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.

摘要