Increasing Uptake of HIV Pre-Exposure Prophylaxis among Young, Black MSM in the South

项目概要： 该K23提案的总体目标是为医学博士Latesha Elopre，MSPH提供必要的指导， 职业发展必须成为一个独立的调查员，其研究将有助于 减少得不到充分服务和受艾滋病毒影响不成比例的人口在健康方面的不平等 感染率。她工作的最初重点将是开发一种行为干预，以增加对 艾滋病毒暴露前预防（PrEP）的年轻人，黑人男子谁与男子发生性关系（MSM）在深 南目前，疾病控制和预防中心估计，50%的黑人男男性接触者将成为 一生中感染艾滋病病毒。此外，美国南部的新移民率最高， 这一人群中的艾滋病毒感染率在年轻的黑人男男性行为者中迅速上升。通过持续使用 PrEP是一种生物医学预防工具，在年轻的黑人男男性行为者中可以看到艾滋病毒感染率的下降。 研究重点是增加艾滋病毒预防服务和减少艾滋病毒发病率方面的健康差距 是国家卫生研究院的首要任务然而，很少有研究评估PrEP吸收， 年轻的黑人男男性接触者与先前的研究一致， 结构性因素导致黑人男男性接触者的污名化和边缘化增加，本研究将扎根于 Andersen行为模式的医疗保健利用与随后的个人层面的干预驱动 情境信息、动机和行为技能的理论框架。这一概念模型将 允许在个人和社会障碍的背景下调查健康行为的核心决定因素 影响卫生服务利用。混合方法的研究设计将有助于有针对性的干预 通过对PrEP吸收的潜在障碍的更细致的理解， 假设：与PrEP、艾滋病毒、种族、宗教和贫困相关的污名化特征，以及 获得医疗保健将是认识和吸收南方年轻黑人男男性行为者PrEP的主要障碍。 这项研究建议的具体目标如下： 目标1：确定关于PrEP意识和年轻人，黑人吸收的关键信念和态度 南方的MSM 目标2：确定向南方年轻的黑人男男性行为者提供PrEP的环境障碍。 目标3：制定有针对性的干预措施，以增加南方年轻黑人男男性行为者对PrEP的吸收。 在我的导师团队的指导下，制定了职业发展计划，以获得以下方面的培训： 行为理论，干预发展和混合方法的研究设计，使额外的 课程作业、实践培训、研讨会和国家讲习班。在完成拟议的科学 目标，我将准备试点理论指导的行为干预，以提高年轻人的PrEP吸收 黑人男男性接触者在美国南方腹地由R系列赠款支持。

PROJECT SUMMARY: The overall goal of this K23 proposal is to provide Latesha Elopre, MD, MSPH the essential mentorship and career development necessary to become an independent investigator whose research will contribute to decreasing health inequity among underserved and disproportionately impacted populations regarding HIV infection rates. The initial focus of her work will be in developing a behavioral intervention to increase uptake of HIV pre-exposure prophylaxis (PrEP) among young, Black men who have sex with men (MSM) in the Deep South. Currently, the Centers for Disease Control and Prevention estimate that 50% of black MSM will become infected with HIV in their lifetime. Furthermore, the Southern United States is seeing the highest rates of new HIV infections in this population, with rates rapidly increasing for young, black MSM. Through consistent use of PrEP, a biomedical prevention tool, decreased HIV infection rates can be seen among young, Black MSM. Research focusing on increasing HIV prevention services and decreasing health disparities in HIV incidence have been high priority for the NIH. However, there have been few studies evaluating PrEP uptake among young, Black MSM in the Deep South. In concordance with prior research that has shown individual and structural factors leading to increased stigma and marginalization for black MSM, this study will be grounded in the Andersen Behavioral Model for Healthcare Utilization with subsequent individual level intervention driven by the situated Information, Motivation and Behavioral skills theoretical framework. This conceptual model will allow for investigation of core determinants of health behavior in the context of individual and societal barriers influencing health service utilization. A mixed-methods research design will aid in targeted intervention development with a more granular understanding of potential barriers for PrEP uptake. Hypothesis: Characteristics that pertain to stigma related to PrEP, HIV, race, religion and poverty as well as healthcare access will be major barriers to awareness and uptake of PrEP for young, Black MSM in the South. The specific aims for this research proposal are as follows: Aim 1: Determine critical beliefs and attitudes regarding PrEP awareness and uptake among young, Black MSM in the South. Aim 2: Determine environmental barriers for delivery of PrEP to young, black MSM in the South. Aim 3: Develop a targeted intervention to increase PrEP uptake among young, Black MSM in the South. With guidance from my mentorship team, a career development plan has been created to gain training in behavioral theory, intervention development and mixed-methods research design enabled by additional coursework, hands on training, seminars and national workshops. Upon completion of the proposed scientific aims, I will be poised to pilot a theory-guided behavioral intervention to enhance PrEP uptake among young black MSM in the U.S. Deep South supported by an R-series grant.