Assessing Psychosocial Predictors of PrEP Adherence and Persistence Among Young Black MSM

评估年轻黑人 MSM 中 PrEP 依从性和持久性的社会心理预测因素

• 批准号: 10010287
• 负责人: Jeb Jones
• 金额: $ 24.84万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10010287
• 关键词: Address; Adherence; Affect; Age; Alcohol or Other Drugs use; Alcohols; Area; Biological Assay; Blood; Characteristics; Data; Development; Dose; Foundations; Future; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV risk; Incidence; Individual; Intervention; Intervention Studies; Interview; Life Cycle Stages; Link; Literature; Longitudinal Studies; Maintenance; Mental Depression; Methods; Oral; Participant; Patient Recruitments; Patient Self-Report; Pattern; Population; Preventive Intervention; Psychosocial Assessment and Care; Psychosocial Factor; Research Design; Risk; Risk Factors; Sex Behavior; Social support; Spottings; Structure; Surveys; Tenofovir; Testing; Time; United States; antiretroviral therapy; black men who have sex with men; depressive symptoms; emtricitabine; experience; follow-up; high risk; medication nonadherence; men who have sex with men; pre-exposure prophylaxis; premature; prevent; protective factors; psychological distress; psychosocial; resilience; risk perception; social stigma; sociodemographics; symptomatology; therapy development

Project Summary/Abstract Young Black men who have sex with men (YBMSM) continue to experience a disproportionate rate of HIV infections in the United States. HIV pre-exposure prophylaxis (PrEP) is a biomedical prevention intervention shown to reduce risk of HIV infection; however, studies suggest YBMSM are less likely to be prescribed PrEP and have significantly lower levels of adherence to PrEP compared to white MSM. PrEP use among YBMSM is estimated at between 3%-20%. In addition to concerns with adherence, persistence on PrEP among YBMSM is low, with discontinuation rates ranging between 17% to 22% within 6 months of starting PrEP. Psychosocial risk and protective factors might contribute to PrEP adherence and persistence among this population. Preliminary evidence suggests a relationship between PrEP adherence among YBMSM and psychosocial factors. Among YBMSM, stigma and low self-perceived HIV risk were cited as the most common reasons for PrEP refusal. However, it is not clear that these findings can be extended to adherence and persistence to PrEP among YBMSM because of the lack of the empirical data on the life cycle of PrEP use among YBMSM. Using a risk and resiliency framework, we will conduct a mixed methods study to understand the natural life cycle of PrEP use among YBMSM in Atlanta. The specific aims of the study are to characterize the patterns of PrEP adherence in the life cycle of PrEP use among YBMSM; identify and describe the psychosocial risk and protective factors to PrEP persistence and adherence; and identify intervention targets for a future PrEP adherence intervention. To achieve these aims, in Aim 1 we will follow 100 YBMSM newly-initiating PrEP for 6 months. Participants will complete weekly assessments of their PrEP use and sexual behavior weekly for the first 90 days and then monthly thereafter. Quarterly, participants will also complete assessments of psychosocial domains (depressive symptomatology, substance use, social support, perceived HIV risk). Adherence will be captured using a self-report item and confirmed via self-collected dried blood spot (DBS) testing at three and six months. In Aim 2, up to 40 YBMSM will complete in-depth individual interviews (IDIs) describing their experiences using PrEP, highlighting their decisions about daily adherence and the psychosocial risk and protective factors that contributed to their levels of adherence and persistence or discontinuation of PrEP. Lastly, drawing upon the psychosocial risk and protective factors associated with PrEP discontinuation and PrEP persistence in Aim 1 and the content and examples from individual interviews in Aim 2, in Aim 3 we will identify psychosocial intervention targets associated with PrEP adherence. This study will lay the foundation for the development of interventions to support PrEP adherence and persistence among this population.

项目摘要/摘要 与男性发生性行为的年轻黑人男性(YBMSM)继续经历不成比例的艾滋病毒感染率 在美国的感染。HIV暴露前预防(PrEP)是一种生物医学预防措施 显示可以降低感染艾滋病毒的风险；然而，研究表明，YBMSM不太可能开PrEP 与白人MSM相比，他们对PrEP的依从性明显较低。YBMSM中使用的Prep是 估计在3%-20%之间。除了对坚持的担忧外，YBMSM对PrEP的坚持 低，在开始PrEP的6个月内停用率在17%到22%之间。心理社会 风险和保护因素可能有助于该人群对PrEP的坚持和坚持。 初步证据表明，青壮年男男性接触者对PrEP的依从性与心理社会有关 各种因素。在YBMSM中，耻辱和自我感觉到的低艾滋病毒风险是最常见的原因 准备拒绝。然而，目前还不清楚这些发现是否可以扩展到坚持和坚持 由于缺乏关于YBMSM中PrEP使用生命周期的经验数据，YBMSM中没有使用PrEP的经验数据。 我们将利用风险和弹性框架，进行一项混合方法研究，以了解自然生命 亚特兰大YBMSM中PrEP的使用周期。这项研究的具体目的是描述 在YBMSM中使用PrEP的生命周期中准备遵守；识别和描述心理社会风险和 保护因素对PrEP的持久性和依从性；确定未来PrEP的干预目标 坚持干预。为了实现这些目标，在目标1中，我们将跟踪100名YBMSM新发起的PrEP为6 月份。参与者将完成每周对他们的PrEP使用情况和性行为的评估 首先是90天，然后是每月。每季度，参与者还将完成对 心理社会领域(抑郁症状、物质使用、社会支持、感知的艾滋病毒风险)。 遵守情况将使用自我报告项目进行捕获，并通过自我收集的干血迹(DBS)进行确认 在三个月和六个月时进行测试。在AIM 2中，多达40名青年男青年将完成深入的个人访谈(IDI) 描述他们使用PrEP的经历，强调他们关于日常遵守和 影响他们坚持和坚持水平的心理社会风险和保护因素 停止使用PrEP。最后，利用与以下方面有关的心理社会风险和保护因素 目标1中的准备停止和PrEP坚持以及个别访谈的内容和例子 在目标2中，在目标3中，我们将确定与PrEP坚持相关的心理社会干预目标。本研究 将为制定干预措施奠定基础，以支持以下方面的坚持和坚持 这群人。