Developing a Patient Navigation Intervention for PrEP Continuum of Care among Young Latino MSM

为年轻的拉丁裔 MSM 制定患者导航干预措施，以实现 PrEP 连续护理

• 批准号: 9410944
• 负责人: Aaron J Blashill
• 金额: $ 19.78万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-10 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410944
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Age; Awareness; California; Caring; Consultations; Continuity of Patient Care; Contracts; Data; Development; Epidemic; Feedback; Future; Goals; HIV; HIV Infections; HIV diagnosis; Health Personnel; Health Professional; Healthcare; Healthy People 2020; Hispanics; Incidence; Individual; Intervention; Intervention Studies; Interview; Knowledge; Language; Latino; Linguistics; Medical; Methods; Outcome; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Phase; Population; Preparation; Process; Public Health; Randomized; Randomized Controlled Trials; Reporting; Risk; Schedule; Services; Tenofovir; Testing; United States Food and Drug Administration; black men who have sex with men; cost; design; efficacy trial; emtricitabine; follow-up; health care availability; health literacy; high risk men; improved; medical appointment; men who have sex with men; men' s group; peer; pre-exposure prophylaxis; programs; racial and ethnic; response; social cognitive theory; social stigma; therapy design; treatment as usual; trend; uptake; willingness; young adult

PROJECT SUMMARY Men who have sex with men (MSM) are the most at-risk group for contracting human immunodeficiency virus (HIV) in the U.S., comprising 67% of new HIV diagnoses in 2014. However, the HIV epidemic impacts some groups of MSM disproportionately. Latino MSM comprise 25.1% of new HIV infections among MSM between the ages of 13 and 29 years. The daily medication tenofovir/emtricitabine was approved by the Food and Drug Administration for pre-exposure prophylaxis (PrEP) in 2012 and has demonstrated strong efficacy in reducing the risk of HIV infection. When taken consistently, PrEP has been shown to reduce new incidence of HIV by 92%. Despite the promise of PrEP to transform HIV prevention, there remain significant barriers to PrEP use among those who would benefit the most, resulting in low rates of uptake. Although Latino MSM have reported the lowest use of PrEP (6.6%), they also reported the greatest willingness to use PrEP compared to White and Black MSM. There have been no known interventions that have been designed to assist Latino MSM with accessing PrEP-related health care or adhering to PrEP. Patient navigation may be an ideal intervention to aid in PrEP uptake among Latino MSM by assisting individuals in overcoming barriers to obtaining and using PrEP. To our knowledge, no known patient navigation programs for PrEP have been developed for Latino MSM. The objectives of this proposed study are to develop, pretest, produce, and pilot test a patient navigation intervention designed to address multiple components of the PrEP cascade among Latino MSM between the age of 18 and 29. During Phase 1, qualitative data will be collected through 30 in-depth interviews to assess needs and assets of young adult Latino MSM regarding engagement and retention in the PrEP cascade. From these findings, health care provider and staff feedback, and through the guidance of a Participatory Planning Group, a patient navigation intervention will be developed and pre-tested through 25 in-depth interviews. During Phase 2, the patient navigation intervention will be pilot-tested with 60 young adult Latino MSM. The patient navigation intervention will be compared to usual care plus written information to evaluate the feasibility and acceptability of the intervention and study methods, as well as the intervention's potential in improving engagement and retention in PrEP-related care. The project will investigate the following specific aims: 1) to assess the needs and assets of young adult Latino MSM regarding engagement and retention in the PrEP cascade; 2) to develop, pretest, and produce a patient navigation intervention designed to facilitate engagement and retention in the PrEP cascade among young adult Latino MSM; and 3) to conduct a pilot randomized controlled trial of the patient navigation intervention by comparing it to usual care to assess feasibility, acceptability, and preliminary impact. The proposed study has significant public health implications and is expected to contribute to efforts to reduce HIV-related disparities and increase adherence to PrEP.

项目摘要 男男性行为者（MSM）是感染人类免疫缺陷病毒的最高危人群 (HIV)在美国，占2014年艾滋病毒新诊断病例的67%。然而，艾滋病毒的流行影响到一些人， 男同性恋者比例过高。拉丁裔男男性行为者占男男性行为者中新感染艾滋病毒者的25.1%， 13岁和29岁。每日用药替诺福韦/恩曲他滨已获食品和药物管理局批准 暴露前预防（PrEP）的管理，并已证明在减少 艾滋病毒感染的风险。当持续服用时，PrEP已被证明可以通过以下方式减少艾滋病毒的新发病例： 百分之九十二尽管PrEP有望改变艾滋病毒预防，但PrEP的使用仍然存在重大障碍 在受益最大的人群中，导致吸收率较低。尽管拉丁裔MSM报告说 PrEP使用率最低（6.6%），与白色相比，他们也报告了使用PrEP的最大意愿， 黑人男男性接触者目前还没有已知的干预措施，旨在帮助拉丁美洲男男性接触者， 访问PrEP相关的医疗保健或坚持PrEP。患者导航可能是一个理想的干预，以帮助 在拉丁美洲男男性接触者中，通过帮助个人克服获得和使用PrEP的障碍， 制备型据我们所知，尚未为拉丁美洲人开发已知的PrEP患者导航程序 男男性接触者这项拟议研究的目标是开发、预测试、生产和试点测试患者导航 干预措施旨在解决拉丁美洲MSM之间PrEP级联的多个组成部分， 18岁和29岁。在第一阶段，将通过30次深入访谈收集定性数据，以评估 年轻的拉丁裔男男性接触者在PrEP级联中的参与和保留方面的需求和资产。从 这些调查结果，卫生保健提供者和工作人员的反馈，并通过指导的一个前瞻性的计划， 组，患者导航干预将通过25个深入访谈开发和预测试。 在第2阶段，患者导航干预将与60名年轻的成年拉丁裔男男性接触者进行试点测试。的 将患者导航干预与常规护理加书面信息进行比较，以评价可行性 干预措施和研究方法的可接受性，以及干预措施在改善 参与和保留PrEP相关护理。该项目将研究以下具体目标：1） 评估年轻成年拉丁裔男男性接触者在PrEP参与和保留方面的需求和资产 级联; 2）开发、预测试和产生患者导航干预，旨在促进 参与和保留在年轻的成年拉丁裔男男性接触者之间的PrEP级联;和3）进行试点 患者导航干预的随机对照试验，将其与常规护理进行比较，以评估 可行性、可接受性和初步影响。这项拟议中的研究具有重大的公共卫生意义 预计将有助于减少与艾滋病毒相关的差异并提高对PrEP的遵守率。