The Collaborative Care PrTNER (Prevention, Treatment, Navigation, Engagement, Resource) Project

项目摘要/摘要 为了结束艾滋病毒的流行，我们需要综合的护理模式，以解决艾滋病毒和PrEP护理，并共存 物质使用(SU)障碍，扰乱对有效干预措施的吸收和持续使用。最重要的是 R01提案的目标是进行一项随机对照试验，以评估 协作式护理预防、治疗、导航、参与、资源(PrTNER)干预 加强暴露前预防(PrEP)(针对艾滋病毒高危人群)并减少病毒载量 (针对艾滋病毒携带者)通过 从事苏氏治疗。协作护理(CC)PrTNER是一种多组件干预 由我们的研究团队成员开发，专门针对15至24岁的YBLMSM高危人群或生存 艾滋病毒携带者。这个模型超越了个人，考虑了更广泛的背景，物质使用，以及 艾滋病毒风险被(重新)产生。 将SU治疗集成到艾滋病毒和PrEP初级保健服务中的增强模式(使用协作 需要结合精神病学家的反馈和同行教练的支持的护理方法) 解决这一人群中物质使用的细微差别。因此，我们建议进行一项随机的 使用以下目标评估综合协作护理模式(CC PrTNER)的试验： 具体目标1：比较YBLMSM和共存的SU感染HIV风险的比例 (启动或重新启动)在CC PrTNER ARM的12个月内与标准护理(SOC)中的PrEP。 具体目标2：比较YBLMSM和同时感染HIV的SU的比例 在协作护理PrTNER组与SOC组相比，HIV病毒在12个月时被抑制。 具体目标3：比较CC、PrTNer和SOC对YLBMSM中非烟草SU的影响 并检测SU的变化对PrEP摄取和HIV病毒抑制的影响。 该提案直接涉及2022年国家艾滋病毒/艾滋病战略的目标1、2和4，以结束艾滋病毒 流行病直通：通过全面的预防、治疗和解决共存的SU疾病 综合护理服务。它还可以进一步改变青少年、卫生部门和瑞安·怀特的护理环境 通过协调PrEP、HIV和SU治疗护理提供服务并实施 协作式护理模式，以解决阻碍吸收和坚持的多层次障碍。

Project Summary/Abstract To end the HIV epidemic, we need integrated care models that address HIV and PrEP care, and co-existing substance use (SU) disorders that disrupt uptake and consistent use of effective interventions. The overarching goal of this R01 proposal is to conduct a randomized controlled trial to assess the ability of a Collaborative Care Prevention, Treatment, Navigation, Engagement, Resource (PrTNER) intervention to increase initiation of preexposure prophylaxis (PrEP) (for those at-risk for HIV) and decrease viral load (for those living with HIV) among young Black and Latino men who have sex with men (YBLMSM) through engagement in SU treatment. The Collaborative Care (CC) PrTNER is a multi-component intervention developed by members of our research team specifically for YBLMSM aged 15 to 24 who are at-risk for or living with HIV. This model moves beyond the individual to consider the broader context in which, substance use, and HIV risk are (re)produced. Enhanced models that integrate SU treatment into HIV and PrEP primary care services (using a collaborative care approach that incorporates feedback from a psychiatrist and support from a peer coach) are needed to address the nuance of substance use in this population. We, therefore, are proposing to conduct a randomized trial to evaluate an integrated collaborative care model (CC PrTNER) using the following aims: Specific Aim 1: To compare the proportion of YBLMSM with co-existing SU at risk for HIV infection who initiate (start or restart) PrEP over the 12 months in the CC PrTNER arm versus standard of care (SOC). Specific Aim 2: To compare the proportion of YBLMSM with co-existing SU living with HIV infection who are HIV virally suppressed at 12 months in the Collaborative Care PrTNER arm versus SOC. Specific Aim 3: To compare the effect of CC PrTNER versus SOC on non-tobacco SU in YLBMSM with co- existing SU and examine the effect of change in SU on PrEP uptake and HIV viral suppression. This proposal directly addresses goals 1, 2, and 4 of the 2022 National HIV/AIDS Strategy to End the HIV Epidemic through: prevention, treatment, and addressing co-existing SU disorders through comprehensive integrated care delivery. It further can transform the adolescent, health department and Ryan White care settings serving YBLMSM through harmonization of PrEP, HIV and SU treatment care delivery and implementation of a collaborative care model to address the multi-level barriers that impede uptake and adherence.