Mhealth for Pre-exposure Prophylaxis Adherence by Young Adult MSM

Mhealth 促进年轻 MSM 遵守暴露前预防

• 批准号: 9347041
• 负责人: Patricia Flynn Weitzman
• 金额: $ 22.5万
• 依托单位: ENVIRONMENT AND HEALTH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-21 至 2019-05-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9347041
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; African American; Age; Alcohol consumption; Anal Sex; Anti-Retroviral Agents; Area; Boston; Brain; Car Phone; Centers for Disease Control and Prevention (U.S.); Chronic; Clinic; Community Practice; Community of Practice; Coupled; Decision Making; Development; Developmental Process; Diagnosis; Disclosure; Doctor of Philosophy; Dose; Education; Effectiveness; Ensure; Environment; Esthesia; Female; Focus Groups; Follow-Up Studies; Foundations; Funding; Goals; Gold; Grant; Guidelines; HIV; HIV Infections; HIV risk; Health; Health education; Hygiene; Incidence; Individual; Informal Social Control; Intervention; Knowledge; Latino; Leadership; Literature; Low income; Meta-Analysis; Methods; Minority; Modeling; Motivation; Participant; Patient Education; Patients; Penetration; Pharmaceutical Preparations; Phase; Prevention; Psychology; Randomized; Randomized Controlled Trials; Recommendation; Research; Research Support; Rest; Risk; Self Efficacy; Sleep; Small Business Innovation Research Grant; Social Network; Stress; System; Teenagers; Testing; Text; Time; United States National Institutes of Health; Victimization; Wood material; base; black men who have sex with men; comparative efficacy; condoms; cost; design; efficacy trial; evidence base; experience; high risk; improved; intervention program; mHealth; male; medication compliance; member; men; men who have sex with men; personalized approach; pill; pre-exposure prophylaxis; programs; sex; social; social cognitive theory; therapy adherence; tool; truvada; uptake; young adult

Abstract: Environment and Health Group, Tufts HIV/AIDS Clinic, and the Boston-area PrEP Community of Practice will collaborate under the leadership of Patricia Weitzman, PhD, to develop and test the feasibility and short-term effectiveness of the first-ever individually-tailored, developmentally- and culturally-sensitive, mobile (mhealth) PrEP adherence tool. It will target culturally-diverse, young adult men ages 20-29 who have sex with men (YMSM). When PrEP is taken daily, it can reduce HIV risk by up to 92%. The CDC estimates PrEP is appropriate for 500,000 MSM in the U.S. Impact models show even modest PrEP adherence could reduce new HIV infections among MSM by 29% over 20 years. The recent rise in HIV infection among young adults age 20-29, particularly minority YMSM, points to the value of PrEP uptake and adherence support for culturally-diverse YMSM. In PrEP trials, younger age was the most consistent correlate with low PrEP adherence. Extensive mobile phone penetration among young adults makes mhealth an ideal, low-cost method for providing PrEP adherence support to YMSM. We bring together a developmental understanding of young adult decision making with principles from social learning theory and positive psychology for supporting PrEP adherence. The proposed project is based on Dr. Weitzman's successful Phase 1 (and current Phase 2) anti-retroviral therapy (ART) mhealth adherence intervention for HIV+ African Americans, which combined tailored pill reminders with age- and culturally-sensitive motivational and educational texts. Experts suggest building PrEP adherence interventions on proven ART adherence interventions as many PrEP adherence facilitators are the same as ART. Moreover, the growing literature on mhealth shows it is a powerful approach to supporting adherence across conditions. In addition to building on our prior ART mhealth tool, we address facilitators/barriers identified in PrEP RCT follow up studies, and CDC PrEP adherence recommendations. Moreover, formative focus groups with diverse YMSM will allow us to identify and target unique adherence barriers and facilitators in this group. The intervention will provide tailored pill reminders with PrEP education texts, as well as developmentally-sensitive motivational texts. We will include sleep hygiene and alcohol use messages, which have direct relevance to young adults. By using a low-cost, accessible mobile phone tool, the intervention eliminates several access barriers to support, which can be a particular problem for low income and minority patients. Our overarching goal is to help stop the rise in HIV among YMSM.

翻译后摘要：环境与健康组，塔夫茨艾滋病毒/艾滋病诊所，和波士顿地区的PrEP 实践社区将在Patricia Weitzman博士的领导下合作， 开发和测试有史以来第一个个性化定制的， 发展和文化敏感，移动的（mhealth）PrEP依从性工具。它将针对 20-29岁与男性发生性关系的文化多样的年轻成年男子（YMSM）。当PrEP 每天服用，可将艾滋病风险降低92%。CDC估计PrEP适用于 影响模型显示，即使是适度的PrEP依从性也可以减少新的 男男性行为者的艾滋病毒感染率在20年内下降了29%。最近艾滋病毒感染率上升， 20-29岁的年轻人，特别是少数YMSM，指出了PrEP摄取的价值， 支持文化多样性的YMSM。在PrEP试验中，年龄较小的人最多 与PrEP依从性低一致。广泛的移动的电话渗透， 年轻人使mhealth成为一种理想的，低成本的方法，为PrEP坚持支持， YMSM。我们将对年轻人决策的发展理解与 社会学习理论和积极心理学的原则，以支持PrEP的坚持。 拟议的项目是基于Weitzman博士成功的第1阶段（和当前阶段） 2)艾滋病毒阳性非洲裔美国人的抗逆转录病毒治疗（ART）健康依从性干预， 它将量身定制的药丸提醒与年龄和文化敏感的激励和 教育文本。专家建议建立PrEP依从性干预措施，以证明ART 坚持干预，因为许多PrEP坚持促进者与ART相同。此外， 越来越多的关于移动医疗的文献表明，这是一种支持跨部门依从性的强有力方法。 条件除了建立在我们以前的ART mhealth工具上，我们还解决了促进者/障碍 在PrEP RCT随访研究和CDC PrEP依从性建议中确定。 此外，具有不同YMSM的形成性焦点小组将使我们能够识别和定位独特的 在这个群体中的坚持障碍和促进者。干预将提供量身定制的药丸 提醒与PrEP教育文本，以及发展敏感的动机文本。 我们将包括睡眠卫生和酒精使用的信息，这与年轻人有直接的关系。 成年人了通过使用低成本、可访问的移动的电话工具，干预消除了几个 获得支持的障碍，这对于低收入和少数族裔来说可能是一个特殊问题 患者我们的首要目标是帮助阻止YMSM中艾滋病毒的上升。