Using behavioral economics to improve the uptake of and persistence on pre-exposure prophylaxis in men who have sex with men to prevent HIV infection

项目总结/摘要 这是一个五年的K 01奖的应用劳伦斯龙博士，研究助理教授在 波士顿大学。K 01奖将支持一系列补充性的培训活动和研究目标 旨在建立龙博士作为一个独立的研究人员在艾滋病毒预防和行为领域的研究。 经济学这将使朗博士能够实现他的长期职业目标，即领导艾滋病毒研究，指导 设计健康服务方案（治疗和预防），鼓励最佳健康行为， 决策。K 01将为实现以下培训目标提供必要的支持：1） 获得专业技术知识，在与男性发生性关系的男性中使用暴露前预防（PrEP） 2）学习、掌握和应用人类决策理论; 3）熟练掌握设计 和实施行为改变干预措施; 4）成功申请独立研究 经费为了实现这些培训目标，龙博士提出了一个以 在行为经济学教学培训的支持下， 方法和研究方法，与弱势群体合作。尽管最大的艾滋病毒治疗 南非的艾滋病毒感染率仍然很高，特别是在关键人群中， 男男性接触者（MSM）最近将艾滋病毒暴露前预防（PrEP）作为 南非的国家预防一揽子计划被认为是降低这些人群发病率的关键， 然而，试点研究表明，在风险最高的人群中，摄入量不够理想，持久性较差。朗医生 研究将侧重于了解为什么南非男同性恋者的PrEP吸收率和持久性较低 以及如何改变向这一人群提供PrEP，以鼓励那些风险最大的人开始 治疗该研究的目的是：1）确定南部地区PrEP启动和持续性的预测因素 非洲男男性接触者在PREP试点检测呈阴性; 2）定性研究认知偏见在 从医疗保健提供者和患者的角度决定请求，提供，接受和继续PrEP; 和3）开发和试点一个简单的干预措施，以增加MSM对PrEP的吸收和持久性， 行为经济学理论，以改善决策。为了实现这些目标，朗博士 访问目前在南非向男男性行为者提供PrEP的两个试点地点。K 01完工前 龙博士将利用这项研究作为R 01资助申请的基础，旨在进行一项 随机对照试验，以确定行为经济干预措施在改善PrEP中的有效性 在不同的关键人群中。

PROJECT SUMMARY / ABSTRACT This is an application for a five-year K01 award for Dr. Lawrence Long, a Research Assistant Professor at Boston University. The K01 award will support a complementary set of training activities and research aims aimed at establishing Dr. Long as an independent researcher in the field of HIV prevention and behavioral economics. This will allow Dr. Long to reach his long-term career goal of leading HIV research that guides the design of health delivery programs (treatment and prevention) which encourages optimal health behavior and decision making. The K01 will provide the support necessary to accomplish the following training goals: 1) to obtain expert technical knowledge in the use of pre-exposure prophylaxis (PrEP) in men who have sex with men; 2) to learn, master and apply the theory of human decision making; 3) to become skilled in the design and implementation of behavior change interventions and 4) to successfully apply for independent research funding. In order to achieve these training goals Dr. Long has proposed a career development plan centered around strong mentorship supported by didactic training in behavioral economics, qualitative research methods, and research approaches for working with vulnerable populations. Despite the largest HIV treatment program in the world South Africa’s HIV incidence remains high, in particular amongst key populations such as men who have sex with men (MSM). The recent inclusion of HIV pre-exposure prophylaxis (PrEP) as part of the national prevention package in South Africa is considered key to reducing incidence in these populations, yet pilot studies show sub optimal uptake and poor persistence amongst those most at risk. Dr. Long’s research will focus on understanding why PrEP uptake and persistence amongst MSM in South Africa is low and how the delivery of PrEP to this population could be altered to encourage those most at risk to start treatment. The research will aim to: 1) identify predictors of PrEP initiation and persistence amongst South African MSM testing negative at PREP pilot sites; 2) qualitatively examine the role of cognitive bias in the decision to request, offer, accept and continue on PrEP from a health care provider and patient perspective; and 3) develop and pilot a simple intervention to increase the uptake of and persistence on PrEP in MSM using behavioral economic theory to improve decision making. In order to accomplish these aims Dr. Long has access to the two pilot sites currently offering PrEP to MSM in South Africa. Before the completion of the K01 award Dr. Long will use this research as the basis for an R01 grant application which would aim to conduct a randomized control trial to establish the effectiveness of behavioral economic interventions in improving PrEP uptake amongst various key populations.