Juntas Adelante: A Peer-coaching Intervention to Promote Chemoprophylaxis for HIV Prevention among Latina Transgender Women in the Washington DC Metropolitan Area

Juntas Adelante：一项同伴辅导干预措施，旨在促进华盛顿特区都会区拉丁裔跨性别女性进行化学预防以预防艾滋病毒

• 批准号: 10626783
• 负责人: Ana María del Río-González
• 金额: $ 33.26万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10626783
• 关键词: Juntas; Adelante; Peer; coaching; Intervention

PROJECT SUMMARY/ABSTRACT Transgender women (TW) bear a disproportionate burden of HIV, with one of the single largest HIV-related disparities found among Latina TW, whose HIV prevalence (26%) is almost four times greater than among their non-Hispanic White counterparts (7%). Based on findings from our Adelante study, a mixed-methods longitudinal pilot project assessing awareness and uptake of PrEP and PEP among immigrant LTW in the DC metropolitan area, this original epidemiological-interventional project seeks to develop and pilot test a peer- coaching intervention to promote chemoprophylaxis (i.e. PrEP and PEP) for HIV prevention that is culturally responsive to the characteristics of the LTW community. To achieve this aim we have established a strong community-academia-government partnership, composed of LTW working for organizations providing services to the LTW community in the DC metropolitan area, officials from the HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) of the DC Department of Health and researchers from the DC Center for AIDS Research (DC CFAR). Using a community-based participatory research (CBPR) approach, all members of our partnership will work collaboratively to develop the intervention, which will include: 1) peer-coaching sessions for improving HIV-risk assessments, providing information about PrEP/PEP, and supporting PrEP/PEP uptake and adherence, 2) navigation to existing PrEP/PEP services and 3) other culturally appropriate components deemed relevant by the CBPR team. We will use a randomized delayed-intervention control trial to examine feasibility, acceptability and preliminary efficacy, randomizing HIV negative LTW to the intervention (n=25) or a 6-month waitlist control group (n=25). PrEP/PEP uptake and adherence will be assessed at baseline and 3, 6 and 12- month follow ups, using self-report, medical records reviews and clinical assays. Intervention feasibility and acceptability will be assessed using qualitative in-depth individual interviews with participants one month after intervention completion. Our community-academia-government partnership is ideally suited to carry out the proposed research with a demonstrated ability to recruit, retain and engage the LTW community in DC in prior HIV research. For the “Adelante” study we recruited 62 immigrant LTW, with an overall retention rate of 82% for the longitudinal portion (n=41/50). We have established strong relationships with organizations serving the LTW community, who will collaborate on this project, ensuring that community needs and priorities drive an effective HIV response. This proposal complements and extends HAHSTA's HIV prevention efforts towards Ending the HIV Epidemic (EHE) in DC by 2030. In line with the EHE plan's key strategy to prevent new HIV transmissions by using proven interventions, this research will support the development of the first evidence-informed HIV prevention intervention targeting LTW. Results from this study will be used to prepare a NIH R–series award to conduct a more stringent test of effectiveness of the intervention. This proposal aligns well with the overarching goal of the MARI program to support innovative implementation science research in a minority community heavily impacted by HIV.

项目摘要/摘要 变性人妇女(TW)承受着不成比例的艾滋病毒负担，与艾滋病毒有关的最大单一负担之一 在拉丁裔TW中发现的差异，他们的艾滋病毒流行率(26%)几乎是他们的四倍 非西班牙裔白人(7%)。基于我们阿德兰特研究的结果，一种混合方法 纵向试点项目评估DC移民LTW对PrEP和PEP的认识和接受 大都会地区，这一独创的流行病学干预项目寻求开发和试点测试同龄人- 指导干预以促进从文化上预防艾滋病毒的化学预防(即PrEP和PEP) 响应LTW社区的特点。为了实现这一目标，我们建立了强大的 社区-学术界-政府伙伴关系，由为提供服务的组织工作的LTW组成 到DC大都市区的LTW社区，艾滋病毒/艾滋病、肝炎、性传播疾病和结核病的官员 华盛顿特区卫生局(HAHSTA)和华盛顿特区艾滋病中心的研究人员 研究(DC CFAR)。使用基于社区的参与性研究(CBPR)方法，我们的所有成员 合作伙伴将合作开发干预措施，其中将包括：1)同伴辅导会议 改进艾滋病毒风险评估，提供有关PrEP/PEP的信息，并支持PrEP/PEP的吸收和 遵从性，2)导航到现有的PrEP/PEP服务，以及3)其他符合文化背景的组件 与CBPR团队相关。我们将使用随机延迟干预对照试验来检验可行性， 可接受性和初步疗效，将HIV阴性的LTW随机分配到干预(n=25)或6个月 等待名单对照组(n=25)。PREP/PEP的吸收和依从性将在基线和3、6和12- 一个月的随访，使用自我报告，医疗记录审查和临床测试。干预的可行性和 可接受性将在一个月后通过与参与者的定性深入个人访谈进行评估 干预完成。我们的社区-学术界-政府伙伴关系非常适合开展 拟议的研究，证明有能力招募、留住和吸引DC的LTW社区参与以前的艾滋病毒 研究。对于阿德兰特的研究，我们招募了62名移民LTW，总体保留率为82% 纵部(n=41/50)。我们已经与服务于LTW的组织建立了牢固的关系 社区，谁将在这个项目上合作，确保社区的需求和优先事项推动有效的艾滋病毒 回应。这项建议补充和扩大了HAHSTA的艾滋病毒预防努力，以结束艾滋病毒 到2030年，华盛顿的流行病(EHE)。与EHE计划的关键战略保持一致，通过使用 经过验证的干预措施，这项研究将支持开发第一个循证知情的艾滋病毒预防 针对LTW的干预。这项研究的结果将被用来准备NIH R系列奖项，以进行更多 严格检验干预措施的有效性。这项提议与马里的总体目标非常一致。 支持在受艾滋病毒严重影响的少数族裔社区进行创新实施科学研究的计划。