Evaluating the Feasibility and Acceptability of "PrEP-Talk": A PrEP Uptake Intervention for Young Black MSM with their Close Friends

摘要 年轻的黑人男男性接触者(YBMSM)感染艾滋病毒的风险极高且不成比例。减少 YBMSM中的艾滋病毒发病率可能需要更多地采用额外的策略 如暴露前预防(PrEP)。Prep是FDA批准的治疗艾滋病毒的药物，也 如果服用得当，可以防止艾滋病毒的传播。需要采取干预措施来解决 接受和遵守PrEP的潜在个人、社会/文化和结构障碍 在YBMSM中帮助遏制艾滋病毒感染。我们的初步研究表明，一些人 YBMSM担心PrEP无效或可能有毒，担心被污名化 如果他们服用PrEP，就会感染艾滋病毒，以及对获得和副作用的担忧。因此，我们 建议使用PrEP-Talk，这是一种使用PrEP顾问(PC)的干预措施，该顾问可以提供 向YBMSM提供信息和指导，包括一位亲密的朋友(CF)以支持PrEP 吸收和坚持。为了解决这些关键和及时的问题，我们开发了 以下是具体目标： 1.开发和制作“PrEP-Talk”，其目的是增加PrEP的摄入量和 YBMSM之间的坚持。这将通过定性的形成性研究来完成(3 12-18个YBMSM和CF DYAD的焦点小组，N=24-36个)；与社区合作 顾问委员会(由了解艾滋病毒与基督教青年会工作的个人组成)； 用5个YBMSM和CF二联体(N=10)进行现场干预试验。 2.审查“PrEP--”的可行性、可接受性和初步效果的指标 关于基督教青年会吸收和坚持PrEP的“谈话”。这将会实现的 通过30个二元组(YBMSM和CFS)的试点随机对照试验 干预组30例，对照组(N=120)。我们将在以下时间进行评估 基线、基线后3个月和6个月。我们还将评估PrEP的使用情况 在每次干预会议上进行支持性沟通，并收集尿样以 测量所有报告使用PrEP的YBMSM摄取PrEP的生物标记物(初始依从性) 关于PrEP的。 这项拟议的研究具有重要意义，因为我们的干预可能会增加PrEP的摄取和 坚持，这可能有助于减少青年男同性恋者中的艾滋病毒发病率。如果建议的 干预显示出希望，我们将准备承担R01资助的全面随机对照试验。

Summary Young Black MSM (YBMSM) are at critically high and disproportionate HIV risk. Reducing HIV incidence rates among YBMSM will likely require increased adoption of additional strategies such as pre-exposure prophylaxis (PrEP). PrEP is a FDA approved medication for HIV that also prevents HIV transmission when taken appropriately. Interventions are needed to address potential individual, social/cultural, and structural barriers to uptake and adherence of PrEP among YBMSM to help curb HIV infections. Our preliminary research suggests that some YBMSM feel concerned that PrEP is not effective or may be toxic, about being stigmatized for having HIV if they take PrEP, as well as concerns about access and side effects. Therefore, we propose “PrEP-Talk”, an intervention that will use a PrEP Counselor (PC) who can provide information and guidance to YBMSM with the inclusion of a close friend (CF) to support PrEP uptake and adherence. In order to address these critical and timely issues, we developed the following specific aims: 1. To develop and manualize “PrEP-Talk,” which aims to increase PrEP uptake and adherence among YBMSM. This will be done through qualitative formative research (3 focus groups with 12-18 YBMSM and CF dyads, N=24-36); partnering with a community advisory board (comprised of individuals knowledgeable about HIV work with YBMSM); and field tests of the intervention with 5 YBMSM and CF dyads (N=10). 2. Examine feasibility, acceptability and indicators of preliminary efficacy of “PrEP- Talk” on PrEP uptake and adherence among YBMSM. This will be accomplished through a pilot randomized controlled trial (RCT) with 30 dyads (YBMSM and CFs) in the intervention and 30 dyads in the control (N=120). We will conduct assessments at baseline, 3-months and 6-months post-baseline. We will also assess PrEP uptake supportive communication at each intervention session and collect urine samples to measure a biomarker of PrEP uptake (initial adherence) from all YBMSM who report use of PrEP. This proposed study is significant because our intervention may increase PrEP uptake and adherence, which may help to reduce HIV incidence among YBMSM. If the proposed intervention shows promise, we will prepare to undertake a full-scale R01-funded RCT.