MyPEEPS Mobile Plus: A Multi-Level HIV Prevention Intervention for Young MSM

MyPEEPS Mobile Plus：针对年轻 MSM 的多层次 HIV 预防干预措施

• 批准号: 10818851
• 负责人: Robert Garofalo
• 金额: $ 116.46万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10818851
• 关键词: 18 year old; AIDS prevention; Address; Adherence; Age; Awareness; Behavior Therapy; Caring; Cellular Phone; Clinic; Communities; Computers; Data; Data Collection; Disparity; Education; Electronics; Enrollment; Epidemic; Face; Family; Feedback; HIV; HIV diagnosis; HIV risk; Health Personnel; Incidence; Intervention; Latino; Logistics; Manuals; Mediation; Methods; Participant; Persons; Population; Predisposition; Prevention program; Principal Investigator; Privatization; Provider; Public Health; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Risk; Risk Behaviors; Risk Reduction; Rural; Sampling; Sampling Studies; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Structure; Tablets; Testing; Time; United States; Youth; barrier to care; black men who have sex with men; care outcomes; condoms; cost; digital; efficacy evaluation; efficacy testing; emotion regulation; epidemiologic data; ethnic disparity; ethnic diversity; ethnic minority; evidence base; experience; future implementation; geographic disparity; group intervention; high risk; iterative design; mHealth; member; men who have sex with men; minority stress; peer; pre-exposure prophylaxis; preventive intervention; primary outcome; psychoeducation; psychoeducational; racial disparity; racial diversity; racial minority; response; satisfaction; scale up; sexual health intervention; side effect; skills; social stigma; theories; tool; treatment arm; uptake; virtual; young men who have sex with men

PROJECT SUMMARY Men who have sex with men (MSM), especially young Black and Latino MSM, have the highest rates of HIV diagnoses in the United States (US), illustrating the need for efficacious HIV prevention tools for these populations. In response to the burgeoning HIV epidemic in young MSM (YMSM), our study team adapted the theory-driven, group-level, evidence-based MyPEEPS intervention for diverse YMSM (R34MH079707; PI: Garofalo) into an mHealth intervention, MyPEEPS Mobile, to overcome challenges of an in-person group intervention. MyPEEPS Mobile is a sexual health intervention delivered through peer avatars whose personal backgrounds and sexual risk scenarios are composites derived from formative research among YMSM, which identified personal, family-based, and relational challenges influencing sexual health. The MyPEEPS Mobile Trial data have shown evidence of efficacy, feasibility, acceptability, and high satisfaction by participants 13-18 years of age. Despite very promising results, pre-exposure prophylaxis (PrEP) initiation to date over the course of the study has been extremely low in our sample (3%), which we partially attribute to a dearth of information on PrEP content in MyPEEPS Mobile and the very young age (13-18 years) of our study participants, for whom PrEP was not approved at the time of data collection. In response, our study team proposes to expand MyPEEPS Mobile to develop MyPEEPS Mobile Plus, a multi-level intervention comprised of MyPEEPS Mobile with added PrEP content (based upon expert advisory and youth feedback) + PrEP E-Peer Navigation to overcome the challenges of PrEP initiation, adherence, and persistence among YMSM. Peer navigation is an evidence-based, widely recommended intervention for reaching youth and MSM for HIV-related care outcomes, with evidence of acceptability among racial/ethnic minority YMSM for PrEP. Peer navigation addresses common reasons for failing to begin or maintain PrEP use, including low perceived risk, structural or logistic barriers to care engagement, and anticipated side effects. Relative to in-person and group-based HIV prevention programs, behavioral interventions with digital and virtual components can have vast reach and present unique potential to rapidly scale delivery to very large and hidden groups. Therefore, we propose to conduct a randomized controlled trial to test the efficacy of MyPEEPS Mobile Plus (a multi-level intervention comprised of MyPEEPS Mobile + PrEP E-Peer Navigation) for promoting initiation, adherence, and persistence of PrEP and decreased HIV risk behavior in YMSM. Building upon our team’s demonstrated ability to enroll large numbers of young racially and ethnically diverse YMSM and extensive experience developing mobile health interventions, the proposed study will test the efficacy of this expanded, multi-level mobile HIV prevention intervention emphasizing PrEP. If efficacious, it will increase PrEP initiation, adherence, and persistence and decrease overall HIV risk in diverse YMSM in the US.

项目概要 男男性行为者 (MSM)，尤其是年轻的黑人和拉丁裔 MSM，艾滋病毒感染率最高 美国 (US) 的诊断，说明需要有效的艾滋病毒预防工具 人口。为了应对年轻 MSM (YMSM) 中艾滋病毒流行的迅速蔓延，我们的研究团队调整了 针对不同 YMSM 的理论驱动、群体层面、基于证据的 MyPEEPS 干预（R34MH079707；PI： Garofalo）参与 mHealth 干预措施 MyPEEPS Mobile，以克服面对面小组的挑战 干涉。 MyPEEPS Mobile 是一种性健康干预措施，通过同伴化身提供，其个人 背景和性风险情景是从 YMSM 的形成性研究中得出的复合材料，其中 确定了影响性健康的个人、家庭和关系挑战。 MyPEEPS 手机 试验数据显示参与者的有效性、可行性、可接受性和高满意度的证据 13-18 岁数。尽管结果非常有希望，但迄今为止在整个过程中仍启动了暴露前预防 (PrEP) 在我们的样本中，这项研究的比例极低（3%），我们部分地将其归因于信息的缺乏 MyPEEPS Mobile 中的 PrEP 内容以及我们的研究参与者的非常年轻的年龄（13-18 岁），对于他们来说 PrEP 在数据收集时尚未获得批准。对此，我们的研究小组建议扩大 MyPEEPS Mobile 将开发 MyPEEPS Mobile Plus，这是一种由 MyPEEPS 组成的多层次干预措施 添加 PrEP 内容的移动设备（基于专家咨询和青少年反馈）+ PrEP E-Peer 导航 克服 YMSM 中 PrEP 启动、坚持和坚持的挑战。同行导航是 一项基于证据、广泛推荐的干预措施，旨在为青少年和男男性行为者提供艾滋病毒相关护理 结果，有证据表明少数族裔 YMSM 对 PrEP 的接受程度。同行导航 解决了未能开始或维持 PrEP 使用的常见原因，包括感知风险低、结构性或 护理参与的后勤障碍以及预期的副作用。相对于面对面和基于群体的艾滋病毒 预防计划、使用数字和虚拟组件的行为干预可以产生广泛的影响和影响 呈现出独特的潜力，可以快速向规模庞大且隐藏的群体提供服务。因此，我们建议 进行一项随机对照试验来测试 MyPEEPS Mobile Plus（一种多层次干预措施）的功效 由 MyPEEPS Mobile + PrEP E-Peer Navigation 组成），用于促进启动、坚持和 YMSM 中 PrEP 的持续性和 HIV 危险行为的减少。以我们团队所展示的能力为基础 招收大量年轻的种族和民族多元化的YMSM并拥有丰富的开发经验 移动健康干预措施，拟议的研究将测试这种扩展的、多层次的移动艾滋病毒的功效 预防干预强调PrEP。如果有效，它将增加 PrEP 的启动、依从性和 在美国不同的 YMSM 中持续存在并降低总体 HIV 风险。