RFA-PS-23-001 - Project PrOVIDE: PrEP Optimization Via Implementation, Dissemination, and Evaluation

项目总结 在美国，在接触前预防(PrEP)预防艾滋病毒方面存在显著差异 与男性相比，女性在PrEP使用者中所占的比例低得不成比例。60%的新艾滋病毒 女性中的确诊病例发生在黑人顺性女性中。PrEP护理的每一步都存在挑战 连续不断的，包括难以识别最有可能感染艾滋病毒的黑人顺性女性 受益于PrEP，妇女自身对艾滋病毒风险的自我认知较低，PrEP知识水平较低，以及 准备开始和坚持不懈。虽然越来越多的人了解干预措施以增加PrEP 在与男性发生性关系的男性和变性人女性中使用，对成功的了解要少得多 实施战略，以增加接受和支持在黑人顺性妇女中的PrEP持久性。 我们团队的初步混合方法工作确定了黑人顺性别的PrEP实施策略 妇女包括：对患者的常规PrEP教育，标准化的提供者培训，电子医疗 记录工具、PrEP导航、临床冠军和mHealth工具。我们建议调整、实施和 评估这些策略对改善黑人顺性女性PrEP连续护理结果的影响 在美国六个县使用实施科学研究方法。准备实施计划 将指导战略选择和确定新的执行战略。我们团队提出了以下建议 目标：目标1：确定、选择和调整使黑人妇女参与PrEP护理的实施战略 在EHE优先地区(中西部、北部、南部)的六个诊所环境中的连续性。目标2：确定有效性 通过以下途径提供六个诊所的黑人顺性女性PrEP感染情况的实施策略 一项杂交II型研究设计。目标3：评估和记录执行成果，并报告关键障碍 以及与使用RE-AIM成功执行执行战略有关的促进者 框架。

PROJECT SUMMARY Significant disparities in pre-exposure prophylaxis (PrEP) for HIV prevention exist in the U.S. with cisgender women making up a disproportionately low percentage of PrEP users compared to men. 60% of new HIV diagnoses among women are among Black cisgender women. Challenges exist at each step of the PrEP care continuum, including difficulty identifying Black cisgender women at highest risk for HIV who are most likely to benefit from PrEP, women’s own low self-perception of HIV risk, low levels of PrEP knowledge, and barriers to PrEP initiation and persistence. While there has been growing knowledge of interventions to increase PrEP use among men who have sex with men and transgender women, much less is known about successful implementation strategies to increase uptake and support PrEP persistence among Black cisgender women. Our team’s preliminary mixed methods work identified PrEP implementation strategies for Black cisgender women consisting of: routine PrEP education for patients, standardized provider training, electronic medical record tools, PrEP navigation, clinical champions, and mHealth tools. We propose to adapt, implement, and evaluate the impact of these strategies to improve PrEP care continuum outcomes for Black cisgender women across six counties in the U.S. using implementation science research methods. PrEP implementation planning will guide strategy selection and identification of new implementation strategies. Our team proposes the following aims: AIM 1: Identify, select, and adapt implementation strategies for engaging Black women in the PrEP care continuum in six clinic settings in EHE priority areas (midwest, north, south). AIM 2: Determine the effectiveness of PrOVIDE implementation strategies on PrEP uptake among Black cisgender women across six clinic sites via a hybrid type II study design. AIM 3: Assess and document implementation outcomes and report on key barriers and facilitators related to successful implementation of the implementation strategies using the RE-AIM framework.