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.

项目总结 男男性行为者(MSM)是感染人类免疫缺陷病毒的最高风险人群 在美国，占2014年新增艾滋病毒诊断病例的67%。然而，艾滋病毒的流行影响了一些人 男男性接触者群体不成比例。拉美裔男男性接触者占男男性接触者新增HIV感染者的25.1% 13岁和29岁。每日服用替诺福韦/恩曲他滨已获美国食品药品监督管理局批准 暴露前预防管理(PrEP)，并已显示出强大的效果，在减少 感染艾滋病毒的风险。如果持续服用，PrEP已被证明可以通过以下方式减少新的艾滋病毒发病率 92%。尽管PrEP承诺改变艾滋病毒预防，但PrEP的使用仍然存在重大障碍 在那些将受益最大的人中，导致吸收率较低。尽管拉丁裔MSM报告说 PrEP的使用率最低(6.6%)，他们还报告说，与White和 黑人男同性恋。目前还没有已知的干预措施旨在帮助拉丁裔MSM 获得PrEP相关的医疗保健或坚持PrEP。患者导航可能是一种理想的辅助干预 通过帮助个人克服获得和使用障碍，在拉丁裔MSM中吸收PrEP 准备好了。据我们所知，还没有为拉丁裔开发出PrEP患者导航程序 MSM。这项拟议研究的目标是开发、预测、生产和试点测试患者导航 干预措施旨在解决拉美裔MSM之间PrEP级联的多个组成部分 年龄分别为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 年轻成年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… 这些发现、卫生保健提供者和工作人员的反馈，并通过参与性规划的指导 小组，将通过25次深度访谈制定和预测患者导航干预措施。 在第二阶段，患者导航干预将在60名年轻的拉丁裔成年MSM中进行试点测试。这个 患者导航干预将与常规护理加书面信息进行比较，以评估其可行性 干预措施和研究方法的可接受性，以及干预措施的改进潜力 参与和保留与PrEP相关的护理。该项目将调查以下具体目标：1) 评估年轻成年拉丁裔男男性接触者在PrEP中的参与和保留方面的需求和资产 级联；2)开发、预测和产生患者导航干预，旨在促进 年轻成年拉丁裔MSM在PrEP级联中的参与和保持；以及3)进行试点 患者导航干预与常规护理对照的随机对照试验 可行性、可接受性和初步影响。建议的研究对公众健康有重大影响。 预计将有助于减少艾滋病毒相关差距的努力，并增加对预防艾滋病方案的遵守。