Acceptability of HIV Treatment as Prevention among MSM

MSM 中艾滋病毒治疗作为预防的接受度

• 批准号: 10011144
• 负责人: Etienne Meunier
• 金额: $ 21.23万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011144
• 关键词: AIDS prevention; Address; Adopted; Adoption; Affect; Awareness; Belief; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Clinical Data; Clinical Trials; Communicable Diseases; Communication; Continuing Education; Couples; Data; Effectiveness; Epidemic; General Population; HIV; HIV Seronegativity; HIV Seropositivity; Health; Health Benefit; Health Personnel; Human immunodeficiency virus test; Incidence; Individual; Infection; Interview; Investigation; Knowledge; Learning; Life Expectancy; Light; Maps; Medicine; Methods; Modeling; NIH Office of AIDS Research; Outcome; Participant; Perception; Personal Satisfaction; Population; Positioning Attribute; Prevention; Prevention strategy; Process; Public Health; Risk; Sampling; Sex Behavior; Sexual Partners; Surveys; Testing; Treatment Effectiveness; Trust; United States; Viral; Viral Load result; barrier to care; condomless anal sex; experience; fighting; improved; male; medication compliance; men; men who have sex with men; pre-exposure prophylaxis; prevent; recruit; screening; sex; sexual HIV transmission; social; social stigma; therapy development; tool; transgender; transmission process; willingness

Project Summary/Abstract From 2012 to 2016, the number of people living with HIV in the US whose infection is attributable to male- to-male sexual contact increased from 462,027 to 542,000 and, at year-end 2016, these men comprised 55% of the HIV-positive population. Continued education about HIV transmission risk and prevention strategies among men and transgender people who have sex with men (MTSM) is crucial. In recent years, treatment as prevention (TasP) has emerged as an effective HIV prevention strategy that could have multiple benefits to the public health. In light of clinic trial evidence, the CDC now states, “People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to their HIV- negative sexual partners.” Making HIV-positive people practically noninfectious, TasP represents an important tool not only for reducing HIV incidence but also for fighting HIV-related stigma and improving the well-being of HIV-positive people. However, TasP will only fulfill its promises if people accept it as an effective and reliable prevention strategy. Unfortunately, the most recent data show that although there seems to be high awareness of TasP among MTSM, few seem to believe in its efficacy or to be willing to use it. This study will use the Precaution Adoption Process Model (PAPM) to investigate the factors associated with different stages of TasP adoption among men and transgender people who have sex with men (MTSM). We will conduct in-depth qualitative interviews with 60–75 MTSM in the US, divided between HIV-positive and HIV-negative/unaware individuals not using PrEP. We will focus on three positions regarding TasP adoption that we have found to be common in our preliminary data and that map onto key stages in the PAPM: TasP skeptics (who do not believe in the effectiveness of TasP), TasP believers (who understand TasP is effective but are not willing to rely on it), and TasP adopters (those who have relied on the strategy). The screening survey we will use to recruit interview participants will provide further data about other stages of TasP adoption (awareness, perceived effectiveness, willingness to use, and actual use) in a larger and more diverse sample of participants (including PrEP users). The specific aims are: 1. To examine (with qualitative interview data) factors associated with MTSM’s perceived effectiveness of TasP and their willingness to rely on it. 2. To understand (with qualitative interview data) the experiences of MTSM who use TasP, how they use the strategy, and how it affects their sexual behaviors and decisions. 3. To describe (with screener survey data) the characteristics of MTSM at different stages of TasP adoption (awareness, perceived effectiveness, willingness to use, and actual use). 4. To begin development of an intervention to correct misconceptions about TasP, overcome barriers to its use, and educate MTSM on how to most effectively use the prevention strategy.

项目总结/摘要 从2012年到2016年，美国感染艾滋病毒的人数可归因于男性， 与男性的性接触从462，027增加到542，000，截至2016年底，这些男性占55% 艾滋病病毒阳性人群。关于艾滋病毒传播风险和预防战略的继续教育 男性和变性人与男性发生性关系（MTSM）是至关重要的。近年来，作为 预防（TasP）已经成为一种有效的艾滋病毒预防战略，可以对艾滋病毒感染者带来多重好处。 公共卫生根据临床试验证据，疾病预防控制中心现在指出，“服用艾滋病毒药物的艾滋病毒感染者， 处方，并获得和保持不可检测的病毒载量有效地没有风险传播艾滋病毒给他们的艾滋病毒- 消极的性伴侣”使艾滋病毒阳性的人几乎没有传染性，TasP代表了一个重要的 这不仅是减少艾滋病毒发病率的工具，也是打击与艾滋病毒有关的耻辱感和改善艾滋病毒感染者福祉的工具。 艾滋病毒阳性的人。然而，只有当人们接受它作为一种有效和可靠的工具时，TasP才会履行其承诺。 预防战略。不幸的是，最新的数据显示，尽管人们似乎对 在MTSM中，几乎没有人相信它的疗效或愿意使用它。 本研究将使用修正采纳过程模式（PAPM）来探讨相关因素 男性和与男性发生性关系的跨性别者（MTSM）采用TasP的不同阶段。 我们将对美国的60-75名MTSM进行深入的定性访谈，分为HIV阳性和 艾滋病毒阴性/不知情的个人不使用PrEP。我们将重点关注关于TasP采用的三个立场 我们发现在我们初步数据和PAPM：TasP中关键阶段的映射中是共同的 怀疑论者（不相信TasP的有效性），TasP信徒（理解TasP是有效的 但不愿意依赖它），和TasP采用者（那些已经依赖该策略的人）。筛选 我们将用于招募面试参与者的调查将提供有关TasP采用其他阶段的进一步数据 （意识，感知有效性，使用意愿和实际使用）在更大和更多样化的样本中 参与者（包括PrEP用户）。具体目标是：1.检查（用定性访谈数据） 影响MTSM对TasP有效性的认知及其依赖意愿的相关因素。到 了解（通过定性访谈数据）使用TasP的MTSM的经验，他们如何使用 策略，以及它如何影响他们的性行为和决定。3.描述（使用筛选器调查数据） 在TasP采用的不同阶段，MTSM的特征（意识，感知的有效性， 使用意愿和实际使用）。4.开始制定干预措施以纠正误解 了解TasP，克服其使用障碍，并教育MTSM如何最有效地使用预防措施 战略