PrEP iT! A Pilot Test of a Mobile Peer Support Intervention to Optimize PrEP Adherence and Retention in PrEP Care

PrEP iT！

• 批准号: 10116478
• 负责人: Jason V Baker
• 金额: $ 20.67万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-08 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10116478
• 关键词: AIDS prevention; Address; Adherence; Adoption; Age; Appointment; Area; Behavioral; Behavioral Sciences; Biological; Blood; Car Phone; Caring; Clinical; Clinical Trials; Collaborations; Communication; Communities; Continuity of Patient Care; Data; Development; Dose; Effectiveness; Epidemiology; Feedback; Focus Groups; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Health Personnel; Healthcare; Hispanics; Infection; Intervention; Interview; Latino; Modeling; Monitor; Moods; Motivation; Outcome; Outcome Study; Patient Self-Report; Persons; Preparation; Prevention approach; Prevention strategy; Preventive; Procedures; Process; Program Sustainability; Protective Agents; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research; Science; Sexual Health; Suggestion; Support Groups; Target Populations; Taste Perception; Technology; Tenofovir; Testing; Text Messaging; Time; Youth; age group; aged; antiretroviral therapy; arm; clinical care; community setting; emtricitabine; ethnic minority population; experience; follow-up; forgetting; high risk population; improved; infection rate; innovation; medication compliance; member; men; men who have sex with men; mobile computing; multidisciplinary; novel; open label; open source; peer; peer support; pill; pre-exposure prophylaxis; racial minority; scale up; skills; social stigma; theories; therapy design; tool; treatment as usual; truvada; usability; virtual; young adult; young men who have sex with men

Abstract Young men who have sex with men (YMSM), especially those who are Black and Hispanic/Latino, are disproportionately impacted by new HIV infections. Pre-exposure prophylaxis (PrEP) is one of the most effective HIV prevention tools, however its benefits are directly correlated with medication adherence to sustain adequate tenofovir (TFV) levels in blood. Recent studies (ATN 110 & 113) show that young MSM prescribed PrEP struggle with adherence, especially when healthcare appointments are reduced from monthly to every 3 months, and most fail to maintain protective drug levels via PrEP over time. This has prompted calls for youth- specific interventions consisting of peer support groups and frequent healthcare interactions for YMSM on PrEP. The proposed study responds directly these recommendations by developing and pilot testing a mobile peer support intervention to improve PrEP adherence and retention in PrEP care for YMSM ages 18-29 years, called “PrEP it Together” (or PrEP iT!). PrEP iT! is grounded in the principles of the Technology Adoption Model and the Information, Motivation, and Behavioral Skills (IMB) model and includes virtual peer interaction and support, youth-centered PrEP and sexual health information, adherence reminders and self-monitoring, text message follow-up for youth whose adherence may be faltering, healthcare appointment reminders, healthcare provider interactions, and gamification components to optimize engagement. First, we will develop the PrEP iT! mobile intervention through focus groups with YMSM and refine iterations through input from a community advisory board (CAB). Four focus groups will be conducted to gain feedback on an existing mobile platform from which PrEP iT! will be adapted. Next, a CAB of YMSM will provide regular feedback during the iterative intervention design process. Usability testing with 6 members of the target population will be conducted, culminating in a final version of PrEP iT! Second, in preparation for a subsequent R01 trial, we will conduct a pilot randomized controlled trial to assess the feasibility, acceptability and preliminary impact of the PrEP iT! intervention for YMSM. Eighty YMSM recently initiating or restarting PrEP will be randomized to receive either PrEP iT! or usual care for 6 months, with biological and self-reported outcomes collected at baseline, and 3- and 6-month follow-up time points. Intervention use data will be collected to assess which intervention components impact study outcomes. Exit interviews of 10 YMSM will be conducted to further refine the intervention for a larger trial. PrEP iT! is innovative because it is the first intervention to use mobile phone technology to facilitate virtual peer support for YMSM on PrEP. The study advances PrEP science by addressing critical gaps (adherence & retention) in PrEP care among YMSM, and is sustainable because it will be built on an open source platform that may be integrated into clinical and community settings serving YMSM. If the PrEP iT! intervention is demonstrated to be effective, it may be quickly scaled up for wide-scale dissemination.

抽象的 与男人发生性关系（YMSM）的年轻人，尤其是黑人和西班牙裔/拉丁裔的年轻人 受新艾滋病毒感染的影响不成比例。暴露前预防（PREP）是最多的 有效的HIV预防工具，但是其收益与药物依从性直接相关以维持 血液中足够的替诺福韦（TFV）水平。最近的研究（ATN 110和113）表明年轻的MSM处方 依从性的准备斗争，尤其是当医疗保健约会从每月减少到每3个 几个月，并且大多数无法通过随着时间的推移来维持受保护的药物水平。这促使呼吁青年 - 由同伴支持小组组成的特定干预措施以及YMSM经常进行医疗保健互动 准备。拟议的研究通过开发和试点测试手机直接做出了这些建议 同行支持干预措施以提高YMSM 18-29岁的YMSM的准备依从性和保留率， 称为“一起准备”（或准备！）。准备它！基于技术采用原则 模型以及信息，动机和行为技能（IMB）模型，包括虚拟同行互动 和支持，以青年为中心的预备和性健康信息，遵守提醒和自我监控， 对年轻人的依从性可能是错误的，医疗保健任命提醒的短信跟进， 医疗保健提供者的互动和游戏化组件以优化参与度。首先，我们将发展 准备！通过与YMMM的焦点小组进行移动干预，并通过输入来完善迭代 来自社区顾问委员会（CAB）。将进行四个焦点小组，以获得有关 现有的移动平台准备它！将适应。接下来，YMMM的驾驶室将提供常规 在迭代干预设计过程中的反馈。与6个目标成员进行可用性测试 人口将进行，最终以Prep IT的最终版本！第二，准备 随后的R01试验，我们将进行一项飞行员随机对照试验，以评估可行性， 预备IT的可接受性和初步影响！ YMSM的干预。最近八十YMSM 启动或重新启动准备将被随机分配以接收任何一个准备！或通常需要6个月的时间 在基线收集的生物学和自我报告的结果，以及3个月和6个月的随访时间点。 将收集干预使用数据，以评估哪些干预成分影响研究结果。出口 将进行10个YMSM的访谈，以进一步完善大型试验的干预措施。准备它！是 创新性是因为它是第一次使用手机技术来促进虚拟同行支持的干预措施 YMSM准备。该研究通过解决关键差距（依从性和保留）来推进Prep Science YMSM之间的预备护理，并且是可持续的，因为它将建立在可能是的开源平台上 集成到为YMSM服务的临床和社区环境中。如果准备就绪！干预被证明 有效，可以快速扩大规模以进行大规模传播。

项目成果

Attitudes Toward and Beliefs in the Effectiveness of Biomedical HIV Prevention Strategies Among Emerging and Young Adult Sexual Minority Men.

新兴和年轻性少数男性对生物医学艾滋病毒预防策略有效性的态度和信念。

• DOI: 10.1007/s12529-023-10244-4
• 发表时间: 2023
• 期刊: International journal of behavioral medicine
• 影响因子: 2.7
• 作者: Ma,Junye;Chase,GregoryE;Black,Ashley;Klaphake,Jonathan;Garcia-Myers,Kelly;Baker,JasonV;Horvath,KeithJ
• 通讯作者: Horvath,KeithJ