Behavioral Research Project:Promoting HIV PrEP among MSM: a Randomized Controlled Trial Protocol

行为研究项目：在 MSM 中推广 HIV PrEP：随机对照试验方案

• 批准号: 9978973
• 负责人: Homero Erwin del Pino
• 金额: $ 24.78万
• 依托单位: CHARLES R. DREW UNIVERSITY OF MED & SCI
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9978973
• 关键词: Address; Age; Alcohol or Other Drugs use; Awareness; Behavior; Behavioral Research; Centers for Disease Control and Prevention (U.S.); Child; Communities; Data; Development; Emotional; Enrollment; Family; Focus Groups; Foundations; Future; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; Health; Health behavior; Heterosexuals; Incidence; Intervention; Interview; Latino; Literature; Longevity; Methods; Modeling; Motivation; Pharmaceutical Preparations; Pilot Projects; Pre-Post Tests; Prevention; Prevention strategy; Probability; Procedures; Process; Protocols documentation; Provider; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research Project Grants; Resources; Sexual and Gender Minorities; Siblings; Social support; Solid; Source; Testing; Time; Translational Research; Work; Youth; base; behavior change; brief intervention; condoms; control trial; design; effective intervention; experience; family support; follow-up; high risk; high risk men; high risk population; improved; man; member; men; men who have sex with men; pre-exposure prophylaxis; racial and ethnic; scale up; social stigma; success; successful intervention; uptake; willingness

Project Summary/Abstract Despite the prevention and treatment efforts of the past 30 years, Latino men who have sex with men (MSM) continue to be disproportionately impacted by HIV: diagnoses increased 14% between 2010-2014 and those younger than 40 years old had the highest incidence rates. HIV biomedical interventions to reduce HIV infections are not reaching Latino communities. Nearly 300,000 Latinos in the nation were eligible for HIV pre- exposure prophylaxis (PrEP) in 2015, yet only 7,600 received a prescription for it. Yet a powerful cultural source of motivation for behavior change has been underutilized: the family. Latinos report a high reliance on family for material and emotional support and often choose healthy behaviors to “do right” by their family. Yet no family-based interventions to promote PrEP have been tested among Latino MSM at high-risk for HIV infection. Although Latino MSM often experience family rejection and stigma, studies show that many continue to prioritize family support for behavior change over other sources of support; that strained family ties are reestablished over time; and that Latino MSM and their siblings come to rely on each other as they age. Siblings are often a lifelong source of social support and 77% of Latinos have at least one sibling. This project aims to engage the siblings of Latino MSM in the development and delivery of PrEP-uptake messages and to evaluate the initial efficacy of involving siblings in HIV biomedical interventions. Specific Aims: (1) To develop intervention messages to increase PrEP use in high-risk Latino MSM that can be delivered by their siblings. We will use IMB model constructs to create these messages. We will conduct in-depth interviews with 30 LMSM-Sibling pairs to identify factors relevant for the development and delivery of messages to increase PrEP-use. Messages will be rated by a panel of experts and tested with 3 focus groups. (2) To implement the intervention messages in an uncontrolled pilot study with Latino MSM and their siblings (n=20 pairs). We will use a pre/post test design with 30-day follow-up with 20 Latino MSM-sibling pairs to gather feasibility and acceptability data, and to refine messages and delivery procedures as needed. (3) To conduct a two-group randomized control trial (n=124) to evaluate the efficacy of sibling-delivered PrEP messages compared with provider-delivered standard PrEP messages for use with high-risk Latino MSM. An important aim of this project is to develop an effective and brief intervention that can be sustained by our community partner and PrEP Center for Excellence, St. John’s Well Child and Family Center, and ultimately scaled-up by health departments and other PrEP stakeholders. Future studies could adapt this approach for other racial/ethnic sexual and gender minorities.

项目摘要/摘要 尽管过去30年进行了预防和治疗工作，但与男性发生性关系的拉丁裔男人（MSM） 继续受到艾滋病毒的影响不成比例：在2010 - 2014年之间，诊断增加了14％， 40岁以下的发病率最高。 HIV生物医学干预措施以减少HIV 感染没有到达拉丁裔社区。全美近30万拉丁美洲人有资格获得艾滋病毒前 2015年的暴露预防（PREP），但只有7,600人获得了处方。 然而，改变行为动机的强大文化来源还没有得到充分利用：家庭。拉丁美洲人 向家庭报告物质和情感支持的高度提醒，并经常选择健康的行为 是的。 在高危HIV感染时。尽管拉丁裔MSM经常会遭受家庭拒绝和污名，但研究表明 许多人继续优先考虑家庭对行为改变而不是其他支持来源的支持；那紧张 随着时间的流逝，家庭关系得到重建；那个拉丁裔MSM及其兄弟姐妹彼此依靠 他们年龄。兄弟姐妹通常是终生的社会支持来源，有77％的拉丁裔至少有一个兄弟姐妹。 该项目旨在让拉丁裔MSM的兄弟姐妹参与预摄取的开发和交付 消息并评估涉及HIV生物医学干预中兄弟姐妹的初始效率。 具体目的： （1）开发干预消息以增加可以是高风险拉丁裔MSM的准备使用 由他们的兄弟姐妹交付。我们将使用IMB模型构造来创建这些消息。我们将进行 对30个LMSM兄弟姐妹的深入访谈，以确定与开发和交付相关的因素 消息以增加预订。消息将由专家小组评估，并通过3个焦点小组进行了测试。 （2）在与拉丁裔MSM及其的一项不受控制的试点研究中实施干预消息 兄弟姐妹（n = 20对）。我们将使用30天的随访前/后测试设计，并使用20个拉丁裔MSM兄弟姐妹 配对以收集可行性和可接受性数据，并根据需要完善消息和交付程序。 （3）进行两组随机对照试验（n = 124），以评估兄弟姐妹的效率 与提供者交付的标准准备消息相比，与高危一起使用的标准准备消息 拉丁裔MSM。 该项目的一个重要目的是开发一种有效而简短的干预措施，我们可以维持我们 社区合作伙伴和卓越预科中心，圣约翰健康和家庭中心，最终 由卫生部门和其他PREP利益相关者扩展。未来的研究可以使这种方法适应 其他种族/种族性和性别少数群体。