PrEP US NoW: PrEP Utilization Through Increasing Social Capital Among YBMSM Networks with Women

PrEP 现在美国：通过增加 YBMSM 女性网络中的社会资本来利用 PrEP

• 批准号: 10456206
• 负责人: Latesha Ellen Elopre
• 金额: $ 22.06万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-23 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10456206
• 关键词: AIDS prevention; AIDS/HIV problem; Access to Information; Acquired Immunodeficiency Syndrome; Address; Adoption; Affect; Alabama; Attitude; Behavior; Belief; Black American; Caring; Charge; Communication; Complex; Data; Development; Diagnosis; Elements; Emotional; Epidemic; Feedback; Financial Support; Funding; Geography; Guidelines; HIV; HIV diagnosis; Health; Health Promotion; Health behavior; Human immunodeficiency virus test; Individual; Intervention; Interview; Knowledge; Link; Maps; Measurement; Measures; Mobile Health Application; Modeling; Motivation; Outcome; Participant; Population; Prevention; Prevention approach; Prevention strategy; Process; Public Health; Randomized; Randomized Controlled Trials; Research; Research Priority; Resources; Respondent; Risk; Role; Sampling; Services; Sexual Health; Site; Social Network; Social support; Source; Strategic Planning; Structure; Surveys; Techniques; Testing; Time; Training; United States; United States National Institutes of Health; Woman; Work; acceptability and feasibility; arm; base; black men who have sex with men; black women; comparative; condomless anal sex; effective intervention; efficacy trial; evidence base; health knowledge; homonegativity; improved; insight; instrument; intervention mapping; mHealth; member; men; mobile application; novel; novel strategies; pilot trial; pre-exposure prophylaxis; programs; recruit; response; scale up; sexual identity; social capital; social norm; social stigma; tool; treatment arm; uptake; usability; virtual

PROJECT SUMMARY HIV, especially in the South, disproportionately affects young Black men who have sex with men (YBMSM). Development and implementation of effective interventions to scale up HIV pre-exposure prophylaxis (PrEP) are urgently needed in this population. Prior work has focused on individual-level approaches to increasing PrEP utilization, while social network-level approaches are comparatively underutilized. Individuals within social networks have access to social capital, which can yield emotional as well as instrumental resources that influence health behaviors. Black women represent a key source of social capital within YBMSM social networks, and this unique role has not been utilized in prior PrEP interventions. We propose to leverage YBMSM’s supportive connections with Black women to develop PrEP US NoW (PrEP Utilization through increasing Social Capital among YBMSM Networks with Women), a novel mobile health intervention that will engage Black women as facilitators in existing networks of YBMSM, as a way of enhancing social capital, decreasing intersectional stigma, and promoting PrEP uptake within the network. The proposal will pursue three specific aims: (1) Qualitatively evaluate core health-promoting elements of social capital bonds between YBMSM and Black women in extant social support networks; (2) Adapt an existing, evidence-based mHealth intervention to create PrEP US NoW; and (3) Evaluate feasibility and acceptability of PrEP US NoW, as well as preliminary efficacy to increase PrEP uptake among YBMSM, in a randomized-controlled pilot trial. For Aim 1, we will conduct qualitative interviews with n=20 YBMSM and n=20 Black women to gain insights into preferred attributes of Black woman facilitators, as well as feedback on intervention content and format. In Aim 2, we will develop the PrEP US NoW mobile app. The central feature of the PrEP US NoW intervention will be real-time, virtual discussions led by a trained Black woman facilitator, delivered to an existing network of YBMSM. Additional features and content will be refined based on our Aim 1 findings. We will conduct usability testing in an iterative process with both YBMSM and Black women. In Aim 3, we will randomize YBMSM networks (up to five members each), recruited using respondent driven sampling techniques, to the intervention (PrEP US NoW) or control study arm (mHealth app without social capital components). Participants (N=60) will complete validated surveys measuring social capital, internalized homonegativity, and PrEP uptake at baseline, 1-month, and at 3-months’ time. HIV testing will be done at baseline and at 3-months’ time. We will assess feasibility, acceptability, and preliminary efficacy. This study will be conducted in an epicenter of the Southern HIV epidemic: Alabama. Upon completion of our aims, we will have collected requisite preliminary data to inform a fully powered multi-site efficacy trial. The proposed research has strong potential to inform effective HIV prevention strategies among YBMSM in the South, leading to improved individual and public health outcomes aligned with national initiatives.

项目总结 艾滋病毒，特别是在南方，对男男性行为的年轻黑人男性(YBMSM)的影响不成比例。 制定和实施有效的干预措施，以扩大艾滋病毒暴露前预防(PrEP) 在这个人口中迫切需要。之前的工作主要集中在个人层面增加PrEP的方法上 利用程度较低，而社交网络层面的方法相对利用不足。社会中的个人 网络可以获得社会资本，这可以产生情感资源和工具资源，从而影响 健康行为。黑人女性是YBMSM社交网络中社会资本的关键来源，而这 在以前的PrEP干预中没有利用独特的作用。我们建议利用YBMSM的支持 与黑人女性的联系发展PrEP美国NOW(通过增加社会资本提高PrEP利用率 在YBMSM与妇女的网络中)，一种新的移动健康干预措施，将吸引黑人妇女作为 YBMSM现有网络中的促进者，作为提高社会资本的一种方式，减少交叉 耻辱，并促进PrEP在网络中的吸收。该建议将追求三个具体目标：(1) 定性评估YBMSM与Black之间社会资本纽带的核心健康促进要素 现有社会支持网络中的妇女；(2)调整现有的、以证据为基础的移动健康干预措施，以创建 (3)评价PrEP US Now的可行性和可接受性，以及对 在一项随机对照的试点试验中，增加YBMSM对PrEP的摄取。对于目标1，我们将进行 对20名YBMSM和n=20名黑人女性进行定性访谈，以深入了解黑人的首选属性 妇女促进者，以及对干预内容和形式的反馈。在目标2中，我们将开发PrEP US Now移动应用程序。PrEP US Now干预的核心特征将是实时、虚拟的讨论 由一名训练有素的黑人妇女协调员领导，向现有的基督教青年会网络提供培训。其他功能和 内容将根据我们的目标1的调查结果进行完善。我们将在迭代过程中进行可用性测试 YBMSM和黑人女性都是。在目标3中，我们将对YBMSM网络(每个网络最多五个成员)进行随机化， 使用受访者驱动抽样技术招募到干预(PrEP US Now)或对照研究ARM (没有社会资本组件的mHealth应用程序)。参与者(N=60)将完成经过验证的调查 在基线、1个月和3个月时，社会资本、内在化同负性和PrEP摄取。艾滋病病毒 测试将在基线和3个月后进行。我们将评估可行性、可接受性和初步 功效。这项研究将在南部艾滋病毒流行的中心阿拉巴马州进行。完工后 为了达到我们的目标，我们将收集必要的初步数据，以便进行全面的多点疗效试验。 这项拟议的研究具有很强的潜力，可以为青壮年男男性接触者提供有效的艾滋病毒预防策略。 在南方，导致改善个人和公共卫生结果，使之与国家倡议保持一致。