Effectiveness of combination HIV preventive interventions for young Thai MSM

泰国年轻男男性接触者联合艾滋病毒预防干预措施的有效性

基本信息

批准号：
10084364
负责人：
Christopher C. Beyrer
金额：
$ 38.23万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10084364
关键词：
AIDS prevention Acute Address Adherence Asia Awareness Car Phone Caring Centers for Disease Control and Prevention (U.S.)Cohort Studies Collaborations Communities Cost Analysis Cost Measures Cost Savings Counseling Data Effectiveness Enrollment Epidemic Foundations Goals HIV HIV Infections HIV Seropositivity Health Promotion Human immunodeficiency virus test Incidence Individual Infection Intervention LGBT Health Lubricants Methods Oral Participant Persons Phase Population Prevention Prevention strategy Preventive Intervention Procedures Process Prostitution Qualitative Methods Recording of previous events Reporting Research Research Design Rights Risk Risk Reduction Scoring Method Service provision Services Structural Models Tenofovir Testing Thailand Time Treatment Cost Universities Work acute infection aged base behavior change community clinic community consultation condoms cost cost effective cost effectiveness density design disability-adjusted life years effectiveness testing effectiveness trial empowerment emtricitabine experience high risk male male sex worker member men men who have sex with men open label pre-exposure prophylaxis public health relevance sex sexual risk taking truvada uptake young man young men who have sex with men

项目摘要

DESCRIPTION (provided by applicant): This Thai-US collaborative application seeks to develop and conduct a non-randomized effectiveness and cost-effectiveness study of a multi-level combination HIV preventive intervention with and without daily oral Tenofovir/Emtricitabine (Truvada) pre-exposure prophylaxis (PrEP) with mobile phone-based SMS adherence support among young men who have sex with men (YMSM) in Bangkok, Thailand. The current epidemic of HIV among Thai YMSM (men aged 18-26) is marked by high HIV incidence (5-12/100py) despite current prevention and treatment efforts, and rates are highest among the youngest men, aged 18-21, and among the subset of YMSM who sell sex. The proposed combination intervention will include individual level components: frequent HIV testing, risk reduction counseling, condom and lubricant distribution, and behavior change counseling; community awareness and mobilization; and an open label offer of PrEP with SMS (FrontlineSMS) adherence support. Participants will include Thai YMSM engaged in sex work or with a history of recent (in the previous 12 months) selling sex. The proposed study will be conducted by Johns Hopkins, Mahidol, and Emory Universities; The Thai MOPH-US CDC Collaboration (TUC) and its Silom Community Clinic @ Trop Med (SCC); and community partners including SWING, a sex worker empowerment and health promotion group; Rainbow Sky, an LGBT health and rights group; and APCOM, the Asia-Pacific Community of MSM. This group combines unique expertise, access, and experience in working with YMSM in this hyper-epidemic context. The study will include a formative phase using qualitative and community engagement methods to refine the intervention; a pilot; the open label intervention assessing effectiveness of combination interventions with and without PrEP and SMS adherence support with an HIV infection endpoint; and a costing and cost-effectiveness assessment which will measure the costs associated with the combined intervention, the number of infections averted through PrEP use, discounted treatment costs save, and assess whether the intervention packages are cost- saving, cost effective, or not cost-effective. The effectiveness study has been powered on the comparison of person time on PrEP versus not on PrEP and will employ propensity score methods to reduce the potential bias inherent in the self-selection design. In all the study proposes to enroll 1240 YMSM, 620 who choose PrEP and 620 who do not choose PrEP.

DESCRIPTION (provided by applicant): This Thai-US collaborative application seeks to develop and conduct a non-randomized effectiveness and cost-effectiveness study of a multi-level combination HIV preventive intervention with and without daily oral Tenofovir/Emtricitabine (Truvada) pre-exposure prophylaxis (PrEP) with mobile phone-based SMS adherence support among young men who have sex with men (YMSM) in Bangkok, Thailand.尽管目前的预防和治疗工作，但泰国YMSM（18-26岁的男性）目前的艾滋病毒流行以高艾滋病毒发病率（5-12/100py）为特征，并且在18-21岁的最年轻的男性中，率是最高的，年龄在18-21岁的男性中，以及卖性别的YMMSM子集中。拟议的组合干预措施将包括个人级别的组成部分：频繁的HIV测试，降低风险咨询，避孕套和润滑剂分配以及行为改变咨询；社区意识和动员；以及带有SMS（Frontlinesms）依从性支持的PREP的开放标签。参与者将包括从事性工作的泰国YMSM或最近（过去12个月）销售性行为的历史。拟议的研究将由约翰·霍普金斯（Johns Hopkins），马希多（Mahidol）和埃默里大学（Emory Universities）进行。泰国MOPH-US CDC合作（TUC）及其Silom社区诊所 @ Trop Med（SCC）；以及社区合作伙伴，包括Swing，性工作者授权和健康促进小组； LGBT健康与权利小组Rainbow Sky；和Apcom，MSM的亚太社区。该小组结合了在这种高流动性背景下与YMSM合作的独特专业知识，访问和经验。该研究将包括使用定性和社区参与方法来完善干预措施的形成阶段；飞行员；开放标签干预措施评估有或没有PREP和SMS依从性支持的组合干预措施的有效性以及HIV感染终点；以及一项成本效益评估，将衡量与合并干预措施相关的成本，通过预备使用避免感染的数量，节省折现的治疗成本以及评估干预软件包是否可以节省成本，成本效益，或者不具有成本效益。有效性的研究已用于比较PrEP与不准备时间的人的比较，并将采用倾向分数方法来减少自选择设计中固有的潜在偏差。总的来说该研究提议注册1240 YMSM，620名选择Prep和620的人，他们不选择PREP。