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

在美国的任何一个晚上，每10个18-25岁的年轻人中就有一个无家可归。最高的艾滋病毒风险 群体经历无家可归的情况不成比例。然而，叶缺乏艾滋病毒预防的机会，包括高度 暴露前和暴露后有效的预防药物(即PrEP、nPEP)。物质使用和压力 对艾滋病毒风险产生负面影响。压力会导致无公寓的性行为、更多的性伴侣和物质使用 这一比例是寄宿青年的两倍。My-Ride，是一款移动健康干预工具，可响应 提供个性化消息传递和行为反馈的生态即时评估。试点数据 发现我的顺风车减少了吸毒、性冲动和压力。这项研究将充分测试我的- 通过进行一项随机注意力控制试验来骑行。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。vbl.使用 激励性访谈和共享决策方法、护士引导和按需会议帮助 尽管他们的住房条件不稳定，叶仍然从事艾滋病毒预防工作。是的，接受个性化服务 解决当前艾滋病毒风险因素以及药物使用、精神健康和 住房。目标1：确定与注意力控制青少年相比，我的顺风车是否减少了药物使用 320例，年龄18~25岁，3、6、12个月。目标2：确定我的顺风车是否会增加艾滋病毒 与注意力控制青少年相比，预防策略(避孕套使用、PrEP摄取、减少性传播感染)。 探索性目标1：评估我的顺风车对服用PrEP的意愿、压力、物质使用冲动和 与注意力控制青少年相比，心理健康和物质使用服务的使用情况。这是一项创新 研究将护士指导的咨询与吉泰技术相结合，在医院提供个性化的预防支持 紧要关头。My-Ride是一种高度可扩展的干预措施，可将覆盖范围扩大到断开连接的 并有助于提供艾滋病毒预防干预措施，超越获得护理的障碍。

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.