HIV Self-Testing in African American Young MSM: A Formative Translational Study

 描述(由申请人提供)：创新的技术和项目需要在临床试验阶段之后进行一段时间的翻译研究，以改进创新的核心组件与客户/消费者的特征和需求之间的匹配。拟议的R21是一系列翻译研究的第一阶段，旨在通过提高实施保真度并最终增加自我实施的艾滋病毒检测计划(OraQuick-SIT)的传播，在与男性发生性关系的年轻非裔美国男性(MSM；年龄17-24岁)中加强社区艾滋病毒检测和联系护理(LTC)。建议的R21研究将检验“程序-客户”匹配对SIT测试的影响--保真度和使用意图 OraQuick LTC推荐网站。这项形成性工作涉及艾滋病毒预防中的一个关键问题：识别艾滋病毒阳性者并将他们与护理联系起来。居住在经济条件较差的城市地区的非裔美国青年男男性接触者感染艾滋病毒的风险很高，这一人群中的很大一部分人仍未接受检测。此外，先前的工作表明，在这一人群中，以临床为基础的艾滋病毒检测存在重大障碍。OraQuick-SIT计划有望减少未经检测的高危人群数量，并将艾滋病毒阳性消费者与治疗联系起来。作为一项自行实施的计划，OraQuick-SIT要求消费者执行3个核心组成部分：(A)标本收集和检测，(B)结果解释，(C)与护理挂钩的转介系统。自我实施中的忠诚度(即，正确实施计划组成部分)对成功的SIT结果至关重要。然而，关于非裔美国MSM青年实施SIT的情况却知之甚少。在先前工作的基础上，假设SIT程序特征与消费者之间的认知和社会文化匹配程度会影响实施保真度。此外，我们还将制定量化措施，以 将在下一阶段研究中使用的与匹配相关的关键概念。拟议的R21将 通过扩展我们对自我实现忠诚度的前因的了解，增加翻译的科学性。此外，拟议的R21提供了四个阶段研究计划的第一步，旨在检查消费者SIT的忠诚度、社区采用和传播SIT、SIT传播计划的可持续性，以及SITS对艾滋病毒检测和与护理挂钩的比率的影响。这一系列研究的首要目标是增加艾滋病毒检测和与护理的联系，旨在减少艾滋病毒的传播、发病率和死亡率。

 DESCRIPTION (provided by applicant): Innovative technology and programs require a period of translation research following the clinical trial phase to improve the fit between the innovation's core components and client/consumer characteristics and needs. The proposed R21 is the first stage in a series of translation studies designed to enhance community HIV testing and linkage-to-care (LTC) among young African American men who have sex with men (MSM; ages17-24), by improving implementation fidelity and, ultimately, increasing dissemination of a self- implemented HIV testing program (OraQuick- SIT). The proposed R21 study will examine the impact of "program-client" fit on SIT testing-fidelity and intentions to use OraQuick LTC referral sites. This formative work addresses a key issue in HIV prevention: identifying HIV positive persons and linking them to care. African American young MSM who reside in economically disadvantaged urban areas are at high risk for HIV and substantial segments of this population remain untested. Moreover, prior work indicates that there are significant barriers to clinic-based HIV testing in this population. The OraQuick-SIT program offers promise in reducing the number of untested at-risk persons, and in linking HIV-positive consumers to treatment. As a self- implemented program, the OraQuick-SIT requires consumers to execute 3 core components: (a) specimen collection and testing, (b) interpretation of results, and (c) a linkage-to-care referral system. Fidelity (i.e., correctly implementing program components) in self-implementation is critical to successful SIT outcomes. However, little is known about how well African American MSM youth implement SIT. Based on prior work, the degree of cognitive and socio-cultural fit between SIT program features and consumers are posited to influence implementation fidelity. In addition, we will develop quantitative measures of key fit-related concepts that will be utilized in the next stage of research. The proposed R21 will add to the science of translation by expanding our knowledge of the antecedents of self-implementation fidelity. Further, the proposed R21 provides an initial step in a four stage program of study designed to examine consumer SIT-fidelity, community adoption and dissemination of SITs, sustainability of SIT dissemination programs, and the impact of SITs on HIV testing and linkage-to-care rates. The overarching goal of this series of studies is to increase HIV testing and linkage-to-care aimed at reducing HIV transmission, morbidity, and mortality.