The Southern Pre-Exposure Prophylaxis Cohort Study: Longitudinal PrEP Initiation and Adherence among Parolees

南方暴露前预防队列研究：假释者的纵向 PrEP 启动和遵守情况

• 批准号: 9765391
• 负责人: Lauren Brinkley-Rubinstein
• 金额: $ 53.19万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9765391
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Awareness; Behavioral; Characteristics; Cohort Studies; Communities; Counseling; Criminal Justice; Data; Employment; Evaluation; Female; Financial compensation; Florida; Funding; Future; General Population; HIV; HIV Infections; HIV risk; Hispanics; Housing; Imprisonment; Incidence; Individual; Intervention; Interview; Kentucky; Knowledge; Location; Longitudinal cohort study; Modality; Modeling; North Carolina; Outcome Study; Pattern; Pharmaceutical Preparations; Play; Policies; Population; Predictive Factor; Prevalence; Prevention approach; Prevention strategy; Prisons; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Rural Population; Sexual and Gender Minorities; Site; Social support; Structure; Suggestion; Supervision; System; Tenofovir; Testing; Time; United States; United States National Institutes of Health; Vulnerable Populations; cohort; condoms; design; effective intervention; emtricitabine; experience; follow-up; health disparity; health service use; high risk; improved; innovation; interest; male; minority health; parole; pre-exposure prophylaxis; prevent; prevention service; racial diversity; racial health disparity; recruit; response; rural underserved; social; social stigma; sociodemographics; socioeconomic disadvantage; therapy development; vision science

PROJECT ABSTRACT The estimated HIV prevalence among criminal justice (CJ) involved individuals is three times higher than the general population. Parolees on post-release supervision after release experience multi-level obstacles (e.g., lack of access to housing, employment) that act as barriers to HIV prevention efforts, making existing approaches to HIV prevention insufficient for reducing HIV incidence. Pre-exposure prophylaxis (PrEP) is a once daily medication (emtricitabine/tenofovir, FTC/TDF) that has demonstrated efficacy in preventing HIV among at-risk groups. Little is known about PrEP knowledge, acceptability, initiation, and sustained use among parolees recently released from prison or how these patterns vary by individual (HIV risk factor, sociodemographic characteristics), social (stigma, social support), and structural (housing, employment) factors. Therefore, we propose to conduct an observational, multi-site cohort study in North Carolina, Kentucky, and Florida—the Southern Pre-Exposure Prophylaxis [PrEP] Cohort Study among Parolees (SPECS-P). This study is guided by the Social Ecological Model and the NIMHD Minority Health and Health Disparities Research Framework, which both have a focus extending beyond the individual and acknowledge that multi-level (individual, social, and structural) factors play a role in the perpetuation of persistent health disparities. The specific aims of the proposed study are: 1) characterize PrEP knowledge and acceptability among parolees; 2) identify the multi-level factors that predict PrEP initiation and sustained use among parolees; 3) qualitatively assess the multi-level factors that affect PrEP acceptability, initiation and sustained use to inform future intervention development. The proposed project will be the first observational cohort study that includes a CJ involved population at extreme risk for HIV acquisition. Our study is aligned with the following high priority topics as defined by the NIH, NIMHD Science Visioning, and Office of AIDS Research: a) advancing evaluation of approaches to improve minority health or to reduce health disparities; and b) reducing incidence of HIV/AIDS and implementing strategies to improve entry into prevention services.

项目摘要 据估计，刑事司法（CJ）涉案人员中的艾滋病毒流行率是2010年的三倍。 一般人。假释人员出狱后监管遭遇多层次障碍 (e.g.,缺乏获得住房、就业的机会），这是艾滋病毒预防工作的障碍， 艾滋病毒预防方法不足以降低艾滋病毒发病率。暴露前预防（PrEP）是一种 每日一次的药物（恩曲他滨/替诺福韦，FTC/TDF）已证明对预防HIV有效 在高危人群中。关于PrEP知识、可接受性、启动和持续使用知之甚少 在最近从监狱释放的假释犯中，或这些模式如何因个人而异（艾滋病毒风险因素， 社会人口特征）、社会（污名、社会支持）和结构（住房、就业） 因素因此，我们建议在北卡罗来纳州进行一项观察性多中心队列研究， 肯塔基州和佛罗里达州--在假释犯中进行的南方暴露前预防[PrEP]队列研究 （SPECS-P）。本研究以社会生态学模型和NIMHD少数民族卫生与健康为指导， 差异研究框架，这两个都有一个重点超出个人和 承认多层次（个人，社会和结构）因素在长期存在中发挥作用 持续的健康差距。拟议研究的具体目标是：1）表征PrEP知识 和可接受性假释; 2）确定预测PrEP启动和持续的多层次因素 在假释犯中使用; 3）定性评估影响PrEP可接受性、启动 并持续使用，为未来的干预措施提供信息。该项目将是第一个 一项观察性队列研究，包括一个CJ参与的艾滋病毒感染极高风险人群。我们 研究与NIH、NIMHD科学愿景和 艾滋病研究办公室：a）推进对改善少数群体健康或减少 B）减少艾滋病毒/艾滋病的发病率，并实施战略， 预防服务。