Addressing Key Issues in HIV Self-Testing Program Implementation for Black and Latino Men Who Have Sex with Men in the US South

摘要 美国南部黑人和拉丁裔男男性行为者(BLMSM)艾滋病毒感染率最高 这个国家的利率。增加对男男性行为者的艾滋病毒检测可能会减少新的艾滋病毒 在这一人群中，艾滋病的感染率很高，但南部的BLMSM人群中的定期检测率很低。HIV自我检测 (HST)，或艾滋病毒筛查设备的自我管理，是增加艾滋病毒检测的有效策略 在与男性发生性关系的男性中。然而，在美国南部的卫生环境中实施HST是 有限的。实施的一个可能障碍是计划规划者对BLMSM如何在 韩国人更喜欢访问HST，以及他们愿意支付多少钱。例如，尽管送货上门和同行 交付是在美国其他地方成功增加BLMSM使用HST的两项战略， 研究人员尚未确定南方的BLMSM更喜欢这些策略中的哪种，以及他们的 相应地愿意为每种策略买单。此外，总体上对促进者和 从公共卫生实施决策者的角度看启动HST项目的障碍 部门，艾滋病毒/性病检测诊所，以及美国南部的社区组织。在这 博士前奖学金，我将在几个州的BLMSM(N=300)中进行一个离散选择实验 在美国南部(路易斯安那州、密西西比州、佐治亚州、佛罗里达州)，以吸引这些人口对 几种HST交付策略，以及他们为每个项目支付的估计美元金额。这个 我将通过离散选择实验评估的交付策略是在药店零售购买， 送货上门和同伴送货。我还将就艾滋病毒预防进行半结构化访谈(N=30) 为美国南部BLMSM提供服务的各种卫生组织的项目决策者了解 HST实施的促进者和障碍。通过增加对HST实施的了解 从患者和提供者的角度来看，该项目将为启动 HST计划在受影响最严重的人群中降低艾滋病毒发病率 美国。

ABSTRACT Black and Latino men who have sex with men (BLMSM) in the US South have the highest HIV infection rates in the country. Increasing HIV testing among men who have sex with men may decrease new HIV infections in this population, yet rates of regular testing among BLMSM in the South are low. HIV self-testing (HST), or the self-administration of an HIV screening device, is an effective strategy to increase HIV testing among men whohave sex with men. However, HST implementation within health settings in the US South is limited. One possible barrier to implementation is program planners’ limited knowledge of how BLMSM in the South prefer to access HST and how much they would pay. For example, although home delivery and peer delivery are two strategies that successfully increase HST use among BLMSM elsewhere in the US, researchers have yet to determine which of these strategies BLMSM in the South prefer and their corresponding willingness to pay for each strategy. In addition, little overall is known about facilitators and barriers to initiating HST programs from the perspectives of implementation decisionmakers at public health departments, HIV / STD testing clinics, andcommunity-based organizations in the US South. In this predoctoral fellowship, I will conduct a discrete choice experiment among BLMSM (N=300) in several states in the US South (Louisiana, Mississippi, Georgia, Florida) to elicit this population’s relative preferences for several HST delivery strategies and an estimated dollar amount they would pay for each program. The delivery strategies I will evaluate through the discrete choice experiment are retail purchase at drugstores, home delivery, and peer delivery. I will also conduct semi-structured interviews (N=30) with HIV prevention program decisionmakers at various health organizations serving BLMSM in the US South to understand facilitators and barriers to HST implementation. By increasing the knowledge of HST implementation outcomes from the perspectives of patients and providers, this project will build a roadmap for the initiation of HST programs to decrease HIV incidence among one of the most disproportionately impacted populations in the US.