An Acceptance Based PrEP Intervention to Engage Young Black MSM in the South

项目总结/摘要 与男性发生性关系的年轻黑人男性（YBMSM）艾滋病毒的发病率很高，特别是在 南因此，迫切需要针对YBMSM制定干预措施，以加强对预防服务的参与 needed. YBMSM之间的PrEP护理参与是不那么理想。修正的社会生态模型 （MSEM）定义了重点人群中艾滋病毒感染风险的多层次域。PrEP使用障碍 在YBMSM中发生在每个层面：1）个人，2）社会和性网络，3）社区，4）政策，5） 艾滋病流行的阶段。例子包括个人（例如对艾滋病毒风险的看法）、社会和性网络 (e.g.耻辱），社区（例如缺乏医疗服务）和公共政策（例如护理费用）。边界 每一层之间的水是可渗透的，因此在拟议的研究中考虑了每一层。利用的组件 接受和承诺疗法（ACT），我们将设计一种干预措施，以改善PrEP的吸收， 坚持和坚持。我们将使用一个通用的框架来适应EBI， 制定针对YBMSM的PrEP简短干预措施，称为ACTPrEP。ACT通过以下方式解决障碍： 促进：1）当下意识，2）接受内部和外部经验，以及3） 参与与价值观一致的行为。为了最大限度地发挥效用，ACTPrEP将由 PrEP导航器。候选人：Arnold博士是一位具有研究背景的医学临床心理学家/科学家 艾滋病相关研究在南方。她的职业生涯主要集中在艾滋病毒的干预和预防。基础上 她正在申请为期五年的K23职业发展奖。指导：一个特殊的 一组高级调查员担任导师。布朗博士是主要的导师，在以下方面拥有专业知识： 设计和实施PrEP干预措施。四位共同导师带来了PrEP的互补专业知识 在南方为YBMSM提供服务并进行依从性监测（Mena博士）;适应行为改变 干预（高迪亚诺博士）;实施科学（埃尔维博士）;和定量数据分析（琼斯博士）。 研究：拟定的目标是：1）从YBMSM（n = 20）和诊所工作人员（n = 10）收集数据，通过 深入访谈，评估措施、干预设计和障碍; 2）利用目标1制定ACTPrEP 数据并与专家反复合作;以及3）通过 随机对照试验（n=66），并比较ACTPrEP与增强标准治疗在摄取、依从性 和PrEP持久性。培训：Arnold博士将接受设计、调整和测试方面的具体培训 以理论为基础的干预措施，解决种族和性别少数群体的健康差距，实施 科学，并通过课程，研讨会，讲习班，指导阅读定量分析， 指导研究。这些培训和研究经验将奠定候选人作为专家的职业生涯 在临床上知情的行为改变干预。候选人得到了罗得岛医院的支持。

PROJECT SUMMARY/ABSTRACT Young Black men who have sex with men (YBMSM) have a high incidence of HIV, particularly in the South. Thus, interventions tailored to YBMSM to enhance engagement in prevention services are urgently needed. Engagement in PrEP care among YBMSM is less then optimal. The modified social ecological model (MSEM) defines the multi-level domains of HIV infection risk among key populations. Barriers to PrEP use among YBMSM occur at each level: 1) individual, 2) social and sexual network, 3) community, 4) policy, and 5) stage of the HIV epidemic. Examples include individual (e.g. perception of HIV risk), social and sexual network (e.g. stigma), community (e.g. lack of medical services), and public policy (e.g. cost of care). The boundary between each level is permeable, thus each is considered in the proposed study. Utilizing components of Acceptance and Commitment Therapy (ACT), we will design an intervention to improve PrEP uptake, persistence, and adherence. We will use a generalized framework for the adaptation of EBIs to inform the development of a brief intervention for PrEP tailored to YBMSM, named ACTPrEP. ACT addresses barriers by promoting: 1) present moment awareness, 2) acceptance of internal and external experiences, and 3) engagement in behaviors that are consistent with values. To maximize utility, ACTPrEP will be delivered by a PrEP navigator. Candidate: Dr. Arnold is a medical clinical psychologist/scientist with a research background in HIV related studies in the South. Her career has focused on HIV intervention and prevention. Building on prior research, she is applying for a five-year K23 Career Development Award. Mentoring: An exceptional team of senior investigators serve as mentors. Dr. Brown is the Primary Mentor and has expertise in the designing and implementing of PrEP Interventions. Four co-mentors bring complementary expertise in PrEP delivery for YBMSM in the South and adherence monitoring (Dr. Mena); adapting behavior change interventions (Dr. Gaudiano); implementation science (Dr. Elwy); and quantitative data analyses (Dr. Jones). Research: The proposed aims are 1) Gather data from YBMSM (n = 20) and clinic staff (n = 10) through in- depth interviews to assess measures, intervention design, and barriers; 2) Develop ACTPrEP utilizing Aim 1 data and working iteratively with experts; and 3) Evaluate ACTPrEP feasibility and acceptability through a randomized control trial (n=66) and compare ACTPrEP vs. enhanced standard of care on uptake, adherence, and PrEP persistence. Trainings: Dr. Arnold will receive specific training in designing, adapting, and testing theory-based interventions, addressing health disparities with racial and sexual minorities, implementation science, and quantitative analyses through coursework, seminars, workshops, directed readings, and mentored research. These training and research experiences will establish the candidate’s career as an expert in clinically informed behavior change interventions. The candidate is supported by Rhode Island Hospital.