FINISHING HIV: An EHE model for Latinos Integrating One-Stop-Shop PrEP Services, a Social Network Support Program and a National Pharmacy Chain

项目总结/摘要 概述和背景。这是一个建议的混合2实施效果随机 完成艾滋病毒的对照试验（RCT），一个社会网络支持的实施策略包 组件和一站式PrEP组件，以改善与同性恋发生性关系的拉丁美洲男性的PrEP启动 男性（LMSM）。PrEP可以减少高达99%的艾滋病毒传播，1然而，PrEP服务并没有得到 在美国艾滋病流行的中心迈阿密，拉美裔人充分接触到这种药物。 没有自我认同为同性恋的人比自我认同为同性恋的LMSM有更低的PrEP意识。 研究，我们已经开发出一种创新的方法，根据性自我认同度身定制LMSM参与 利用社区社交活动和药店。前期工作审判是直接从 我们的“结束艾滋病毒流行”（EHE）计划补充，我们在那里进行了必要的初步 研究启动这一混合试验，并与ISCI 3的支持下，该小组共同评估可行性，完善战略， 并建立了一个由本地上下文需求和偏好通知的逻辑模型。在过去的两年里，PI 与Latinos Salud（当地的LMSM艾滋病毒机构）和CVS Health建立了伙伴关系。设计我们将使用 创新的基于网络的方法，由PI的K99/R 00资助的研究和社会传染 理论4指出，健康行为偏好，包括PrEP启动，受到意见和 社会环境中普遍存在的态度，并通过友谊网络传播。 药房和社会活动将导致参与者随机分配到完成艾滋病毒 （社交网络支持组件+一站式PrEP组件; N=24个种子和288个LMSM朋友）或 标准健康促进（N=312）。参与者将在基线进行评估，并接受随访， 在6个月和12个月时收集干血斑以定量替诺福韦二磷酸盐浓度。为 实现（目标1），我们将使用RE-AIM框架6来评估达到（高风险 参与计划的人）和实施（实施的程度 艾滋病的预防和治疗（艾滋病的预防和治疗）我们还将使用综合框架， 实施科学研究7，以检查与范围和实施相关的背景因素 (e.g.,促进者以及影响和实施的挑战或障碍;参与者对这些挑战或障碍的反应 战略）。我们将比较PrEP启动策略的有效性（目标2）（主要结局）， 以及PrEP知识、保留和依从性（次要结局）。我们将确定基于理论 主持人（例如，在社会活动中招募与药店招募）和社会网络干预调解人 方面的影响.我们还将评估友谊网络结构演变如何有助于增加PrEP 入会仪式影响。我们使用社交网络支持，一站式PrEP，以及社区和国家 连锁药店合作伙伴是一个很有前途的模式，可以在全国其他EHE优先领域复制。

Project Summary/Abstract Overview and Background. This is a proposal for a hybrid 2 implementation-effectiveness randomized controlled trial (RCT) of FINISHING HIV, an implementation strategy bundle of a social network support component and a one-stop-shop PrEP component to improve PrEP initiation of Latino men who have sex with men (LMSM). PrEP can reduce HIV transmission by up to 99%,1 however, PrEP services are not being sufficiently accessed by Latinos in Miami, the epicenter of the HIV epidemic in the US.2 Further, LMSM who do not self-identify as gay have lower PrEP awareness than LMSM who self-identify as gay.3 To prepare for this study, we have developed an innovative approach that tailors LMSM engagement based on sexual self-identity using community-based social events and pharmacies. Preliminary work. The trial is a direct next step from our “Ending the HIV Epidemic” (EHE) planning supplements, where we conducted the needed preliminary study to launch this hybrid trial, and with ISCI3 support, the team jointly assessed feasibility, refined strategies and built a logic model informed by local context needs and preferences. Over the past two years, the PI has built partnerships with Latinos Salud (a local HIV agency for LMSM) and CVS Health. Design. We will use an innovative network-based approach informed by the PI’s K99/R00 funded research and Social Contagion Theory,4 which states that health behavior preferences, including PrEP initiation, are affected by opinions and attitudes prevailing in one’s social environment, and spread through friendship networks.5 Penetration at pharmacies and social events will lead to random assignment of the participants to either FINISHING HIV (social network support component + one-stop-shop PrEP component; N=24 seeds and 288 LMSM friends) or to standard health promotion (N=312). Participants will be assessed at baseline, and receive follow ups and dried blood spots collection at 6 and 12 months to quantify tenofovir diphosphate concentrations. For implementation (Aim 1), we will use RE-AIM framework6 to evaluate Reach (the extent to which high risk persons initiate participation in the program), and Implementation (the extent to which implementation strategies are delivered as designed) of FINISHING HIV. We will also use Consolidated Framework for Implementation Science Research7 to examine contextual factors associated with Reach and Implementation (e.g., facilitators and challenges or barriers to reach and implementation; participants reaction to these strategies). We will compare effectiveness (Aim 2) of the strategies in PrEP initiation (primary outcome), as well as PrEP knowledge, retention, and adherence (secondary outcomes). We will identify theory-based moderators (e.g., recruitment at social events vs. pharmacies) and social network mediators of intervention effects. We will also assess how friendship network structural evolutions contribute to increasing PrEP initiation. Implications. Our use of a social network support, one-stop-shop PrEP, and community and national pharmacy chain partners is a promising model that can be replicated in other EHE priority areas nationwide.