Assessing the use of MY-RIDE, a just-in-time adaptive intervention, to Improve HIV prevention and Substance Use in Youth Experiencing Homelessness

评估 MY-RIDE（一种及时适应性干预措施）的使用情况，以改善无家可归青少年的艾滋病毒预防和药物使用

• 批准号: 10836097
• 负责人: Diane M. Santa Maria
• 金额: $ 72.9万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 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 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10836097
• 关键词: AIDS prevention; Accounting; Address; Attention; Behavioral; Caring; Communities; Counseling; County; Data; Detection; Discrimination; Drug usage; Ecological momentary assessment; Eligibility Determination; Epidemic; Face; Feedback; Geography; Goals; HIV; HIV disparities; HIV risk; Health; Health Care Costs; Health Insurance; Health Services Accessibility; Health Status; Health Technology; Healthcare; Heterosexuals; Homelessness; Housing; Hybrids; Infection; Intervention; Investments; Lead; Life Experience; Mental Health; Mental Health Services; Modeling; Motivation; Nurses; Personal Satisfaction; Pharmaceutical Preparations; Population; Prevalence; Prevention; Prevention strategy; Prophylactic treatment; Randomized; Reporting; Risk; Risk Factors; Services; Sexual Partners; Shelter facility; Stress; Technology; Testing; Time; Transcend; Transportation; Unsafe Sex; Wait Time; Youth; adaptive intervention; aged; attentional control; children of color; condoms; cost; design; digital health; digital intervention; emotion dysregulation; experience; health care service utilization; health equity; high risk; housing instability; implementation trial; improved; individualized prevention; innovation; mHealth; marginalization; meetings; men; mental disorder diagnosis; mobile computing; motivational enhancement therapy; pre-exposure prophylaxis; prevent; prevention service; preventive intervention; randomized trial; screening; service delivery; sex; shared decision making; skills; social determinants; social health determinants; social stigma; substance use; time use; transgender; uptake; willingness; young adult; young men who have sex with men; young woman

On any given night in the U.S., one in 10 youth aged 18-25 experience homelessness. The highest HIV risk groups disproportionately experience homelessness. Yet, YEH lack access to HIV prevention including highly effective pre- and post-exposure prophylaxis medications (i.e., PrEP, nPEP). Substance use and stress negatively impact HIV risk. Stress contributes to condomless sex, more sexual partners, and substance use with rates being twice that of housed youth. MY-RIDE, is a mobile health intervention that responds to Ecological Momentary Assessments to deliver personalized messaging and behavioral feedback. Pilot data found that MY-RIDE decreased drug use, sexual urges, and stress among YEH. This study will fully test MY- RIDE by conducting a randomized attention-controlled trial. MY-RIDE addresses HIV risk and its antecedents in real-time using messages developed using the Information-Motivation-Behavioral Skills model. Using Motivational Interviewing and Shared Decision Making approaches, nurse-led and on-demand sessions help YEH engage in HIV prevention despite their unstable housing circumstances. YEH receive personalized mobile messages that address their current HIV risk factors as well as substance use, mental health, and housing. Aim 1: Determine whether MY-RIDE decreases substance use compared to attention control youth (N=320; aged 18-25 years) at 3, 6, and 12 months. Aim 2: Determine whether MY-RIDE increases HIV prevention strategies (condom use, PrEP uptake, reduced STIs) when compared to attention control youth. Exploratory Aim 1: Evaluate MY-RIDE effects on willingness to take PrEP, stress, substance use urge, and use of mental health and substance use services when compared to attention control youth. This innovative study combines nurse-led counseling with JITAI technology to deliver personalized prevention supports at the time of heightened need. My-RIDE is a highly scalable intervention that increases reach to a disconnected population and facilitates delivery of an HIV prevention intervention that transcends barriers to access to care.

在美国的任何一个晚上，十分之一的 18 至 25 岁青少年都会无家可归。艾滋病毒风险最高 群体中不成比例地经历过无家可归的经历。然而，YEH 缺乏艾滋病毒预防措施，包括高度 有效的暴露前和暴露后预防药物（即 PrEP、nPEP）。物质使用和压力 对艾滋病毒风险产生负面影响。压力会导致无套性行为、更多性伴侣和药物滥用 其比率是被安置的年轻人的两倍。 MY-RIDE 是一种移动健康干预措施，可响应 生态瞬时评估可提供个性化的消息传递和行为反馈。试点数据 发现 MY-RIDE 减少了 YEH 的吸毒、性冲动和压力。这项研究将全面测试 MY- 通过进行随机注意力对照试验来 RIDE。 MY-RIDE 解决艾滋病毒风险及其前因 实时使用使用信息-动机-行为技能模型开发的消息。使用 动机性访谈和共同决策方法、护士主导的按需课程会有所帮助 尽管住房条件不稳定，YEH 仍致力于艾滋病毒预防。 YEH 接收个性化 解决他们当前的艾滋病毒风险因素以及物质使用、心理健康和 住房。目标 1：确定与注意力控制青少年相比，MY-RIDE 是否减少物质使用 （N=320；年龄 18-25 岁）3、6 和 12 个月时。目标 2：确定 MY-RIDE 是否会增加 HIV 感染 与注意力控制青少年相比，预防策略（使用安全套、接触 PrEP、减少性传播感染）。 探索性目标 1：评估 MY-RIDE 对服用 PrEP 的意愿、压力、物质使用冲动和 与注意力控制青少年相比，他们使用心理健康和药物使用服务。这种创新的 研究将护士主导的咨询与 JITAI 技术相结合，为患者提供个性化的预防支持 需求增加的时间。 My-RIDE 是一种高度可扩展的干预措施，可扩大对离线地区的覆盖范围 人口并促进艾滋病毒预防干预措施的实施，克服获得护理的障碍。