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).

这项拟议的研究的目标是适应“救生员” - 一种有效且独特的群体 - 年轻跨性别妇女（YTW）16-29岁的艾滋病毒预防干预措施有艾滋病毒的风险 传输或收购移动平台；一旦改编，进行全尺度随机进行 对照试验（RCT）确定其在降低HIV风险行为方面的有效性。在美国，YTW是关键 艾滋病毒感染的高风险人口，在城市YTW范围内，美国的艾滋病毒患病率估计 从19-22％。有证据表明，社会经济边缘化以及相关的心理社会共同 病态驱动高水平的HIV相关风险YTW，表明需要预防全面的HIV 针对其独特情况和脆弱性的计划。迄今为止没有循证 EBIS cDC汇编中列出的YTW的HIV预防干预措施（EBIS）；干预是 需要广泛可扩展到实践环境。我们将通过以下内容解决这个差距 研究目的：1）将Lifeskills调整到基于移动Web的平台，包括1A）修改和更新 救生员干预以包括扩大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）调整干预内容以与移动部署一起使用 通过定性焦点小组，以用户为中心 设计会议和可用性测试。 2）试点测试改编的移动干预以提高可行性 并以40 YTW年龄16-29岁的艾滋病毒收购或传播风险的可接受性（10名参与者/站点） 并准备充分实施。 3）测试移动救生员干预的效率 与延迟的干预对照组进行比较：无避孕套性别的数量 行为（肛门和阴道； 4个月的召回），而无需保护准备/艺术；和次要结果： 获得HIV/STI（泌尿生殖器/肛门衣原体和淋病，梅毒）。此外，我们将：3a） 通过干预概念调解人在干预组之间检查艾滋病毒风险中的调解： 跨性别适应/整合，集体自尊/授权，信息，动机和 行为技巧。 3b）与控制相比，评估移动救生员干预的效率 关于预防HIV和护理连续体的结果的条件，包括PREP/HIV护理联系， 启动和保留，并评估艾滋病毒状况（实验室确认）对效应修饰的评估。

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