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PrEP for Black MSM: Community-Based Ethnography and Clinic-Based Treatment

黑人 MSM 的 PrEP：基于社区的民族志和基于临床的治疗

基本信息

批准号：
9118362
负责人：
PAUL W COLSON
金额：
$ 57.78万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-21 至 2018-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9118362
关键词：
AIDS prevention AIDS/HIV problem Adherence Affect Anti-Retroviral Agents Behavior Therapy Behavioral Caring Clinic Clinical Clinical Research Clinical Trials Communities Couples Development Effectiveness Elements Epidemic Ethnography Face Generations HIV HIV Infections HIV diagnosis Health Health Knowledge, Attitudes, Practice Health Personnel Health Priorities Health system Infection Intervention Interview Investigation Latino Life Link Maps Measures Methods New York City Oral Participant Perception Pharmaceutical Preparations Play Population Population Group Populations at Risk Prevalence Prevention Preventive Intervention Primary Health Care Prophylactic treatment Randomized Randomized Controlled Trials Research Research Design Research Methodology Research Personnel Risk Risk Behaviors Role Sampling Services Shapes Social Concepts Social Environment Social Network Surveys Testing United States Woman Work arm base black men who have sex with men clinical care community based participatory research compare effectiveness contextual factors design evidence base experience high risk informant innovation men men who have sex with men next generation pill population based pre-clinical trial prevent primary care setting scale up sex sex risk sexual relationship social social science research success tool transmission process uptake

项目摘要

DESCRIPTION (provided by applicant): In the United States, men who have sex with men (MSM) comprise the group most severely affected by the HIV epidemic: 61% of all new infections in 2009 occurred in this population. Black MSM experience an even more disproportionate burden of infections, with prevalence of 28% in contrast to 16% in White, non- Latino MSM. HIV-infected Black MSM are also more likely than White MSM to receive an HIV diagnosis at their first testing experience, suggesting that they are less likely than other group to benefit from HIV prevention and control services. Clearly, the reduction of HIV-related disparities in Black MSM is a national health priority, essential to the success of efforts to contol and prevent HIV/AIDS as articulated in the National HIV/AIDS Strategy. Pre-Exposure Prophylaxis (PrEP), which has been shown to reduce acquisition among MSM, could play a critical role in the next generation of combination prevention interventions. Before PrEP is scaled up on a national level, however, critical questions must be answered regarding both the community-level factors that will shape uptake of and adherence to PrEP among Black MSM and the optimal clinical package for delivering PrEP in a way that is both scalable and effective. There is, moreover, a relationship between the broader social needs and perceptions of Black MSM and that clinical care package, and so we propose a multi-method study that incorporates community-based ethnography and an intervention in a community primary care clinic. The community-based ethnographic research will consist of institutional mapping, key informant interviews, ethnographic interviews with a systematic ethnographic sample, participant observation, and analysis of material culture. Drawing on the concepts of social risk, life projects, and social networks, we will explore the structural and cultural factors that shape men's sexual relationships, health systems engagement, and knowledge attitudes and practices related to HIV prevention in general and PrEP in particular. Findings from the ethnographic research will provide urgently needed information regarding community-contextual factors relevant to designing combination prevention interventions that include PrEP, and will lay the groundwork for the randomized controlled trial for PrEP for Black MSM in a community-based clinic. The clinic-based research will randomize eligible HIV- negative Black MSM to an enhanced versus standard PrEP package of care and compare their effectiveness on adherence with PrEP and reduction in sexual risk behaviors. The RCT will generate critical information regarding the acceptability of PrEP for Black MSM in a community clinical context, adherence to PrEP under non-experimental conditions, health providers' experiences with PrEP, and the impact of PrEP on sexual risk practices.

描述（由申请人提供）：在美国，男男性行为者（MSM）是受艾滋病毒流行影响最严重的群体：2009年所有新感染病例中有61%发生在这一人群中。黑人男男性接触者的感染负担更不成比例，其患病率为28%，而白人、非拉丁裔男男性接触者的患病率为16%。感染艾滋病毒的黑人男同性恋者在第一次检测时也比白人男同性恋者更有可能得到艾滋病毒诊断，这表明他们比其他群体更不可能从艾滋病毒预防和控制服务中受益。显然，缩小黑人男男性行为者中与艾滋病毒有关的差距是国家卫生优先事项，对《国家艾滋病毒/艾滋病战略》所阐明的控制和预防艾滋病毒/艾滋病的努力取得成功至关重要。暴露前预防（PrEP）已被证明可减少男男性行为者的感染，可在下一代联合预防干预措施中发挥关键作用。然而，在PrEP在国家层面上扩大之前，必须回答关于社区层面因素的关键问题，这些因素将影响黑人男男性接触者对PrEP的吸收和坚持，以及以可扩展和有效的方式提供PrEP的最佳临床方案。此外，更广泛的社会需求和黑人男同性恋者的认知与临床护理包之间存在关系，因此我们提出了一项多方法研究，将社区民族志和社区初级保健诊所的干预结合起来。以社区为基础的民族志研究将包括机构绘图、关键信息提供者访谈、系统民族志样本的民族志访谈、参与者观察和物质文化分析。借鉴社会风险、生活项目和社会网络的概念，我们将探索塑造男性的结构和文化因素

项目成果

期刊论文数量（2）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Response Rates of Medical Providers to Internet Surveys Regarding Their Adoption of Preexposure Prophylaxis for HIV: Methodological Implications.

DOI：
10.1177/2325958218798373
发表时间：
2018-01
期刊：
Journal of the International Association of Providers of AIDS Care
影响因子：
0
作者：
Silverman TB;Schrimshaw EW;Franks J;Hirsch-Moverman Y;Ortega H;El-Sadr WM;Colson PW
通讯作者：
Colson PW

Corrigendum.