Characterizing the HIV pre-exposure prophylaxis care continuum for African American and Hispanic/Latino men who have sex with men

描述非裔美国人和男男性行为西班牙裔/拉丁裔男性的艾滋病毒暴露前预防护理连续性

• 批准号: 10206014
• 负责人: Philip Andrew Chan
• 金额: $ 64.28万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10206014
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; African American; Behavioral; Benchmarking; Bisexual; Blood; Caring; Categories; Clinical; Continuity of Patient Care; Data; Deep South; Development; Drops; Enrollment; Epidemic; Epidemiology; FDA approved; Future; Gays; Geographic Locations; Geography; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; Hispanics; Incidence; Individual; Intervention; Interview; Latino; Longitudinal cohort; Longitudinal cohort study; Measurement; Measures; Midwestern United States; Mississippi; Missouri; Modeling; Outcome; Patients; Population; Prospective cohort; Publishing; Rhode Island; Risk; Seasons; Site; Spottings; Structure; Testing; Time; United States; Ursidae Family; Visit; Work; adherence rate; base; behavior change; black men who have sex with men; burden of illness; care outcomes; clinical infrastructure; clinical research site; cohort; disparity reduction; experience; improved; inner city; men who have sex with men; pre-clinical; pre-exposure prophylaxis; prevent; primary outcome; programs; prospective; psychosocial; racial and ethnic disparities; retention rate; social; therapy design; transmission process; uptake

PROJECT SUMMARY Young African American (AA) and Hispanic/Latino (H/L) MSM bear a disproportionate share of the HIV disease burden in the United States (US). Pre-exposure prophylaxis (PrEP) is highly effective in reducing HIV acquisition risks among MSM, but its ability to reduce HIV acquisition among AA and H/L MSM hinges on optimal implementation and expanded use in “real-world” clinical settings. Preliminary studies demonstrate that AA and H/L initiate PrEP and are retained in PrEP care at lower rates than their White counterparts, but little is known about longer-term adherence and retention in PrEP care among AA and H/L MSM. The manner in which structural, social, and individual level factors impact PrEP outcomes in real-world settings, particularly among young AA and H/L MSM, are not yet well understood. MSM who initiate PrEP may change behaviors (e.g., enter a monogamous relationship with an HIV negative partner) and no longer be indicated for PrEP. Furthermore, it is largely unknown why individuals, especially AA and H/L MSM, are not retained in PrEP care which complicates development of appropriate interventions to enhance retention in PrEP care. This proposed study follows a longitudinal, observational cohort (n=450) of White, AA and H/L MSM in real-world PrEP programs in Mississippi, Missouri, and Rhode Island to both characterize a PrEP care continuum and predict why MSM are sub-optimally adherent or lost to care, with a focus on measuring racial and ethnic disparities (Specific Aim 1). We will conduct individual interviews with MSM who are prescribed PrEP but sub-optimally adherent or drop out of PrEP care (Specific Aim 2) to elucidate reasons for sub-optimal adherence and retention and to identify components of potential interventions to improve adherence and retention in care. Using data from our longitudinal cohort, we will perform microsimulations in the context of an agent-based model to evaluate the impact of sub-optimal PrEP adherence and retention in care on HIV incidence in three diverse US settings. We will then predict the impact of potential interventions on PrEP care continuum outcomes (Specific Aim 3).

项目总结