PrEP US NoW: PrEP Utilization Through Increasing Social Capital Among YBMSM Networks with Women

PrEP 现在美国：通过增加 YBMSM 女性网络中的社会资本来利用 PrEP

• 批准号: 10325097
• 负责人: Latesha Ellen Elopre
• 金额: $ 26.55万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-23 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10325097
• 关键词: AIDS prevention; AIDS/HIV problem; Access to Information; Acquired Immunodeficiency Syndrome; Address; Adoption; Affect; African American; Alabama; Attitude; Behavior; Belief; Caring; Charge; Communication; Complex; Data; Development; Diagnosis; Elements; Emotional; Epidemic; Feedback; Financial Support; Funding; Geography; Guidelines; HIV; HIV diagnosis; Health; Health Promotion; Health behavior; Human immunodeficiency virus test; Individual; Intervention; Interview; Knowledge; Link; Maps; Measurement; Measures; Mobile Health Application; Modeling; Motivation; Outcome; Participant; Population; Prevention; Prevention approach; Prevention strategy; Process; Public Health; Randomized; Research; Research Priority; Resources; Respondent; Risk; Role; Sampling; Services; Sexual Health; Site; Social Network; Social support; Source; Strategic Planning; Structure; Surveys; Techniques; Testing; Time; Training; United States; United States National Institutes of Health; Woman; Work; acceptability and feasibility; arm; base; black men who have sex with men; black women; comparative; condomless anal sex; control trial; effective intervention; efficacy trial; evidence base; health knowledge; improved; insight; instrument; intervention mapping; mHealth; member; men; mobile application; novel; novel strategies; pilot trial; pre-exposure prophylaxis; programs; recruit; response; scale up; sexual identity; social capital; social norm; social stigma; tool; treatment arm; uptake; usability; virtual

PROJECT SUMMARY HIV, especially in the South, disproportionately affects young Black men who have sex with men (YBMSM). Development and implementation of effective interventions to scale up HIV pre-exposure prophylaxis (PrEP) are urgently needed in this population. Prior work has focused on individual-level approaches to increasing PrEP utilization, while social network-level approaches are comparatively underutilized. Individuals within social networks have access to social capital, which can yield emotional as well as instrumental resources that influence health behaviors. Black women represent a key source of social capital within YBMSM social networks, and this unique role has not been utilized in prior PrEP interventions. We propose to leverage YBMSM’s supportive connections with Black women to develop PrEP US NoW (PrEP Utilization through increasing Social Capital among YBMSM Networks with Women), a novel mobile health intervention that will engage Black women as facilitators in existing networks of YBMSM, as a way of enhancing social capital, decreasing intersectional stigma, and promoting PrEP uptake within the network. The proposal will pursue three specific aims: (1) Qualitatively evaluate core health-promoting elements of social capital bonds between YBMSM and Black women in extant social support networks; (2) Adapt an existing, evidence-based mHealth intervention to create PrEP US NoW; and (3) Evaluate feasibility and acceptability of PrEP US NoW, as well as preliminary efficacy to increase PrEP uptake among YBMSM, in a randomized-controlled pilot trial. For Aim 1, we will conduct qualitative interviews with n=20 YBMSM and n=20 Black women to gain insights into preferred attributes of Black woman facilitators, as well as feedback on intervention content and format. In Aim 2, we will develop the PrEP US NoW mobile app. The central feature of the PrEP US NoW intervention will be real-time, virtual discussions led by a trained Black woman facilitator, delivered to an existing network of YBMSM. Additional features and content will be refined based on our Aim 1 findings. We will conduct usability testing in an iterative process with both YBMSM and Black women. In Aim 3, we will randomize YBMSM networks (up to five members each), recruited using respondent driven sampling techniques, to the intervention (PrEP US NoW) or control study arm (mHealth app without social capital components). Participants (N=60) will complete validated surveys measuring social capital, internalized homonegativity, and PrEP uptake at baseline, 1-month, and at 3-months’ time. HIV testing will be done at baseline and at 3-months’ time. We will assess feasibility, acceptability, and preliminary efficacy. This study will be conducted in an epicenter of the Southern HIV epidemic: Alabama. Upon completion of our aims, we will have collected requisite preliminary data to inform a fully powered multi-site efficacy trial. The proposed research has strong potential to inform effective HIV prevention strategies among YBMSM in the South, leading to improved individual and public health outcomes aligned with national initiatives.

项目摘要 艾滋病毒，特别是在南方，不成比例地影响与男性发生性关系的年轻黑人男子（YBMSM）。 制定和实施有效的干预措施，以扩大艾滋病毒暴露前预防（PrEP）， 这是这一人群迫切需要的。先前的工作集中在个人层面的方法，以增加PrEP 利用率，而社会网络一级的办法相对利用不足。社会中的个人 网络可以获得社会资本，这可以产生情感和工具性资源， 健康行为。黑人妇女是YBMSM社交网络中社会资本的主要来源， 在先前的PrEP干预中未使用独特的作用。我们建议利用YBMSM的支持 与黑人妇女建立联系，以发展PrEP US NoW（通过增加社会资本来利用PrEP） 在YBMSM与妇女网络之间），这是一种新颖的移动的健康干预措施，将使黑人妇女参与其中， 促进者在现有的网络YBMSM，作为一种方式，加强社会资本，减少交叉 污名化，并促进网络内的PrEP吸收。该建议将追求三个具体目标：（1） 质量评估YBMSM和黑人之间社会资本纽带的核心健康促进要素 现有社会支持网络中的妇女;（2）调整现有的循证移动健康干预措施， PrEP US NoW;（3）评价PrEP US NoW的可行性和可接受性，以及对以下方面的初步疗效： 在一项随机对照试点试验中，增加YBMSM中PrEP摄取。对于目标1，我们将进行 对n=20名YBMSM和n=20名黑人女性进行定性访谈，以深入了解黑人女性的首选属性 妇女调解人，以及对干预内容和形式的反馈。在目标2中，我们将开发PrEP US NoW移动的应用程序。PrEP US NoW干预的中心特征将是实时虚拟讨论 由一名受过训练的黑人妇女主持人领导，提供给青年BMSM现有网络。附加特征和 内容将根据我们的目标1调查结果进行改进。我们将在迭代过程中进行可用性测试， YBMSM和黑人女性。在目标3中，我们将随机化YBMSM网络（每个网络最多五个成员）， 使用应答者驱动抽样技术招募干预（PrEP US NoW）或对照研究组 （没有社会资本成分的mHealth应用程序）。参与者（N=60）将完成经验证的调查， 社会资本、内化同负性和基线、1个月和3个月时的PrEP摄取。艾滋病毒 将在基线和三个月时进行测试。我们将评估可行性、可接受性和初步 功效这项研究将在南部艾滋病流行的中心：亚拉巴马进行。完成后 我们的目标是，我们将收集必要的初步数据，为充分的多中心疗效试验提供信息。 拟议的研究有很大的潜力，为青年BMSM提供有效的艾滋病毒预防策略。 南部，导致个人和公共卫生成果的改善与国家举措保持一致。