Identifying preferences for receiving HIV prevention services among GBMSMs and for providing HIV prevention services among HCPs who are active-duty service members

确定 GBMSM 中接受艾滋病毒预防服务的偏好以及现役军人 HCP 中提供艾滋病毒预防服务的偏好

基本信息

项目摘要

PROJECT SUMMARY The proposed research project addresses an important gap in HIV prevention by applying innovative methods to help bolster uptake of HIV Pre-Exposure Prophylaxis (PrEP), as well as identify ways to improve the delivery of sexual health services among active-duty service members in the US military who are at most risk for HIV acquisition: gay, bisexual, and other men who have sex with men (GBMSM). Annually, the military diagnoses approximately 350 new HIV infections, with 236 new HIV infections occurring in 2020, and another 433 new infections diagnosed between January 1, 2021, through June 30, 2022. HIV PrEP is a highly effective prevention strategy, currently underutilized by active-duty service members. When taken as directed, PrEP is ~99% effective at reducing HIV-seroconversion in at-risk populations, such as GBMSM. Despite authorization to provide PrEP and related care free of cost, PrEP uptake among active-duty service members is low. Prior research has noted psychosocial barriers, such as stigma, may exist from residuals of the ‘Don’t Ask, Don’t Tell’ policy era that emphasized hiding one’s identity as a lesbian, gay, bisexual, or transgender (LGBT) and engagement in same-sex behaviors. Other factors may impede uptake-provision of PrEP, such as one’s comfort level of discussing sex-related topics and identifying whether someone is a candidate for PrEP. Currently, there is limited data describing what factors affect active-duty service members’ demand for PrEP and what factors influence providers’ willingness to prescribe it. The proposed project – from a promising doctoral student with a strong mentorship team – will apply an exploratory sequential mixed-method preference-based study to identify how best to bolster the uptake-delivery of sexual health and HIV prevention, including PrEP, among GBMSM and healthcare providers (HCP) who are active-duty service members in the US military. The integrated behavioral model (IBM) will guide the study to accomplish the proposed Specific Aims: (1) Qualitatively explore preferences for receiving sexual health services, including PrEP, among active-duty GBMSM and explore preferences for receiving sexual health services, including PrEP, among active-duty HCP service members. (2) Quantitatively identify, describe, and compare HIV/STI prevention program preferences among active-duty GBMSM and active-duty HCPs using Choice-Based Conjoint and MaxDiff preference-based methods. Findings from this timely, innovative project will identify ways to tailor sexual health services to the individual’s risk profile, merge overlapping concepts from the patient and provider perspective, facilitate more patient-centered provision of sexual health services, and optimize PrEP uptake among GBMSM service members, and PrEP provision among HCPs in the military.
项目摘要 拟议的研究项目通过应用创新方法来帮助解决艾滋病毒预防方面的一个重要差距, 加强对艾滋病毒暴露前预防(PrEP)的接受,并确定改善性健康服务的方法 美国军队中最有可能感染艾滋病毒的现役军人:同性恋,双性恋, 和其他与男性发生性关系的男性(GBMSM)。每年,军方诊断出大约350名新的艾滋病毒感染者, 感染,2020年新增236例艾滋病毒感染,1月1日至2019年1月30日期间确诊433例新感染, 2021年,至2022年6月30日。艾滋病毒PrEP是一种非常有效的预防策略,目前未被现役部队充分利用 服务成员。当按指示服用时,PrEP在降低高危人群中的HIV血清转化方面的有效性约为99%, 例如GBMSM。尽管授权免费提供PrEP和相关护理, 服务人员低。先前的研究已经注意到,心理障碍,如耻辱,可能存在于残留的 “不问,不说”政策时代,强调隐藏自己作为女同性恋,男同性恋,双性恋或变性人的身份 (LGBT)和参与同性行为。其他因素可能会阻碍PrEP的摄入,例如 讨论与性有关的话题并确定某人是否是PrEP的候选人的舒适度。目前, 有限的数据描述了哪些因素影响现役军人对PrEP的需求以及哪些因素影响 提供者的意愿规定它。拟议的项目-从一个有前途的博士生与强大的导师 团队-将采用探索性的顺序混合方法偏好为基础的研究,以确定如何最好地支持 在GBMSM和医疗保健提供者中接受性健康和艾滋病毒预防,包括PrEP 他们是美国军队中的现役军人。综合行为模型(IBM)将指导研究, 实现拟议的具体目标:(1)定性研究接受性健康服务的偏好, 包括PrEP,在现役GBMSM中,并探索接受性健康服务的偏好,包括PrEP, 在现役医护人员中(2)量化识别、描述和比较艾滋病毒/性传播感染预防 现役GBMSM和现役HCP之间使用基于选择的联合和最大差异的程序首选项 基于偏好的方法。这个及时的创新项目的结果将确定量身定制性健康服务的方法 个人的风险状况,从患者和提供者的角度合并重叠的概念, 以患者为中心提供性健康服务,并优化GBMSM服务成员的PrEP摄取,以及 PrEP在军队中的HCP中提供。

项目成果

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