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Acceptability of HIV Treatment as Prevention among MSM

MSM 中艾滋病毒治疗作为预防的接受度

基本信息

批准号：
10192833
负责人：
Etienne Meunier
金额：
$ 24.55万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-15 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10192833
关键词：
AIDS prevention Address Adopted Adoption Affect Awareness Belief Caring Centers for Disease Control and Prevention (U.S.)Characteristics Clinic Clinical Data Clinical Trials Communicable Diseases Communication Continuing Education Couples Data Effectiveness Epidemic General Population HIV HIV Seronegativity HIV Seropositivity Health Health Benefit Health Personnel Human immunodeficiency virus test Incidence Individual Infection Interview Investigation Knowledge Learning Life Expectancy Light Maps Medicine Methods Modeling NIH Office of AIDS Research Outcome Participant Perception Personal Satisfaction Population Positioning Attribute Prevention strategy Process Public Health Risk Sampling Sex Behavior Sexual Partners Surveys Testing Treatment Effectiveness Trust United States Viral Viral Load result barrier to care condomless anal sex experience fighting improved male medication compliance men men who have sex with men pre-exposure prophylaxis prevent recruit screening sex sexual HIV transmission social social stigma therapy development tool transgender transmission process treatment as prevention willingness

项目摘要

Project Summary/Abstract From 2012 to 2016, the number of people living with HIV in the US whose infection is attributable to male- to-male sexual contact increased from 462,027 to 542,000 and, at year-end 2016, these men comprised 55% of the HIV-positive population. Continued education about HIV transmission risk and prevention strategies among men and transgender people who have sex with men (MTSM) is crucial. In recent years, treatment as prevention (TasP) has emerged as an effective HIV prevention strategy that could have multiple benefits to the public health. In light of clinic trial evidence, the CDC now states, “People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to their HIV- negative sexual partners.” Making HIV-positive people practically noninfectious, TasP represents an important tool not only for reducing HIV incidence but also for fighting HIV-related stigma and improving the well-being of HIV-positive people. However, TasP will only fulfill its promises if people accept it as an effective and reliable prevention strategy. Unfortunately, the most recent data show that although there seems to be high awareness of TasP among MTSM, few seem to believe in its efficacy or to be willing to use it. This study will use the Precaution Adoption Process Model (PAPM) to investigate the factors associated with different stages of TasP adoption among men and transgender people who have sex with men (MTSM). We will conduct in-depth qualitative interviews with 60–75 MTSM in the US, divided between HIV-positive and HIV-negative/unaware individuals not using PrEP. We will focus on three positions regarding TasP adoption that we have found to be common in our preliminary data and that map onto key stages in the PAPM: TasP skeptics (who do not believe in the effectiveness of TasP), TasP believers (who understand TasP is effective but are not willing to rely on it), and TasP adopters (those who have relied on the strategy). The screening survey we will use to recruit interview participants will provide further data about other stages of TasP adoption (awareness, perceived effectiveness, willingness to use, and actual use) in a larger and more diverse sample of participants (including PrEP users). The specific aims are: 1. To examine (with qualitative interview data) factors associated with MTSM’s perceived effectiveness of TasP and their willingness to rely on it. 2. To understand (with qualitative interview data) the experiences of MTSM who use TasP, how they use the strategy, and how it affects their sexual behaviors and decisions. 3. To describe (with screener survey data) the characteristics of MTSM at different stages of TasP adoption (awareness, perceived effectiveness, willingness to use, and actual use). 4. To begin development of an intervention to correct misconceptions about TasP, overcome barriers to its use, and educate MTSM on how to most effectively use the prevention strategy.

项目摘要/摘要从2012年到2016年，美国艾滋病毒携带者的数量是由男性感染的- 与男性的性接触从462,027人增加到542,000人，2016年底，这些男性占55% 艾滋病毒阳性人群的比例。关于艾滋病毒传播风险和预防策略的持续教育在男性和变性人中，与男性发生性关系的人(MTSM)至关重要。近年来，像这样的待遇预防(TasP)已成为一种有效的艾滋病毒预防战略，可能对公共卫生。根据临床试验证据，美国疾病控制与预防中心现在表示，“艾滋病毒携带者将艾滋病毒药物作为开处方、获取和保持无法检测到的病毒载量实际上没有将艾滋病毒传播给他们的艾滋病毒的风险- 消极的性伴侣。“使艾滋病毒阳性者几乎不具传染性，TasP代表着一个重要的不仅是减少艾滋病毒发病率的工具，而且也是与艾滋病毒相关的耻辱作斗争和改善艾滋病毒呈阳性的人。然而，只有当人们接受TasP是有效和可靠的时，TasP才会兑现承诺预防策略。不幸的是，最新数据显示，尽管似乎有很高的意识在MTSM中的TasP中，似乎很少人相信它的有效性或愿意使用它。本研究将使用预防采用过程模型(PAPM)来调查相关因素在男性和跨性别者中采用TasP的不同阶段(MTSM)。我们将对美国60-75名MTSM进行深入的定性采访，分为HIV阳性和HIV阳性两种艾滋病毒阴性/未意识到未使用PrEP的个人。我们将重点关注关于TasP采用的三个立场我们发现这在我们初步数据中是常见的，并映射到PAPM的关键阶段：TASP 怀疑者(不相信TasP的有效性)，TasP的信徒(了解TasP是有效的但不愿意依赖它)和TasP采用者(依赖该策略的人)。放映我们将用来招募面试参与者的调查将提供有关TASP采用的其他阶段的进一步数据 (意识、感知有效性、使用意愿和实际使用)在更大和更多样化的样本中参与者(包括PrEP用户)。具体目标是：1.检验(用定性访谈数据) 与MTSM感知的TasP有效性以及他们依赖TasP的意愿相关的因素。2.至了解(使用定性访谈数据)使用TasP的MTSM的经历、他们如何使用策略，以及它如何影响他们的性行为和决定。3.描述(用筛子调查数据) TASP采用不同阶段MTSM的特点(意识、感知有效性、使用意愿和实际使用)。4.开始制定干预措施以纠正误解关于TasP，克服使用障碍，并教育MTSM如何最有效地使用预防策略。