Onboarding Positives and PrEP users to Engage Negatives (OPPEN): peer-driven education to link YMSM of color to PrEP

100.7项目摘要/摘要 暴露前预防(PrEP)在男男性行为者(YMSM)中的普及缓慢， 特别是那些在美国经历高艾滋病毒新感染率的有色人种。有限的PrEP 知识，不熟悉如何获得PrEP，医学上的不信任，以及关于艾滋病毒和性行为的耻辱是 青年男性接触者参与PrEP护理的障碍，包括有色人种障碍。同行驱动型社交网络 将个人培训为同伴教育者的干预措施，以传播关于艾滋病毒预防和 在他们的社交网络中实施了治疗，以解决类似的障碍并改善艾滋病毒 在难以接触到的人群中取得成果。从事HIV/PrEP护理的有色人种青年男性接触者经常使用弹性 克服艾滋病毒预防和护理方面的社会结构性障碍的进程。因此，培训YMSM的颜色 从事艾滋病毒/PrEP护理的同行PrEP教育者可能会将他们定位为PrEP信息的可靠来源 谁能影响YMSM中有色人种同龄人的行为变化(即PrEP关怀参与) 社交网络通过其在其上下文中传播具有文化能力的PrEP消息的能力 使用这些弹性流程在医疗系统中导航的个人经验、医疗不信任、 和耻辱。利用现有的同行驱动的社交网络干预，创新和 信息-动机-行为技能模型，哈珀等人的S韧性框架，以及来自我们的 最近的焦点小组，建议的R34将开发和试点入职积极和PrEP用户参与 负面(Oppen)，一种同行驱动的PrEP教育社交网络干预，在有色人种(拉丁裔)的YMSM中 或黑人)在加利福尼亚州圣地亚哥。通过三个小组和两个一对一的训练，奥彭将进行训练 从事HIV/PrEP护理的有色人种基督教男青年会在他们的社交网络中成为PrEP的同龄人。在第一阶段， Oppen将使用一个迭代过程进行开发、预先测试和改进，该过程整合了来自 通过Oppen和YMSM培训的有色人种YMSM与HIV阳性和PrEP阳性的YMSM的访谈 社交网络中的有色人种同龄人(目标1)。在第二阶段，Oppen将以随机方式进行试点 对70名从事HIV/PrEP护理(即指数；50%HIV阳性)的有色人种青年男性接触者进行随机对照试验 被分配到Oppen组(n=35)或时间和注意力匹配的控制组(n=35)。所有索引都将收到 优惠券招募YMSM社交网络中的有色人种同龄人参加这项研究。出席会议的同行们 研究地点(即同行招募人员)将接受艾滋病毒检测。对PrEP感兴趣的HIV阴性同龄人将被 安排了一次PrEP诊所的访问。通过调查(基线和3个月的考察访问)和体检收集的数据 记录将被用来评估Oppen对PrEP兴趣、联系和摄取的初步影响 同伴招募(AIM 2)和Oppen针对指数和同伴招募的基于理论的机制 (目标3)。将使用混合方法评估OPPEN的可接受性和可行性(目标4)。 研究结果将用于进一步改进Oppen，并为未来的R01疗效试验提供信息。

100.7 PROJECT SUMMARY/ABSTRACT Pre-exposure prophylaxis (PrEP) uptake has been slow among young men who have sex with men (YMSM), particularly those of color who experience a high rate of new HIV infections in the United States. Limited PrEP knowledge, unfamiliarity with how to access PrEP, medical mistrust, and stigma around HIV and sexuality are barriers to PrEP care engagement among YMSM, including those of color. Peer-driven social network interventions that train individuals as peer educators to disseminate information about HIV prevention and treatment within their social networks have been implemented to address similar barriers and improve HIV outcomes within hard to reach populations. YMSM of color engaged in HIV/PrEP care often employ resilience processes to overcome socio-structural barriers to HIV prevention and care. As such, training YMSM of color engaged in HIV/PrEP care as peer PrEP educators may position them as credible sources of PrEP information who can influence behavior change (i.e., PrEP care engagement) among YMSM peers of color within their social networks via their ability to disseminate culturally competent PrEP messages in the context of their personal experiences using these resilience processes to navigate the healthcare system, medical mistrust, and stigma. Drawing on existing peer-driven social network interventions, the diffusion of innovations and information-motivation-behavioral skills models, Harper et al.'s resilience framework, as well as data from our recent focus groups, the proposed R34 will develop and pilot Onboarding Positives and PrEP users to Engage Negatives (OPPEN), a peer-driven PrEP education social network intervention, among YMSM of color (Latino or Black) in San Diego, California. Through three small-group and two one-on-one sessions, OPPEN will train YMSM of color engaged in HIV/PrEP care to be peer PrEP educators within their social networks. In Phase I, OPPEN will be developed, pretested, and refined using an iterative process that integrates feedback from YMSM of color and interviews with HIV-positive and PrEP-using YMSM of color trained via OPPEN and YMSM peers of color within their social networks (AIM 1). In Phase II, OPPEN will be piloted in a randomized controlled trial with 70 YMSM of color engaged in HIV/PrEP care (i.e., indexes; 50% HIV-positive) randomly assigned to OPPEN (n=35) or a time- and attention-matched control condition (n=35). All indexes will receive coupons to recruit YMSM peers of color within their social networks to the study. Peers who present at the study site (i.e., peer-recruits) will undergo HIV testing. HIV-negative peer-recruits interested in PrEP will be scheduled for a PrEP clinic visit. Data collected via surveys (baseline and 3-month study visits) and medical records will be used to evaluate the preliminary effect of OPPEN on PrEP interest, linkage, and uptake among peer-recruits (AIM 2) and theory-based mechanisms targeted by OPPEN among indexes and peer-recruits (AIM 3). OPPEN acceptability and feasibility will be evaluated using a mixed-methods approach (AIM 4). Findings will be used to further refine OPPEN and inform a future R01 efficacy trial.