Adapting effective mhealth interventions to improve uptake and adherence of the HIV pre- exposure prophylaxis (PrEP) in Thai young MSM

采用有效的移动健康干预措施，以提高泰国年轻 MSM 的 HIV 暴露前预防 (PrEP) 的接受度和依从性

• 批准号: 10676114
• 负责人: NITTAYA PHANUPHAK
• 金额: $ 20.26万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10676114
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; Agreement; Asia; Asthma; Awareness; Behavioral; Biological Markers; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Chronic; Clinic; Computers; Counseling; Country; Development; Drug usage; Enrollment; Epidemic; General Population; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV Seroprevalence; HIV/STD; Health; Health behavior; Health system; Incidence; Individual; Intervention; Interview; Literature; Massage; Methods; Modeling; Monitor; Motivation; Nature; Oral; Participant; Patient Recruitments; Pattern; Persons; Pharmaceutical Preparations; Phase; Population; Prevalence; Prevention strategy; Process; Protocols documentation; Randomized; Randomized, Controlled Trials; Recommendation; Regimen; Reporting; Risk; Risk Taking; System; Technology; Testing; Text; Thailand; Treatment Efficacy; United States Preventative Services Task Force; Work; Youth; acceptability and feasibility; aged; antiretroviral therapy; behavior change; comparison control; digital; effective intervention; efficacy testing; efficacy trial; feasibility research; follow-up; high risk population; improved; infection rate; innovation; intervention refinement; live text; mHealth; men who have sex with men; mobile computing; motivational enhancement therapy; motivational intervention; participant retention; pilot test; post intervention; pre-exposure prophylaxis; prevent; programs; recruit; response; satisfaction; scale up; side effect; skills; social stigma; success; transmission process; uptake; usability; young man; young men who have sex with men

Young men having sex with men (YMSM) are the fastest growing HIV+ population worldwide. Thailand has the highest adult HIV seroprevalence in Asia; 28.6% of men having sex with men in Bangkok are HIV+. The HIV incidence rate among YMSM in Bangkok is 12.2 per 100 person-years. Effective prevention strategies are urgently needed to prevent HIV transmission in this high-risk population. Pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention strategy recommended by the CDC and WHO for all at-risk individuals, including HIV-negative MSM. PrEP is highly effective when taken as prescribed, but PrEP utilization has been low and adherence is often inadequate. To address these challenges among Thai YMSM, we propose to develop a technology facilitated intervention combining Motivational Enhancement System for PrEP Uptake and Adherence (MES-PrEP) and Motivational Interactive Text Messaging (MTM) to increase uptake of and sustained adherence to PrEP among HIV-negative, Thai YMSM. MTM will be programmed and tested to send two-way motivational messages to promote PrEP uptake and adherence. Our primary aim is to develop and pilot test MES-PrEP and MTM and associated protocols and to assess preliminary evidence of the effect of the technology facilitated intervention. The proposed study includes 3 phases. Phase I includes in-depth interviews with 30 HIV-negative Thai YMSM to explore barriers and facilitators of PrEP initiation and adherence to inform intervention content. Phase II consists of adapting and beta testing MES-PrEP and MTM for functionality and feasibility using 10 HIV-negative Thai YMSM. In Phase III, we will conduct a pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary efficacy of MAS-PrEP and MTM to increase PrEP uptake and adherence among Thai YMSM. We will enroll 60 HIV-negative Thai YMSM who have not started PrEP and 60 YMSM who are on PrEP but not adherent to it. Participants will be randomized 2:1 to received MES-PrEP and MTM (n=40) or Standard PrEP Counseling (n=20). Feasibility and acceptability of the intervention will be assessed through paradata of usage patterns and the System Usability Scale. Preliminary impact will be assessed by evaluating the proportion of PrEP initiation and level of adherence to PrEP. Participants will complete the assessments at baseline and 1, 3, and 6 months post- intervention. Biomarkers of adherence to PrEP and HIV/STI will be collected. Upon project completion, we shall have developed a highly innovative mHealth intervention to support MSM using PrEP which will be ready for testing in a larger efficacy trial.

青年男男性行为者(YMSM)是全球增长最快的HIV+人群。泰国有 亚洲成人HIV血清阳性率最高；曼谷男男性行为者中有28.6%是HIV+。这个 曼谷基督教男同性恋者中艾滋病毒的发病率为每100人年12.2人。有效的预防策略是 迫切需要防止艾滋病毒在这一高危人群中传播。暴露前预防(PrEP)是 疾控中心和世卫组织为所有高危个人推荐的有效艾滋病毒预防战略， 包括HIV阴性的男男性接触者。PREP在按规定服用时非常有效，但PrEP利用率一直在 低和坚持往往是不够的。为了应对泰国基督教青年会面临的这些挑战，我们建议开发 结合PrEP摄取和激励增强系统的技术促进干预 遵守(MES-PrEP)和激励性互动文本消息(MTM)，以增加对和的接受 在HIV阴性的泰国YMSM中持续坚持PrEP。将对MTM进行编程和测试以发送 双向激励信息，以促进PrEP的吸收和遵守。我们的主要目标是发展和 试点测试MES-PrEP和MTM及其相关方案，并评估初步证据表明 技术促进了干预。拟议的研究包括三个阶段。第一阶段包括深入研究 与30名HIV阴性的泰国YMSM进行访谈，探讨PrEP启动和促进因素 坚持告知干预内容。第二阶段包括适应和测试版MES-PrEP和MTM 使用10个HIV阴性的泰国YMSM的功能性和可行性。在第三阶段，我们将进行试点 评价MAS-PrEP和MAS-PrEP的可行性、可接受性和初步疗效的随机对照试验 MTM将提高泰国基督教青年会对PrEP的摄取率和依从性。我们将招收60名HIV阴性的泰国YMSM 没有开始PrEP的人和60名正在服用PrEP但没有遵守PrEP的YMSM。参与者将是 随机分为MES-PrEP+MTM组(n=40)和标准PrEP咨询组(n=20)。可行性和 干预的可接受性将通过使用模式和系统可用性的ParaData进行评估 比例。初步影响将通过评估启动PrEP的比例和 坚持PrEP。参与者将在基线以及1、3和6个月后完成评估 干预。将收集遵守PrEP和HIV/STI的生物标记物。在项目完成后，我们 已经开发了一种高度创新的mHealth干预措施，以支持使用PrEP的MSM，该干预措施将准备就绪 以便在更大的疗效试验中进行测试。

项目成果

Adapting Effective mHealth Interventions to Improve Uptake and Adherence to HIV Pre-Exposure Prophylaxis Among Thai Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

• DOI: 10.2196/46435
• 发表时间: 2023-09-04
• 期刊: JMIR research protocols
• 影响因子: 1.7