Next generation partner notification and intervention services

描述（由申请人提供）：本开发申请（R34）要求资金用于完善和试点测试一种灵活的伴侣通知服务暴露前预防（PS-PrEP）干预措施，该干预措施将使现有的公共卫生部门（DPH）伴侣通知服务与临床PrEP护理联系起来，为来自不同背景的艾滋病毒血清阴性高危人群提供服务。要求提供这些资金的原因是，在随机对照试验显示了部分预防PrEP功效之后，在功效实施方面仍然存在明显的分歧。在这些试验之后，卫生保健机构尚未将PrEP纳入现有的艾滋病毒预防规划，导致很少有人接受PrEP，而那些可能最受益的人（最高风险人群）没有接受PrEP。为了解决这些差距，我们的目标是将预防工作纳入现有的预防卫生活动，特别是预防卫生伙伴通知服务。由疾病干预专家（DIS）实施的DPH伴侣通知服务在国内艾滋病毒高流行地区广泛存在，潜力巨大。伙伴通知服务（让新感染艾滋病毒的人的风险伙伴参与）是疾病预防控制中心建议的艾滋病毒预防服务，经常由公共卫生部门开展。来自南芝加哥的数据显示，超过50%的风险接触者感染了艾滋病毒。艾滋病毒的高流行率超过了同一地理区域内传统风险群体的流行率，这表明我们将我们的想法从个人风险（肛交、注射毒品）转变为网络风险（与艾滋病毒感染者有联系的人）。PS-PrEP通过培训DIS工作人员提供简短的量身定制的PrEP联系计划/激励、通过短信/电话进行的小型加强会议，以及直接将客户与PrEP护理联系起来，测试将PrEP纳入日常DPH服务。PS-PrEP将通过检查早期PrEP护理的两个关键组成部分，为一项大型试验奠定基础：1)作为伴侣通知服务的一部分，PS-PrEP在将高危血清阴性客户与PrEP护理联系起来方面的功效；2)个人特征（如风险行为）和

DESCRIPTION (provided by applicant): This developmental application (R34) requests funds to refine and pilot test a flexible Partner notification services Pre-exposure Prophylaxis (PS-PrEP) intervention that will engage existing department of public health (DPH) partner notification services in linkage to clinical PrEP care for at risk HIV seronegative persons from diverse backgrounds. These funds are requested because there remains a stark efficacy implementation divide following randomized controlled trials which have demonstrated partial PrEP efficacy. Following these trials, DPHs have yet to integrate PrEP into existing HIV prevention programs resulting in few people on PrEP and those who might benefit most (highest risk populations) are not receiving it. To address these gaps, we aim to integrate PrEP into existing DPH activities, and in particular, DPH partner notification services. DPH partner notification services implemented by Disease Intervention Specialists (DIS) are widespread in high HIV prevalence areas domestically and have great potential. Partner notification services (engaging the risk partners of newly infected HIV persons), is recommended by the CDC for HIV prevention and is frequently conducted by public health departments. In data from South Chicago over 50% of these risk contacts are HIV infected. This high HIV prevalence outpaces that of traditional risk groups in the same geographic area and suggests that we shift our thinking of who an appropriate candidate for PrEP linkage is from individual risk (anal sex, injecting drugs), to network risk (people connected to HIV infected persons). PS-PrEP tests the integration of PrEP into routine DPH services by training DIS staff to provide brief tailored PrEP linkage planning/motivation, mini-booster sessions via text/phone, and to directly link clients int PrEP care. PS-PrEP will set the stage for a large trial by examining two key components of early PrEP care: 1) efficacy of PS-PrEP in linking high-risk seronegative clients to PrEP care as part of partner notification services; and 2) how personal characteristics (e.g. risk behavior) and downstream PrEP cascade metrics (e.g. retention and adherence to PrEP) of study participants identified through partner notification services compare to other individuals initiating PrEP withi the same clinical context and time frame. We aim to: 1) Refine the PS-PrEP intervention protocol, materials and assessments by shifting more of the intervention to focus on direct PrEP linkage and by developing a network visualization component where participants complete an interactive sociogram of individuals in their own risk network; 2) Pilot test the feasibility (reac, adoption, safety and implementation) and initial efficacy (higher linkage to care) of the PS-PrEP intervention versus treatment as usual at 3 months post randomization among a sample of contacts >18 years old recruited from partner notification services; and 3) Compare sociodemographic, HIV risk and two distal PrEP cascade metrics (retention and adherence) of PS-PrEP intervention participants linked to PrEP care with other individuals initiating PrEP within the same clinical context and time frame (12 months).