PS23-003 - A Community-based Assessment of Preferences for Long-Acting Antiretroviral Therapy Options Among Cis-gender Black Women across Six Ending the HIV Epidemic Jurisdictions in the South

PS23-003 - 基于社区的六个顺性别黑人女性对长效抗逆转录病毒治疗方案偏好的评估，结束南方艾滋病毒流行管辖区

• 批准号: 10812111
• 负责人: Lauren Frances Collins
• 金额: $ 33.29万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10812111
• 关键词: PS23; 003; Community; based; Assessment

PROJECT ABSTRACT Efforts to curb the HIV epidemic in the United States (US) are impeded by suboptimal access and adherence to antiretroviral therapy (ART), particularly among cis-gender Black women with HIV (CgBWH) in the Southern US who have lower care linkage, engagement, and viral suppression, and higher mortality, than their male and White female peers. Long-acting (LA) ART has the potential to transform the HIV treatment landscape, but the uptake of LA-injectable (LAI) ART has been low due to multi-level challenges and the lack of tailored approaches for key groups, including CgBWH. To help fill this gap, over the past six years our multidisciplinary team has led mixed methods research on women’s LA ART interest, preferences, barriers, and facilitators. However, these data were collected prior to LA ART approval, queried hypothetical use, and did not include young women or focus on the South. To realize the Ending the HIV Epidemic (EHE) initiative “Treat” pillar, we must develop novel approaches to optimize and tailor care linkage and ART adherence strategies for CgBWH. This proposal builds on our existing multisite research infrastructure and robust academic-community partnerships to explore Southern CgBWH preferences and implementation challenges in the era of approved LA ART; it will integrate stakeholders’ needs and values to co-create prototype tools for education, referral, and linkage to HIV treatment tailored to CgBWH. We will leverage the Study for Treatment And Reproductive Outcomes (STAR) infrastructure, that is currently enrolling 1200 CgBWH in six Southern sites including urban and rural EHE priority jurisdictions (AL, FL, GA, MS, NC, DC). To advance this work, we will use the Consolidated Framework for Implementation Research and Human-centered design to inform our data collection, analyses and the development of educational, referral, and linkage prototype toolkits to support CgBWH LA ART access and use. In Aim 1 we will examine CgBWH preferences, facilitators, and barriers to LA ART uptake and novel delivery via an ongoing LA ART survey in STAR (n=1200 CgBWH) and longitudinal interviews with 120 CgBWH who vary by adherence, LA ART use, age, and rurality. In Aim 2 we will identify strategies to equitably scale up LA ART for CgBWH through interviews with 60 HIV service providers including from community-based organizations (CBOs) that vary by role, LA ART availability, funding, and rurality. In Aim 3 we will use human-centered design approaches via a series of 3 workshops across four CBOs (2 rural, 2 urban) to integrate the voices of CgBWH and HIV service providers and iteratively develop LA ART educational, referral and linkage tools that are tailored, acceptable and feasible for CgBWH and a range of delivery sites. Given our established academic-community research infrastructure, clinical leadership in LA ART programming, and expertise in HIV and women’s health, qualitative methods and implementation science, we are well-positioned to rapidly implement this mixed methods study and disseminate knowledge to all stakeholders, thus addressing the EHE “Treat” pillar in HIV hotspots.

项目摘要 在美国，遏制艾滋病毒流行的努力受到以下因素的阻碍： 抗逆转录病毒治疗（ART），特别是在美国南部的顺性别黑人艾滋病毒感染者（CgBWH）中 与男性和白色人相比， 女性同行长效抗逆转录病毒疗法有可能改变艾滋病毒治疗的格局， 由于多层次的挑战和缺乏针对性的方法， 关键群体，包括CgBWH。为了填补这一空白，在过去的六年里，我们的多学科团队领导了 混合方法研究妇女的LA ART兴趣，偏好，障碍和促进者。但这些 在LA ART批准之前收集数据，询问假设使用，不包括年轻女性或 专注于南方。为了实现终止艾滋病毒流行（EHE）倡议的“治疗”支柱，我们必须开发新的 优化和定制CgBWH的护理联系和ART依从性策略的方法。这一建议建立 我们现有的多站点研究基础设施和强大的学术社区伙伴关系， 探索南方CgBWH的偏好和批准LA ART时代的实施挑战; 将整合利益相关者的需求和价值观，共同创建用于教育、转诊和联系的原型工具， 针对CgBWH的艾滋病毒治疗。我们将利用治疗和生殖结局研究（星星） 基础设施，目前在包括城市和农村EHE在内的六个南部地点招收了1200名CgBWH 优先管辖区（AL，FL，GA，MS，NC，DC）。为了推进这项工作，我们将利用《综合框架》 实施研究和以人为本的设计，以告知我们的数据收集，分析和 开发教育、转诊和联系原型工具包，以支持CgBWH LA ART的获取和使用。 在目标1中，我们将研究CgBWH偏好，促进者和LA ART吸收和新交付的障碍， 正在进行的星星LA ART调查（n=1200 CgBWH）和120 CgBWH的纵向访谈， 坚持，LA ART使用，年龄和农村。在目标2中，我们将确定公平扩大LA ART的战略 通过与60名艾滋病毒服务提供者（包括社区组织）的访谈， （社区组织），不同的角色，LA ART的可用性，资金和农村。在目标3中，我们将使用以人为本的设计 通过在四个社区组织（2个农村组织，2个城市组织）举办一系列3个讲习班， 和艾滋病毒服务提供者，并反复开发LA ART教育，转诊和联系工具， 可接受的和可行的CgBWH和一系列交付地点。鉴于我们建立的学术社区 研究基础设施，洛杉矶ART规划的临床领导力，以及艾滋病毒和妇女健康方面的专业知识， 定性方法和实施科学，我们有能力快速实施这种混合方法 研究并向所有利益攸关方传播知识，从而解决艾滋病毒热点地区的教育和保健“治疗”支柱问题。