Developing and testing a telehealth intervention to increase HIV pre-exposure prophylaxis uptake and adherence among sexual minority men in Nigeria

项目摘要 背景在尼日利亚，性少数男性（SMM）的艾滋病毒感染率高得不成比例 与一般人群相比。高依从性，每日口服暴露前预防（PrEP） 降低SMM中感染艾滋病毒的风险。增加PrEP摄取和依从性可以 显著降低艾滋病毒发病率，但迄今为止，尼日利亚尚无针对SMM PrEP干预措施。 这种K 01应用的科学前提是，PrEP的远程医疗交付模型可以 规避尼日利亚SMM获得PrEP的障碍。有一个强有力的概念证明， 建议的方法，因为远程保健干预措施，以提高PrEP的访问已被证明， 是可以接受的，并增加了PrEP的吸收和坚持，在美国的SMM之间，而 尼日利亚的远程保健干预措施增加了对其他保健服务的利用，但没有研究表明， 调查了向SMM提供PrEP卫生服务的可行性、可接受性和有效性， 尼日利亚通过远程保健方法。 项目概述。我的长期目标是成为一名独立的研究人员， 制定和测试远程保健干预措施，以改善艾滋病毒预防和护理结果， 撒哈拉以南非洲的SMM。在第一年，我将与艾滋病毒阴性的SMM进行定性访谈 （n=20），同伴教育者（n=20）和医疗保健提供者（n=20）在拉各斯尼日利亚，以确定 内容、形式和实施远程医疗干预的可预见挑战， PrEP意识，吸收，SMM之间的坚持。在第二年，我将进行定性访谈， SMM（n=30）迭代设计远程医疗干预，以增加PrEP摄取， 在尼日利亚的拉各斯，在第3-5年，我将进行一项试点随机对照研究， 试验（RCT），以测试远程医疗干预的可行性，可接受性和初步疗效 在6个月内优化PrEP依从性，90例PrEP初治、HIV阴性的高风险SMM， 尼日利亚的拉各斯。我成功地完成了拟议的研究和培训目标， 在该补助金的最后一年提交R 01，以进行多地点RCT，以测试干预措施的 功效

PROJECT SUMMARY Background. In Nigeria, sexual minority men (SMM) have disproportionately higher levels of HIV compared to the general population. With high adherence, daily oral pre-exposure prophylaxis (PrEP) reduces risk for HIV acquisition among SMM. Increasing PrEP uptake and adherence could significantly reduce HIV incidence, but to date no PrEP intervention have focused on SMM in Nigeria. The scientific premise of this K01 application is that a telehealth delivery model for PrEP could circumvent barriers to PrEP access for SMM in Nigeria. There is a strong proof of concept for the proposed approach given that telehealth interventions to enhance PrEP access have been shown to be acceptable and have increased PrEP uptake and adherence, among SMM in the U.S. While telehealth interventions in Nigeria have increased utilization of other health services, no study has investigated the feasibility, acceptability, and efficacy of delivering PrEP health services to SMM in Nigeria through a telehealth approach. Overview of project. My long-term goal is to become an independent researcher with expertise in developing and testing telehealth interventions to improve HIV prevention and care outcomes among SMM in sub-Saharan Africa. In Year 1, I will conduct qualitative interviews with HIV-negative SMM (n=20), peer educators (n=20), and healthcare providers (n=20) in Lagos Nigeria to identify the content, format, and foreseeable challenges to implementing a telemedicine intervention to increase PrEP awareness, uptake, and adherence among SMM. In Year 2, I will conduct qualitative interviews with SMM (n=30) to iteratively design a telemedicine intervention to increase PrEP uptake and adherence among SMM in Lagos, Nigeria. In Years 3-5, I will conduct a pilot randomized controlled trial (RCT) to test the feasibility, acceptability, and preliminary efficacy of the telemedicine intervention to optimize PrEP adherence over 6 months with 90 PrEP-naïve, HIV-negative high risk SMM in Lagos, Nigeria. My successful completion of the proposed research and training aims will position me to submit a R01 in the final year of this grant to conduct a multisite, RCT to test the intervention’s efficacy.