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

项目摘要 结束艾滋病毒的流行将需要新的战略，以扩大艾滋病毒预防的男子连续 男男性行为者（MSM），他们受艾滋病毒的影响不成比例。COVID-19疫情 强调需要采取艾滋病毒自我检测（HIVST）等远程护理方法，以持续获得艾滋病毒 服务然而，自我测试的好处是有限的，如果他们不刺激行为的变化或联系， 然而，只有十分之一的自我检测的男男性行为者在事后获得预防性护理， PrEP的适应症从未使用过它。支持与HIVST联系的干预措施， 艾滋病毒“中性状态”的连续性是必要的。为了最大限度地发挥艾滋病毒/艾滋病防治的影响， 需要解决的实践差距，可以通过同行干预来弥合的差距， 支持联系和PrEP吸收。为了在男男性行为者中扩大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吸收， 自我测试后的同行联系。这个职业发展奖的总体目标是为塞德里克·比恩博士提供- Gund具备必要的研究技能，成为发展中的独立临床研究者， 评估和实施预防艾滋病毒感染的行为干预措施。为了实现这一目标，我们 我组建了一个指导小组，并提出了一个严格的训练计划，以发展他在混合运动中的技能 行为干预方法，2）干预设计和实施映射，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，制定和试行行为干预措施，通过以下方式增加MSM与PrEP的联系： 将艾滋病毒/艾滋病传播和同伴主导的联系与PrEP相结合。具体目标是：1）确定障碍， 男男性行为者艾滋病毒自我检测后PrEP联系的促进者，2）制定同伴主导的联系干预措施， HIVST，3）测试PrEP连锁干预的可接受性，可行性和初步疗效， 通过进行试点随机对照试验，在MSM中的吸收。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的吸收。的 拟议的研究解决了艾滋病毒预防连续性的第一步，并将支持Bien-Gund博士的 目标是成为一名独立的调查员，在行为干预方面具有专业知识，以结束艾滋病毒 疫情这项研究将为R 01应用程序提供初步数据，以测试混合动力车中的干预措施。 I型有效性-实施试验，目标是通过密切联系， 测试后的差距

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.