Integration of Electronic SBI(RT) into an HIV Testing Program to Reduce Substance Use and HIV risk Behavior among MSM in Argentina

将电子 SBI(RT) 纳入 HIV 检测计划，以减少阿根廷 MSM 的药物使用和 HIV 风险行为

• 批准号: 10669561
• 负责人: Ivan C Balan
• 金额: $ 23.77万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10669561
• 关键词: AIDS prevention; Acute; Address; Affect; Alcohol consumption; Alcohols; Argentina; Caring; Client; Cocaine; Collaborations; Communities; Dependence; Development; Drug usage; Early Intervention; Effectiveness; Electronics; Europe; Evidence based intervention; Feeling; Funding; Future; Gays; General Population; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Human immunodeficiency virus test; Incidence; Individual; Infection; Infrastructure; Intervention; Latin America; Lesbian Gay Bisexual Transgender; Link; Measures; Mental Health; Motivation; Outcome; Participant; Persons; Population; Postpartum Women; Prevalence; Process; Professional counselor; Randomized; Reporting; Research Infrastructure; Resources; Risk; Risk Behaviors; Risk Reduction; Services; Substance Addiction; Substance Use Disorder; Substance abuse problem; Sulfate; Tablets; Testing; Time; Training; Tranquilizing Agents; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; acceptability and feasibility; aged; brief intervention; condomless anal sex; effective intervention; efficacy trial; evidence base; high risk; illicit drug use; implementation barriers; implementation intervention; male health; marijuana user; men; men who have sex with men; motivational enhancement therapy; pilot trial; preventive intervention; programs; prospective; recruit; reduced substance use; retention rate; screening; screening guidelines; screening, brief intervention, referral, and treatment; sexual risk behavior; substance abuse treatment; substance use; uptake; young man; young men who have sex with men

Men who have sex with men (MSM) are disproportionally affected by HIV and substance abuse in the U.S., Europe, and Latin America. However, as in the general population, identifying and engaging MSM with problematic substance use (PSU) into treatment is a significant challenge, which results in the great majority of MSM with PSU never receiving treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends Screening (S), Brief Intervention (BI), and Referral to Treatment (RT; SBIRT) as an early intervention for non-treatment-seeking individuals with risky alcohol and drug use, as well as the timely referral to more intensive substance abuse treatment for those with substance use disorders. The need for such an intervention is particularly acute in Argentina and Latin America, where there is little implementation of evidence-based interventions for MSM with PSU. The proposed study seeks to address this glaring gap by developing and piloting an electronic-SBI program tailored for MSM awaiting their HIV test at Nexo Asociacion Civil, our community partners in Buenos Aires. The tablet-based e-SBI will integrate substance use and sexual risk behavior screeners and individually tailored Motivational Interviewing (MI) as the BI. We will also adapt and pilot the implementation of the Young Men’s Health Project (YMHP, now MHP since it will not be limited to young MSM), a four-session MI-based intervention that effectively reduced substance use and condomless anal intercourse among substance using MSM, as a brief treatment provided at Nexo for participants with moderate or high-risk substance use. The Specific Aims of this R34 study are to: 1) develop a tailored e-SBI intervention for MSM in an HIV testing context aimed at reducing substance use and HIV risk behavior (Primary); 2) assess the feasibility and acceptability of integrating e-SBI into the HIV testing process at Nexo as measured by a) percent of MSM testing clients at Nexo who accept entry into the study; b) percent of participants who complete e-SBI; c) e-SBI acceptability ratings (Primary); 3) assess the feasibility and acceptability of implementing adapted YMHP at Nexo, as measured by a) the percent of MSM with moderate or high-risk substance use who enter and/or complete MHP; b) acceptability of MHP among those who received it; and c) percentage of sessions conducted by each MHP counselor that meets criteria for MI fidelity (Secondary). In Stage 1 (Development) we will develop e-SBI, adapt YMHP into MHP, train MHP counselors, and pilot e-SBI with 50 MSM coming to Nexo for HIV testing. In Stage 2 (RCT Pilot), we will randomize 200 MSM coming to Nexo for HIV testing at a 3:1 ratio (eSBI: Screening Assessments Only-SA) to assess the feasibility and acceptability of e-SBI among MSM coming to Nexo for HIV testing and establish and pilot the RCT process for a future trial. As a secondary aim, we will assess uptake, acceptability, and feasibility of delivering MHP to participants with low or moderate risk substance use and subsequent referrals to substance abuse treatment among participants with high-risk substance use or dependence. Lastly, we will explore preliminary findings on substance use and sexual risk reduction outcomes.

与男性发生性关系（MSM）的男性在美国受到艾滋病毒和滥用毒品的影响， 欧洲和拉丁美洲。但是，就像一般人群一样，识别和参与MSM 有问题的物质使用（PSU）进入治疗是一个重大挑战，这导致了绝大多数 PSU的MSM永远不会接受治疗。药物滥用和心理健康服务管理 （SAMHSA）建议筛查（S），简短干预（BI）和转介治疗（RT； SBIRT）作为 对于有风险的饮酒和吸毒的非治疗的人的早期干预，以及及时的 转介针对患有药物使用障碍的患者进行更密集的药物滥用治疗。需要这样的 在阿根廷和拉丁美洲，干预措施特别严重，那里几乎没有实施 MSM与PSU的基于证据的干预措施。拟议的研究旨在通过 开发和驾驶针对MSM量身定制的电子SBI计划，等待其Nexo Asociacion的HIV测试 民事，我们在布宜诺斯艾利斯的社区合作伙伴。基于平板电脑的E-SBI将整合药物使用和性 风险行为筛查者和单独量身定制的动机访谈（MI）作为BI。我们还将适应 驾驶年轻男子健康项目的实施（YMHP，现在是MHP，因为它不限于年轻 MSM），一种基于四节MI的干预措施，可有效减少药物使用和无避孕套肛门 使用MSM的物质之间的性交，作为Nexo提供的简短治疗，用于现代参与者 或使用高风险的物质。这项R34研究的具体目的是：1）开发量身定制的E-SBI干预措施 在艾滋病毒测试环境中，旨在减少药物使用和艾滋病毒风险行为（主要）的MSM； 2）评估 通过A测量的NEXO的HIV测试过程的可行性和可接受性 在Nexo的MSM测试客户中，接受研究的客户； b）完成的参与者中的百分比 e-sbi; c）E-SBI可接受性评分（主要）； 3）评估实施适应的可行性和可接受性 ymhp在nexo中，如a）中等或高风险物质使用的MSM百分比 和/或完整的MHP； b）在接受它的人中，MHP的可接受性； c）会议的百分比 每个MHP辅导员都符合MI Fidelity（中学）的标准。在第1阶段（开发）我们 将开发E-SBI，将YMHP适应MHP，训练MHP耦合器和Pilot E-SBI，50 msm来到NEXO 用于HIV测试。在第2阶段（RCT飞行员）中，我们将以3：1的比例随机将200 MSM送到NEXO进行HIV测试 （ESBI：仅筛选评估）评估MSM的E-SBI的可行性和可接受性 向Nexo进行艾滋病毒测试，并建立和试点RCT过程以进行未来的试验。作为次要目标，我们将 评估将MHP交付给低风险基板或中等风险的参与者的吸收，可接受性和可行性 使用高风险药物使用或 依赖。最后，我们将探讨有关药物使用和减少性风险结果的初步发现。