Exploring Real-time ART Adherence Monitoring In Young African American MSM

探索年轻非裔美国 MSM 的实时 ART 依从性监测

• 批准号: 9198162
• 负责人: Mark S Dworkin
• 金额: $ 20.81万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-26 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9198162
• 关键词: Accounting; Address; Adherence; African American; Anti-Retroviral Agents; Antiretroviral resistance; Behavior; Behavioral; Caring; Case Manager; Cellular Phone; Communication; Communities; Coupled; Data; Development; Devices; Dose; Drug resistance; Event; Failure; Focus Groups; Future; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Hispanics; Incidence; Intervention; Intervention Trial; Interview; Logistics; Modeling; Monitor; Morbidity - disease rate; Motivation; Neighborhoods; Patients; Persons; Pharmaceutical Preparations; Population; Prevention; Prophylactic treatment; Public Health; Publishing; Race; Reaction Time; Recruitment Activity; Research; Resistance; Resources; Retrospective Studies; Social support; Technology; Text; Time; Treatment Failure; Triage; Viral; Viral Load result; Virus; Wireless Technology; antiretroviral therapy; design; experience; improved; medication compliance; men; men who have sex with men; mortality; patient population; prevent; real time model; response; skills; social; theories; therapy adherence; time use; transmission process

ABSTRACT This exploratory/developmental application proposes to determine the acceptability of a promising new intervention using real-time adherence monitoring and to determine reasons for missed antiretroviral therapy (ART) doses in young AAMSM. Adherence to ART is critical to prevent morbidity, mortality, and emergence of resistant virus. Adherence to Pre-Exposure Prophylaxis (PrEP) with antiretrovirals is critical to prevent HIV transmission. In the US, African American men account for the largest proportion of new HIV infections by race and disproportionately experience associated mortality. Among HIV-positive persons treated with ART, African Americans are significantly less likely than Whites and Hispanics to be virally suppressed. In addition, young MSM have low adherence to PrEP. Guided by the Information Motivation, Behavioral Skills Model, real-time adherence monitoring with a triaged response to missed doses may increase patient information about the consequences of non adherence, motivate medication adherence, and positively influence adherence behavioral skills, resulting in improved behavior that leads to viral suppression and/or more sustained protective PrEP drug levels. The proposed study will recruit young AAMSM from high HIV incidence neighborhoods where improvement in ART adherence has the potential to produce high personal and public health gain, potentially contributing towards lowering HIV incidence rates in these communities. The aims of this study are to: 1) Determine the acceptability of real-time adherence monitoring in young AAMSM by conducting participative formative research with focus groups of young HIV-positive AAMSM patients with detectable viral load in the past 12 months and young AAMSM who are taking PrEP and; 2) Conduct qualitative interviews to determine reasons for missed doses detected in real-time in young HIV-infected AAMSM patients who had a detectable viral load in the past 12 months. We will analyze interview data to identify salient behavioral and/or emergent subpopulation factors that contribute to non adherence. These data will provide a deeper understanding of ART adherence than previous retrospective studies and will inform development of a theory-driven real-time ART adherence intervention including choice of response messages, understanding to what extent perceived social/logistic factors may contribute to these events, and exploring subject's motivation to address reasons for missed doses to prevent future events.

抽象的 此探索性/发展应用程序建议确定有希望的新的 使用实时依从性监测的干预并确定丢失的抗逆转录病毒疗法的原因 （艺术）年轻AAMSM的剂量。遵守艺术对于防止发病，死亡率和出现至关重要 抗性病毒。遵守抗逆转录病毒的预防前预防（PREP）对于预防HIV至关重要 传播。在美国，非洲裔美国男性占种族新艾滋病毒感染的最大比例 并不成比例地经历相关的死亡率。在接受艺术治疗的艾滋病毒阳性人中 美国人比白人和西班牙裔被病毒抑制的可能性要小得多。另外，年轻 MSM的依从性较低。在信息动机，行为技能模型，实时的指导下 通过对遗漏剂量的三重反应进行依从性监测可能会增加有关该的患者信息 非依从性的后果，激励药物依从性并积极影响依从性 行为技能，导致行为改善，导致病毒抑制和/或更持续 保护性药物水平。拟议的研究将从高HIV发病率招募年轻AAMSM 改善艺术依从性的社区有可能产生高级个人和公众 健康增长，有助于降低这些社区的艾滋病毒发病率。目的 这项研究是：1）确定通过 与年轻的HIV阳性AAMSM患者进行参与性形成研究 在过去的12个月中，可检测的病毒负荷和正在准备的年轻AAMSM； 2）行为 定性访谈以确定年轻的HIV感染的实时检测到的遗漏剂量的原因 在过去的12个月中，AAMSM患者患有可检测的病毒负荷。我们将分析面试数据 确定有助于依从性的显着行为和/或新兴的亚群体。这些数据 将比以前的回顾性研究更深入地了解艺术依从性，并将告知 开发理论驱动的实时艺术依从性干预措施，包括选择响应信息， 理解在多大程度上感知到的社会/逻辑因素可能会导致这些事件，并探索 受试者解决遗漏剂量的原因以防止未来事件的动机。