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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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要艾滋病毒，尤其是在南方，对男男性行为的年轻黑人男性影响尤为严重 (YBMSM)。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）的范围这个人群迫切需要。之前的工作重点是个人层面的增加 PrEP 的方法利用率，而社交网络层面的方法相对未得到充分利用。社会中的个人网络可以获得社会资本，这可以产生影响的情感和工具资源健康行为。黑人女性是 YBMSM 社交网络中社会资本的重要来源，这之前的 PrEP 干预措施中尚未利用其独特的作用。我们建议利用 YBMSM 的支持与黑人妇女建立联系，发展 PrEP US Now（通过增加社会资本来利用 PrEP） YBMSM 女性网络），这是一种新颖的移动健康干预措施，将让黑人女性参与 YBMSM 现有网络中的促进者，作为增强社会资本、减少交叉性的一种方式耻辱，并促进网络内 PrEP 的采用。该提案将追求三个具体目标：(1) 定性评估 YBMSM 和 Black 之间社会资本债券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、基于证据的移动医疗干预措施，以创建立即美国 PrEP； (3) 评估 PrEP US NowW 的可行性和可接受性，以及初步效果在一项随机对照试点试验中，增加 YBMSM 对 PrEP 的吸收。对于目标 1，我们将进行对 n=20 YBMSM 和 n=20 黑人女性进行定性访谈，以深入了解黑人的偏好属性女性协调员，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 NowW 干预的核心特点是实时、虚拟讨论由训练有素的黑人女性协调员领导，交付给现有的 YBMSM 网络。附加功能和内容将根据我们的目标 1 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。在目标 3 中，我们将随机化 YBMSM 网络（每个网络最多 5 名成员），使用受访者驱动抽样技术招募干预组（PrEP US Now）或对照研究组（没有社会资本成分的移动医疗应用程序）。参与者 (N=60) 将完成经过验证的调查，衡量基线、1 个月和 3 个月时的社会资本、内在同负性和 PrEP 吸收情况。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。完成后为了实现我们的目标，我们将收集必要的初步数据，为全面的多站点功效试验提供信息。拟议的研究具有很大的潜力，可以为 YBMSM 中的有效艾滋病毒预防策略提供信息南方，导致个人和公共卫生成果的改善与国家举措保持一致。