Increasing HIV/STI Home Testing, Linkage to Care, and Linkage to PrEP via a Digital Intervention among Black Women in a Geographic Hotspot

通过对地理热点地区黑人妇女进行数字干预，增加 HIV/STI 家庭检测、与护理的联系以及与 PrEP 的联系

• 批准号: 10328173
• 负责人: Liesl A Nydegger
• 金额: $ 24.95万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10328173
• 关键词: Accounting; Adoption; Appointment; Behavior; Behavioral; Behavioral Model; COVID-19 pandemic; Caring; Centers for Disease Control and Prevention (U.S.); Clinic; Communities; Contracts; County; Diagnosis; Diagnostic Reagent Kits; Discrimination; Early Diagnosis; Emergency department visit; Environmental Impact; Epidemic; Ethnic Origin; Evaluation; Failure; Focus Groups; Fright; Future; Geography; Goals; HIV; HIV Seropositivity; HIV diagnosis; HIV risk; High Risk Woman; Home; Hour; Human immunodeficiency virus test; Income; Infection; Intervention; Lead; Link; Location; Low income; Medical; Medical Care Costs; Methods; Modeling; Motivation; Online Systems; Outcome; Participant; Persons; Phase; Population; Preventive service; Protocols documentation; Psyche structure; Race; Randomized; Research; Risk; Self Efficacy; Sexually Transmitted Diseases; Structure; Symptoms; Testing; Texas; Time; Transportation; Treatment Cost; Underserved Population; Woman; acceptability and feasibility; austin; base; black women; community partnership; cost; digital intervention; economic impact; efficacy trial; field study; follow up assessment; follow-up; high risk; home test; infection rate; innovation; pre-exposure prophylaxis; prevent; racial disparity; risk perception; screening; sexual HIV transmission; skills; social; social stigma; therapy design; transmission process; trend; virtual; web-based assessment; web-based intervention

PROJECT SUMMARY: In Travis County, Texas, deemed a HIV geographic hotspot due to high HIV rates, Black women are 18.4 times more likely to contract HIV compared to women of other races/ethnicities. Black women also have higher rates of sexually transmitted infections (STIs) than other women; many STIs have no symptoms, are undiagnosed, and are untreated. Having an STI triples one's risk for contracting HIV. In Travis County, over 20% of women learned one year after contracting HIV that they were HIV-positive, highlighting barriers to testing. Home HIV/STI testing has promise to increase rates of testing by circumventing barriers and thereby reduce medical costs through early detection and care. Home HIV/STI testing is also a prime opportunity to link Black women at high risk for HIV to pre-exposure prophylaxis (PrEP). Yet, home testing alone may not overcome all barriers. Pairing home testing with an intervention designed to increase motivation and overcome barriers has the most promise to increase HIV/STI testing rates. The proposed project draws on 3 components, the situated, information-motivation-behavioral (sIMB) model, mental contrasting, and implementation intentions to develop a new, web-based intervention. This intervention is comprised of 5 sessions: 1) using the HIV/STI home testing kit, 2) mailing in the kit, 3) checking results, 4) obtaining treatment, and 5) attending an appointment for PrEP. Each session is structured the same: information regarding the importance of each behavior (i.e., taking the home test, mailing in the test, checking results, linkage to care, and linkage to PrEP), motivation via mental contrasting (identifying positive outcomes and barriers to each session) and methods to overcome the identified barriers (implementation intentions), and behavioral skills to increase self-efficacy. The project will occur in 3 phases that coincide with the aims to develop and culturally tailor the intervention. 1) Conduct formative research to develop the intervention. Four focus groups (n=4-6), with 24 Black women from Travis County will explore the constructs of sIMB, mental contrasting, and implementation intentions to develop the intervention protocol to be field tested in Aim 2. 2) Field test the intervention. We will test the preliminary feasibility and acceptability of the intervention with 6 participants to make any necessary adjustments for Aim 3. 3) Conduct a feasibility pilot of the intervention. We will determine the feasibility, acceptability, and preliminary efficacy among 60 Black women in Travis County. Participants will be randomly assigned to the intervention or a web-based educational control. We hypothesize that the intervention will be feasible, acceptable, and demonstrate a trend toward efficacy for completion of home testing, linkage to care, and linkage to PrEP. Follow-up web-based assessments will be administered 2-, 4-, and 6-months after baseline. The web-based design of the intervention greatly increases the opportunity for implementation on a large scale. The long-term goal is to increase HIV/STI testing among low-income Black women via scalable and sustainable methods to decrease HIV transmission and subsequent disparities.

项目概述：在德克萨斯州特拉维斯县，由于艾滋病毒感染率高，被视为艾滋病毒地理热点，