Promoting linkage to PrEP after HIV self-testing through a peer-led intervention for MSM

通过同伴主导的 MSM 干预措施，促进 HIV 自我检测后与 PrEP 的联系

• 批准号: 10700283
• 负责人: Cedric Howshan Bien-Gund
• 金额: $ 19.44万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-05 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700283
• 关键词: AIDS prevention; Address; Adherence; Adopted; Affect; Behavior; Behavior Therapy; Behavioral; COVID-19; COVID-19 pandemic; Caring; Clinical Trials Design; Collaborations; Complement; County; Cross-Sectional Studies; Data; Decentralization; Development; Epidemic; Evaluation; Feedback; Goals; HIV; HIV Infections; HIV diagnosis; HIV/STD; Health Professional; Health behavior; Health system; Human immunodeficiency virus test; Hybrids; Individual; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Life Experience; Link; Measures; Mentors; Methodology; Methods; Motivation; Persons; Philadelphia; Population; Prevention; Preventive care; Public Health; Questionnaires; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Risk; Risk Reduction; Self Efficacy; Services; Social support; Target Populations; Testing; Training; Treatment Efficacy; Underserved Population; antiretroviral therapy; behavior change; career; design; effectiveness-implementation RCT; effectiveness/implementation hybrid; effectiveness/implementation trial; evidence base; high risk men; implementation measures; implementation outcomes; implementation science; implementation strategy; innovation; intervention mapping; intervention refinement; men who have sex with men; novel; novel strategies; patient oriented; peer; pilot test; pre-exposure prophylaxis; prevent; remote health care; self testing; service delivery; skills; social stigma; testing uptake; theories; therapy design; tool; uptake

Project Summary Ending the HIV epidemic will require novel strategies to expand the HIV prevention continuum among men who have sex with men (MSM), who are disproportionately affected by HIV. The COVID-19 pandemic has underscored the need for remote care approaches such as HIV self-testing (HIVST) to sustain access to HIV services. However, the benefits of self-testing are limited if they do not spur behavioral change or linkage to care, yet only 1 in 10 MSM who self-test obtain preventive care afterwards, and the majority of MSM with indications for PrEP have never used it. Interventions to support linkage from HIVST, the first key step in the HIV “status neutral” continuum, are needed. To maximize the impact of HIVST, linkage to care is a critical practice gap that needs to be addressed, a gap that can potentially be bridged by a peer intervention to support linkage and PrEP uptake. To expand the HIV prevention continuum among MSM, this research will leverage HIVST and evaluate a peer-led intervention to support engagement in care and PrEP uptake through peer linkage after self-testing. The overall goal of this career development award is to provide Dr. Cedric Bien- Gund with the necessary research skills to become an independent clinician-investigator in the development, evaluation, and implementation of behavioral interventions to prevent HIV infections. To achieve this goal, we have assembled a mentoring team and proposed a rigorous training plan to develop his skills in 1) mixed methods for behavioral interventions, 2) intervention design and mapping for implementation, and 3) advanced clinical trial design, including implementation science designs. These training objectives complement a research plan to develop and pilot a behavioral intervention to increase linkage to PrEP among MSM through integration of HIVST distribution and peer-led linkage to PrEP. The specific aims are: 1) identify barriers and facilitators to PrEP linkage after HIV self-testing among MSM, 2) develop a peer-led linkage intervention for HIVST, and 3) test the acceptability, feasibility, and preliminary efficacy of the intervention on PrEP linkage and uptake among MSM by conducting a pilot randomized controlled trial. This project will leverage an ongoing collaboration with the Philadelphia Department of Public Health to expand HIVST and PrEP uptake. The proposed research addresses the first steps in the HIV prevention continuum and will support Dr. Bien-Gund's goal of becoming an independent investigator with expertise in behavioral interventions to end the HIV epidemic. This research will provide preliminary data for an R01 application to test the intervention in a hybrid type I effectiveness-implementation trial, with the goal of optimizing the impact of HIVST by closing the linkage gap after testing.

项目概要 结束艾滋病毒流行需要采取新的策略来扩大男性艾滋病毒预防的连续性 男男性行为者 (MSM)，他们受到艾滋病毒的影响尤为严重。 COVID-19 大流行已 强调需要采取艾滋病毒自检 (HIVST) 等远程护理方法，以维持获得艾滋病毒的机会 服务。然而，如果自我测试不能刺激行为改变或与他人建立联系，那么自我测试的好处是有限的。 护理，但只有十分之一的 MSM 在自检后获得了预防性护理，并且大多数 MSM PrEP 的适应症 从未使用过它。支持 HIVST 联系的干预措施是艾滋病防治工作的第一个关键步骤 需要艾滋病毒“状态中立”连续体。为了最大限度地发挥 HIVST 的影响，与护理的联系至关重要 需要解决的实践差距，这一差距可以通过同行干预来弥补 支持联动和 PrEP 吸收。为了扩大 MSM 中艾滋病毒预防的连续性，本研究将 利用 HIVST 并评估同行主导的干预措施，以支持参与护理和 PrEP 的采用 自测后进行同行联动。该职业发展奖的总体目标是为 Cedric Bien 博士提供： Gund 具备成为一名独立的临床研究者所需的研究技能， 评估和实施行为干预措施以预防艾滋病毒感染。为了实现这一目标，我们 组建了一个指导团队并提出了严格的培训计划来发展他在 1) 混合方面的技能 行为干预方法，2) 干预设计和实施规划，以及 3) 高级 临床试验设计，包括实施科学设计。这些培训目标补充了 研究计划开发和试点行为干预措施，以通过以下方式增强 MSM 与 PrEP 的联系： 将 HIVST 分发和同行主导的联系与 PrEP 相结合。具体目标是：1）识别障碍并 促进者在 MSM 中进行 HIV 自我检测后建立 PrEP 联系，2) 制定同伴主导的联系干预措施 HIVST，3) 测试 PrEP 联动干预措施的可接受性、可行性和初步效果 通过开展一项试点随机对照试验，MSM 的吸收率有所提高。该项目将利用正在进行的 与费城公共卫生部合作，扩大 HIVST 和 PrEP 的采用。这 拟议的研究涉及艾滋病毒预防连续性的第一步，并将支持 Bien-Gund 博士的研究 目标是成为一名独立调查员，拥有终止艾滋病毒行为干预方面的专业知识 流行性。这项研究将为 R01 应用提供初步数据，以测试对混合动力车的干预 I 类有效性实施试验，目标是通过关闭联系来优化 HIVST 的影响 测试后的差距。