce newly developed social norms within the network, and practical tools to support daily adherence. PrEP Use. Participants will be provided with daily Truvada for the 6-month study period. Assessment Procedures, Timing and Measures. There will be three major assessment points: baseline, short-term outcome (3 month), and long-term outcome (6 month). The primary outcome of the intervention will be a comparison of PrEP adherence in the intervention and control groups. Findings will be used to support an NIH-funded R01 proposal using social networks of TW and social media technologies to generate, implement, and reinforce new social norms of PrEP adherence, sexual risk behavior, and HIV prevention.