Mobile Adaptation and Testing of a Uniquely Targeted HIV Intervention for Young Transgender Women

针对年轻跨性别女性的独特针对性艾滋病毒干预措施的移动适应和测试

• 批准号: 9765545
• 负责人: Lisa Mary Kuhns
• 金额: $ 30万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-21 至 2020-09-20
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9765545
• 关键词: AIDS prevention; Address; Adolescent and Young Adult; Age; Anus; Attitude; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Chicago; Chlamydia; Cities; Comorbidity; Continuity of Patient Care; Control Groups; Counseling; Enrollment; Environment; Focus Groups; Funding; Genitourinary system; Goals; Gonorrhea; HIV; HIV Infections; HIV diagnosis; HIV risk; HIV/STD; Individual; Interdisciplinary Study; Intervention; Knowledge; Los Angeles; Mediation; Mediator of activation protein; Mental Depression; Modality; Modification; Motivation; National Institute of Mental Health; Online Systems; Outcome; Participant; Persons; Population; Population Decreases; Prevalence; Prevention; Prevention program; Preventive Intervention; Process; Randomized; Randomized Controlled Trials; Research; Research Project Grants; Risk; Risk Behaviors; Safe Sex; Services; Sexual Health; Sexual Partners; Site; Syphilis; Target Populations; Technology; Testing; Trauma; Update; Vagina; base; burden of illness; community based participatory research; condoms; data format; effective intervention; efficacy testing; empowerment; evidence base; group intervention; high risk; interest; intervention effect; intimate partner violence; mHealth; member; mobile computing; pre-exposure prophylaxis; prevent; primary outcome; psychosocial; secondary outcome; self esteem; sex; skills; social; social exclusion; socioeconomics; standard of care; therapy development; transgender; transgender women; transmission process; treatment arm; usability; user centered design

The goals of this proposed study are to adapt “LifeSkills”- an efficacious and uniquely targeted group- based HIV prevention intervention for young transgender women (YTW) ages 16-29, at risk for HIV transmission or acquisition- to a mobile platform; and once adapted, to conduct a full-scale randomized controlled trial (RCT) to determine its efficacy in decreasing HIV risk behavior. In the U.S., YTW are a key population at high risk of HIV infection, with HIV prevalence estimates in U.S. among urban YTW ranging from 19-22%. Evidence suggests that socioeconomic marginalization, and related psychosocial co- morbidities drive high levels of HIV-related risk YTW, indicating a need for comprehensive HIV prevention programs targeted to their unique circumstances and vulnerabilities. To date there are no evidence-based HIV prevention interventions (EBIs) for YTW listed in the CDC compendium of EBIs; interventions are needed that are widely scalable to the practice environment. We will address this gap via the following study aims: 1) adapting LifeSkills to a mobile web-based platform, including 1a) revising and updating the LifeSkills intervention to include expanded biomedical HIV prevention and treatment modalities (e.g., PrEP and HIV Treatment as Prevention); 1b) adapting the intervention content for mobile deployment with the larger investigative team and YTW at each enrollment site via qualitative focus groups, user-centered design sessions, and usability testing. 2) Pilot testing the adapted mobile intervention to enhance feasibility and acceptability with 40 YTW ages 16-29 at-risk of HIV acquisition or transmission (10 participants/site) and prepare for full implementation. 3) Testing the efficacy of the mobile LifeSkills intervention in comparison to a delayed intervention control group on the primary outcome: number of condomless sex acts (anal and vaginal; 4-month recall) without protection of PrEP/ART; and secondary outcome: acquisition of HIV/STIs (urogenital/anal chlamydia and gonorrhea, syphilis). Furthermore, we will: 3a) examine mediation in HIV risk between intervention groups by the conceptual mediators of the intervention: transgender adaptation/integration, collective self-esteem/empowerment, information, motivation, and behavioral skills. 3b) assess the efficacy of the mobile LifeSkills intervention in comparison to the control condition on outcomes across the HIV prevention and care continuum, including PrEP/HIV care linkage, initiation, and retention, with assessment of effect modification by HIV status (lab-confirmed).

这项拟议研究的目标是适应“生活技能”--一种有效和独特的目标群体-- 为16-29岁、有艾滋病毒风险的年轻变性人妇女(YTW)提供艾滋病毒预防干预 传输或获取--到移动平台；一旦适应，就进行全面的随机 对照试验(RCT)，以确定其在减少艾滋病毒危险行为方面的有效性。在美国，YTW是一个关键 HIV感染高危人群，美国城市YTW中HIV流行率的估计范围 从19%到22%。有证据表明，社会经济边缘化和相关的心理社会共同 疾病导致高水平的艾滋病毒相关风险YTW，表明需要全面预防艾滋病毒 针对其独特环境和漏洞的计划。到目前为止，还没有基于证据的 美国疾病控制与预防中心《预防艾滋病简编》中列出的YTW的艾滋病毒预防干预措施；干预措施包括 需要可广泛扩展到实践环境的。我们将通过以下方式解决这一差距 研究目标：1)使LifeSkills适应基于移动网络的平台，包括1)修订和更新 生活技能干预，包括扩展的生物医学艾滋病毒预防和治疗方式(例如PrEP 和艾滋病毒治疗作为预防)；1b)调整干预内容，以用于移动部署 通过以用户为中心的定性焦点小组，在每个注册地点组建更大的调查团队和YTW 设计会议和可用性测试。2)试点测试适应的移动干预，以增强可行性 40名16-29岁的青年妇女感染或传播艾滋病毒的风险(10名参与者/站点) 并为全面实施做好准备。3)测试移动生活技能干预在 与延迟干预对照组的主要结果比较：无避孕套的性行为数量 没有PrEP/ART保护的ACTs(肛门和阴道；4个月召回)；和次要结果： 获得艾滋病毒/性传播感染(泌尿生殖道/肛门衣原体和淋病、梅毒)。此外，我们还将：3A) 通过干预的概念性调解人检查干预小组之间艾滋病毒风险的调解： 变性人适应/融入、集体自尊/赋权、信息、动机和 行为技能。3b)与对照组相比，评估移动生活技能干预的效果 整个艾滋病毒预防和护理连续体的结果情况，包括PrEP/艾滋病毒护理联系， 启动和保留，以及根据艾滋病毒状况评估效果修改(实验室确认)。

项目成果

A Uniquely Targeted, Mobile App-Based HIV Prevention Intervention for Young Transgender Women: Adaptation and Usability Study.

• DOI: 10.2196/21839
• 发表时间: 2021-03-31
• 期刊: Journal of medical Internet research
• 影响因子: 7.4
• 作者: Kuhns LM;Hereth J;Garofalo R;Hidalgo M;Johnson AK;Schnall R;Reisner SL;Belzer M;Mimiaga MJ
• 通讯作者: Mimiaga MJ