Developing and Pilot Testing Peer Ambassador Stories for Increasing HIV-Prevention and Behavioral Health Treatment Uptake among Latino MSM

项目摘要 背景资料。迈阿密是艾滋病毒高发区，原因是与男性发生性关系的拉丁裔男子之间的艾滋病毒差异 (LMSM)。行为健康问题(例如，精神健康、药物使用)有助于艾滋病毒的感染、形成 协同效应差异。然而，被证实的艾滋病毒预防干预措施(例如，预防前)对拉丁裔MSM的接触不足 暴露预防)和行为健康治疗。母公司K23正在开发和试运行 实施战略(DIME MáS)，以扩大预防接种计划、艾滋病毒检测和行为健康的覆盖面 LMSM的治疗。根据PI的初步数据，拟议的补编寻求开发和试点 测试另一种利用LMSM同行影响力的实施战略，以扩大PrEP的覆盖范围， 对LMSM进行艾滋病毒检测和行为健康治疗。推进健康差距科学，实现 结束艾滋病毒流行目标，需要有针对性的执行战略，以确保公平交付 向LMSM提供预防接种计划、艾滋病毒检测和行为健康服务。研究策略。目标1：识别LMSM 同行大使故事的内容和设计的优先事项。根据我的初步数据，我预计 同行大使故事将是一个应用程序/网站/论坛，展示LMSM的个人故事 预科和行为健康治疗。用户将通过观看同行故事和潜在的 在平台内与同行聊天。形成性研究的两个阶段的结果(访谈和戏剧 使用LMSM进行测试)将用于提炼同行大使的故事，并开发用于 试飞测试。目标2：试点测试同行大使的故事。建立在父K23的基础上，该公司正在进行 试行测试将DIME MáS与标准外展(对照)进行比较，我将利用拟议的补充内容添加一个 试点试验的第三个武器：同行大使的故事。LMSM将以1：1：1的比例随机分配给每种情况 (n=90，约50%在美国出生)。增刊将评估同伴故事与对照(和一角硬币)之间的影响 MáS VS对照)通过检查PrEP、艾滋病毒检测和行为健康吸收 小组和探索作用的机制。我们还将审查与以下方面相关的执行成果 通过离职访谈和调查的同行故事(例如，适当性、可接受性、可行性、成本) 参加者和外展工作人员。结果。拟议的补充方案将支持母公司K23，即 制定和试行检测DIME MáS，这是一项扩大预防接种计划覆盖范围的执行战略，艾滋病毒检测， 通过添加健壮的对等组件，向LMSM提供行为健康服务。如果只有同龄人的故事 可以接受并导致更多人接受，K23将产生两个战略，以扩大在 LMSM，它是密集型的，也是不那么密集型的，但潜在地更具可扩展性，以减少资源 设置。这些发现将为随后的R01有效性-实施试验奠定基础，进一步 增进对LMSM差距的这些实施战略的科学知识。本副刊 将确定实现LMSM艾滋病毒和行为健康公平的战略，与EHE计划保持一致。

Project Summary Background. Miami is an HIV hotspot, driven by HIV disparities among Latino men who have sex with men (LMSM). Behavioral health problems (e.g., mental health, substance use) contribute to HIV acquisition, forming synergistic disparities. Yet, Latino MSM are underreached by proven HIV-prevention interventions (e.g., pre- exposure prophylaxis) and behavioral health treatments. The parent K23 is developing and pilot testing an implementation strategy (Dime Más) to increase the reach of PrEP, HIV testing, and behavioral health treatment to LMSM. Informed by the PI's preliminary data, the proposed supplement seeks to develop and pilot test another implementation strategy, which leverages LMSM peer influence, to enhance the reach of PrEP, HIV testing, and behavioral health treatment to LMSM. To advance health disparities science and achieve the Ending the HIV Epidemic goals, tailored implementation strategies are needed to ensure the equitable delivery of PrEP, HIV testing, and behavioral health services to LMSM. Research Strategy. Aim 1: Identify LMSM priorities for the content and design of the peer ambassador stories. From my preliminary data, I anticipate that the peer ambassador stories will be an app/website/forum that shows LMSM's personal stories of obtaining PrEP and behavioral health treatments. Users will interface by watching the peer stories and potentially chatting with peers within the platform. Results of two phases of formative research (interviews and theater tests with LMSM) will be used to refine the peer ambassador stories and develop the final module to be used in the pilot test. Aim 2: Pilot test the peer ambassador stories. Building on the parent K23, which is conducting a pilot test comparing Dime Más to standard outreach (control), I will utilize the proposed supplement to add a third arm to the pilot trial: the peer ambassador stories. LMSM will be randomized 1:1:1 to each condition (N=90, ~50% U.S. born). The supplement will evaluate the impact of the peer stories vs. control (and Dime Más vs. control) on health disparities by examining PrEP, HIV testing, and behavioral health uptake across groups and exploring mechanisms of effects. We will also examine implementation outcomes associated with the peer stories (e.g., appropriateness, acceptability, feasibility, cost) via exit interviews and surveys with participants and outreach workers. Outcomes. The proposed supplement will bolster the parent K23, which is developing and pilot testing Dime Más, an implementation strategy to enhance the reach of PrEP, HIV testing, and behavioral health services to LMSM, by adding a robust peer component. If the peer stories alone are acceptable and lead to increased uptake, the K23 will generate two strategies for increasing reach among LMSM, one which is intensive and one which is less intensive but potentially more scalable to lower resource settings. The findings will lay the foundation for a subsequent R01 effectiveness-implementation trial, further advancing scientific knowledge about these implementation strategies on LMSM disparities. This supplement will identify strategies for achieving HIV and behavioral health equity for LMSM, aligned with the EHE plan.