Male Access to Sexual Health Services and PrEP

项目总结 全球艾滋病毒预防工作传统上侧重于通过以下途径支持妇女和重点人群 治疗作为预防导致病毒抑制(不可检测=不可传播，U=U)。这呈现了 有机会制定支持在15-49岁异性恋男子中预防艾滋病毒的干预措施。自.以来 科学家称，目前还没有针对HIV血清阴性的异性恋男性感染PrEP的干预措施 K43的目标是开发和制作一种循证干预的原型，以遏制南方的艾滋病毒感染 感染艾滋病毒风险较高的非洲男子。行为经济学(BE)理论认为，背景和 个体因素影响健康行为。BE将被用来理解与Pre-Rate相关的这些因素 南非男性的暴露预防(PrEP)摄取。候选人：我是一名南非行为学家 我有南非艾滋病流行社区艾滋病研究的背景，我致力于改善健康 在这群人中寻找。这款K43将支持我的培训、指导和研究，使我成为 独立调查员。指导：我已经组建了一个多学科团队，拥有全球公认的 拥有各自领域的专业知识，致力于南非的艾滋病毒研究。我的主要导师是艾莉森·布滕海姆博士 (以美国为基础，行为经济学干预设计，基于证据的艾滋病毒护理提供，混合方法 研究)，Linda-Gail Bekker博士(S.A.，临床试验，PrEP，关键人群研究)。我的同事- 导师团队包括：约瑟夫·丹尼尔斯博士(美国，定性研究，艾滋病毒预防和治疗)， Andrew Medina-Marino博士(S.A.，流行病学、男性健康、实施科学)。培训： K43将支持指导和严格的培训，以支持我发展行为经济学方面的专业知识 干预设计，2)队列设计和管理临床试验，3)混合方法研究设计和 分析。这些目标将得到导师的支持，他们是艾滋病毒预防领域的全球领导者，资源有限 社区。研究：南非男性(45-49岁)的艾滋病毒流行高峰比女性(35-49岁)晚 39岁)同龄人和男性倾向于选择年轻的女性性伴侣。减少艾滋病病毒感染 在LMICs中生活的男性是打破这一传播循环的核心。本课题的具体研究目的是 获奖的奖项是：1)调查环境因素对PrEP摄取的影响，2)描述相关因素 对于自然减员和持续的PrEP，使用BE来开发和制作支持PrEP的干预措施的原型 在男性中的吸收。这项研究嵌套在现有的移动诊所服务中，在Klipfontein运营 开普敦地区，最近获得了PrEP实施赠款(比尔和梅琳达·盖茨 基金会，PI Bekker)，以评估基于社区的PrEP接受情况。这项研究将推动美国国立卫生研究院关于艾滋病毒的科学研究 在艾滋病毒疾病负担较高的社区预防男性。证据将被用来设计一个被告知的 干预一项更大规模的临床试验，调查其对减少艾滋病毒感染和传播的影响 男人。

PROJECT SUMMARY Global HIV prevention efforts have conventionally focused on supporting women and key populations through treatment as prevention resulting in viral suppression (Undetectable = Untransmittable, U=U). This presents the opportunity to develop interventions that support HIV prevention in heterosexual men, aged 15-49 years. Since there are no interventions that address PrEP uptake among HIV seronegative heterosexual men, the scientific goal of this K43 is to develop and prototype an evidence-based intervention to curb HIV acquisition in South African men at high risk of HIV acquisition. Behavioral economics (BE) theory posits that contextual and individual factors influence health behavior. BE will be used to understand these factors associated with pre- exposure prophylaxis (PrEP) uptake in South African men. Candidate: I am a South African behavioral scientist with a background in HIV research in HIV endemic communities in South Africa I am committed to improve health seeking in this population. This K43 will support my training, mentorship, and research towards becoming an independent investigator. Mentoring: I have assembled a multi-disciplinary team with globally recognized expertise in their fields, committed to HIV research in South Africa. My primary mentors are Dr. Alison Buttenheim (U.S. based, behavioral economics intervention design, evidence-based HIV care delivery, mixed methods research), Dr. Linda-Gail Bekker (S.A.-based, clinical trials, PrEP, research in key populations). My co- mentorship team includes: Dr. Joseph Daniels (U.S.-based, qualitative research, HIV prevention and treatment), Dr. Andrew Medina-Marino (S.A.-based, epidemiology, men’s health, implementation science). Training: The K43 will support mentoring and rigorous training to support me to develop expertise in 1) behavioral economics intervention design, 2) cohort design and managing clinical trials, 3) mixed methods research design and analysis. These aims will be supported by mentors who are global leaders in HIV prevention in limited resource communities. Research: HIV prevalence peaks in South African males (45-49 years) later than their female (35- 39 years) counterparts and males tend to choose younger female sexual partners. Reducing HIV acquisition among men living in LMICs is central to breaking this cycle of transmission. The specific research aims of this award are to: 1) investigate the influence of contextual factors on PrEP uptake, 2) describe factors associated with attrition and sustained PrEP use 3) to use BE to develop and prototype an intervention to support PrEP uptake among men. This research is nested in the existing mobile clinic services operating in the Klipfontein district in Cape Town, which was recently awarded a PrEP implementation grant (Bill and Melinda Gates Foundation, PI Bekker) to assess community-based PrEP uptake. This study will advance NIH science on HIV prevention in men in high HIV disease burden communities. The evidence will be used to design a BE informed intervention for a larger clinical trial investigating the impact on reducing HIV acquisition and transmission in men.