Tailoring Delivery of LongActing PrEP for Cisgender (MSM) who Use Methamphetamine

为使用甲基苯丙胺的顺性别 (MSM) 量身定制长效 PrEP

• 批准号: 10760968
• 负责人: Vanessa McMahan
• 金额: $ 18.31万
• 依托单位: PUBLIC HEALTH FOUNDATION ENTERPRISES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10760968
• 关键词: AIDS prevention; Adherence; Appointment; Behavioral; Cities; Code; Data; Data Collection; Development; Effectiveness; Ensure; Equity; Evaluation; Formulation; Frequencies; Future; HIV; HIV Infections; HIV Seronegativity; HIV risk; Heterogeneity; Hour; Housing; Implant; Incentives; Inequity; Injections; Intervention; Interview; Location; Methamphetamine; Modality; Modeling; Morbidity - disease rate; Oral; Participant; Patient Recruitments; Patients; Phase; Population; Prevalence; Prevention strategy; Provider; Reporting; Research; Risk; Sampling; San Francisco; Services; Site; Source; Subgroup; Surveys; System; Time; United States; Work; cis-male; cisgender; cognitive interview; condomless anal sex; experience; experimental study; follow-up; forgetting; health disparity; high risk; informant; interest; medication compliance; men who have sex with men; methamphetamine use; mortality; novel; pre-exposure prophylaxis; preference; prevent; programs; public health relevance; service providers; social stigma; statistics; subcutaneous; therapy development; transgender women; truvada; uptake

PROJECT SUMMARY/ABSTRACT Methamphetamine (MA) use and related morbidity and mortality are rapidly increasing in the United States. MA use disproportionately impacts cisgender men who have sex with men (MSM) and is strongly associated with increased risk for HIV acquisition. MA use is also associated with suboptimal pre-exposure prophylaxis (PrEP) adherence, diminishing the benefit of daily, oral PrEP for HIV prevention among MSM who use MA. Long- acting (LA) PrEP is a promising prevention strategy for MSM who use MA, since its effectiveness does not rely on daily medication adherence. In December 2021, long acting cabotegravir (CAB LA) PrEP received FDA approval, after it was found to be superior to daily, oral Truvada. There are other LA PrEP agents in earlier stages of development, including biannual injections and subdermal implants. To help ensure that populations at highest risk for HIV effectively engage in LA PrEP programs, we will assess interest in different LA PrEP formulations, and facilitators, barriers, and preferences for delivery of CAB LA PrEP among MSM who use MA. We will assess the level of interest and correlates of interest in different LA PrEP formulations among MSM who use MA via the 2023 National HIV Behavioral Surveillance (NHBS) survey at five of the western US sites (San Francisco and San Diego, CA; Portland, OR; Seattle, WA; and Denver, CO) (Aim 1). We will explore multilevel (i.e., on the patient, provider, and system level) barriers to and facilitators of LA PrEP use and important attributes of CAB LA PrEP delivery through in-depth interviews (Aim 2). We will interview up to 40 HIV-negative MSM who use MA (up to 20 who have never taken PrEP and 20 who have) and up to 20 key informants (e.g., clinicians, service providers). We will identify important attributes and levels for LA PrEP delivery across interviews to inform a subsequent discrete choice experiment (DCE). Prior to the DCE we will conduct 10 cognitive interviews to ensure that the DCE inputs accurately capture the perspectives shared during the initial interviews. We will then conduct a DCE (Aim 3) to identify preferences for CAB LA PrEP delivery among MSM who use MA using the final attributes and levels from Aim 2. Our findings will inform engagement of MSM who use MA in LA PrEP programs and the development of an intervention that will be evaluated in a future trial.

项目总结/摘要 在美国，甲基苯丙胺的使用和相关的发病率和死亡率正在迅速增加。马 使用不成比例地影响与男性发生性关系的顺性别男性（MSM），并与以下因素密切相关： 增加感染艾滋病毒的风险。MA的使用也与暴露前预防（PrEP）不佳相关 坚持，减少每日口服PrEP对使用MA的MSM预防艾滋病毒的益处。长- 代理（LA）PrEP是使用MA的MSM的一种有前途的预防策略，因为其有效性不依赖于 每天坚持服药。2021年12月，长效cabotegravir（CAB LA）PrEP获得FDA 在发现其优于每日口服Truvada后获得批准，因为它比每日口服Truvada更上级。早些时候还有其他洛杉矶的准备工作人员 发展阶段，包括一年两次注射和皮下植入。 为了帮助确保艾滋病毒高风险人群有效参与LA PrEP计划，我们将评估 对不同LA PrEP制剂的兴趣，以及CAB LA提供的促进者、障碍和偏好 使用MA的MSM中的PrEP。我们将评估不同LA的兴趣水平和相关性 通过2023年国家艾滋病毒行为监测（NHBS）调查，使用MA的MSM中的PrEP制剂 在美国西部的五个地点（加利福尼亚州的旧金山弗朗西斯科和圣地亚哥;俄勒冈州的波特兰;华盛顿州的西雅图;和丹佛， （目标1）。我们将探索多层次（即，在患者、提供者和系统层面上）， LA PrEP使用的促进者和CAB LA PrEP交付的重要属性通过深入访谈（Aim 2）的情况。我们将采访多达40名使用MA的HIV阴性MSM（多达20名从未服用过PrEP，20名从未服用过PrEP）。 谁有）和多达20个关键线人（例如，临床医生、服务提供者）。我们将确定重要属性 和水平的LA PrEP交付的采访，以告知随后的离散选择实验（DCE）。 在DCE之前，我们将进行10次认知访谈，以确保DCE输入准确地捕捉到 在最初的采访中分享的观点。然后，我们会进行一项发展成效评估（目的3）， 在使用MA的MSM中使用目标2的最终属性和级别进行CAB LA PrEP交付。我们的研究结果 将告知在LA PrEP计划中使用MA的MSM的参与以及干预措施的制定， 将在未来的试验中进行评估。