Adapting effective mhealth interventions to improve uptake and adherence of the HIV pre- exposure prophylaxis (PrEP) in Thai young MSM

采用有效的移动健康干预措施，以提高泰国年轻 MSM 的 HIV 暴露前预防 (PrEP) 的接受度和依从性

• 批准号: 10258607
• 负责人: NITTAYA PHANUPHAK
• 金额: $ 26.62万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258607
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; Advisory Committees; Asia; Asthma; Awareness; Behavioral; Biological Markers; Car Phone; Centers for Disease Control and Prevention (U.S.); Chronic; Clinic; Computers; Counseling; Country; Development; Drug usage; Enrollment; Epidemic; General Population; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV Seroprevalence; HIV/STD; Health; Health behavior; Health system; Incidence; Individual; Intervention; Interview; Literature; Massage; Methods; Modeling; Monitor; Motivation; Nature; Oral; Participant; Patient Recruitments; Pattern; Persons; Pharmaceutical Preparations; Phase; Population; Prevalence; Prevention strategy; Preventive service; Process; Protocols documentation; Randomized; Randomized Controlled Trials; Recommendation; Regimen; Reporting; Risk; Risk-Taking; System; Technology; Testing; Text; Text Messaging; Thailand; Time; Treatment Efficacy; Work; Youth; acceptability and feasibility; aged; antiretroviral therapy; base; behavior change; digital; effective intervention; efficacy testing; efficacy trial; feasibility research; follow-up; high risk population; improved; infection rate; innovation; mHealth; men; men who have sex with men; mobile computing; motivational enhancement therapy; motivational intervention; participant retention; post intervention; pre-exposure prophylaxis; prevent; programs; recruit; response; satisfaction; scale up; sex; side effect; skills; social stigma; success; transmission process; uptake; usability; young man; young men who have sex with men

Young men having sex with men (YMSM) are the fastest growing HIV+ population worldwide. Thailand has the highest adult HIV seroprevalence in Asia; 28.6% of men having sex with men in Bangkok are HIV+. The HIV incidence rate among YMSM in Bangkok is 12.2 per 100 person-years. Effective prevention strategies are urgently needed to prevent HIV transmission in this high-risk population. Pre-exposure prophylaxis (PrEP) is an efficacious HIV prevention strategy recommended by the CDC and WHO for all at-risk individuals, including HIV-negative MSM. PrEP is highly effective when taken as prescribed, but PrEP utilization has been low and adherence is often inadequate. To address these challenges among Thai YMSM, we propose to develop a technology facilitated intervention combining Motivational Enhancement System for PrEP Uptake and Adherence (MES-PrEP) and Motivational Interactive Text Messaging (MTM) to increase uptake of and sustained adherence to PrEP among HIV-negative, Thai YMSM. MTM will be programmed and tested to send two-way motivational messages to promote PrEP uptake and adherence. Our primary aim is to develop and pilot test MES-PrEP and MTM and associated protocols and to assess preliminary evidence of the effect of the technology facilitated intervention. The proposed study includes 3 phases. Phase I includes in-depth interviews with 30 HIV-negative Thai YMSM to explore barriers and facilitators of PrEP initiation and adherence to inform intervention content. Phase II consists of adapting and beta testing MES-PrEP and MTM for functionality and feasibility using 10 HIV-negative Thai YMSM. In Phase III, we will conduct a pilot randomized controlled trial to evaluate the feasibility, acceptability, and preliminary efficacy of MAS-PrEP and MTM to increase PrEP uptake and adherence among Thai YMSM. We will enroll 60 HIV-negative Thai YMSM who have not started PrEP and 60 YMSM who are on PrEP but not adherent to it. Participants will be randomized 2:1 to received MES-PrEP and MTM (n=40) or Standard PrEP Counseling (n=20). Feasibility and acceptability of the intervention will be assessed through paradata of usage patterns and the System Usability Scale. Preliminary impact will be assessed by evaluating the proportion of PrEP initiation and level of adherence to PrEP. Participants will complete the assessments at baseline and 1, 3, and 6 months post- intervention. Biomarkers of adherence to PrEP and HIV/STI will be collected. Upon project completion, we shall have developed a highly innovative mHealth intervention to support MSM using PrEP which will be ready for testing in a larger efficacy trial.

与男性发生性关系的年轻人（YMSM）是全球增长最快的艾滋病毒+人群。泰国有 亚洲最高的成年艾滋病毒血清血清阳性；在曼谷与男性发生性关系的男性中有28.6％为艾滋病毒+。这 曼谷YMSM的艾滋病毒发病率为每100人年12.2。有效的预防策略是 迫切需要在这种高危人群中防止HIV传播。暴露前预防（PREP）为 疾病预防控制中心推荐的有效的艾滋病毒预防策略，以及所有高危个人， 包括HIV阴性MSM。按规定服用时，PREP非常有效，但是PREP利用率已有 低和依从性通常不足。为了解决泰国YMSM之间的这些挑战，我们建议 一项技术促进干预措施，结合了动机增强系统，以进行准备和 依从性（MES-PREP）和动机互动文本消息传递（MTM），以增加吸收和 在HIV阴性泰国YMSM中持续遵守准备。 MTM将进行编程和测试以发送 双向动机信息，以促进预备力的吸收和依从性。我们的主要目的是发展和 试验测试MES-PREP和MTM以及相关方案，并评估初步证据 技术促进干预。拟议的研究包括3个阶段。第一阶段包括深入 接受30个HIV阴性泰国YMSM的访谈，以探索准备启动的障碍和促进者 遵守干预内容。第二阶段包括适应和β测试MES-PREP和MTM 使用10个HIV阴性泰式YMSM进行功能和可行性。在第三阶段，我们将进行飞行员 随机对照试验评估MAS-PREP和 MTM增加泰国YMSM中的预备摄取和依从性。我们将注册60个HIV阴性泰国YMSM 他们尚未启动PreP和60 YMSM的人，他们正在准备但不遵守。参与者会 随机2：1接收到MES-PREP和MTM（n = 40）或标准准备咨询（n = 20）。可行性和 干预措施的可接受性将通过使用模式和系统可用性来评估 规模。初步影响将通过评估准备启动的比例和水平来评估 遵守准备。参与者将在基线和1、3和6个月的评估完成 - 干涉。将收集依从性和HIV/STI的生物标志物。项目完成后，我们 应已经开发出高度创新的MHealth干预措施，以使用PREP支持MSM 用于在更大的功效试验中进行测试。