TransPrEP: Social Network-Based PrEP Adherence for Transgender Women in Peru

描述(申请人提供)：暴露前预防(PrEP)减少艾滋病毒传播的有效性强烈依赖于坚持，这受到个人、社会和结构性因素的影响。我们提出了一种基于社交网络的干预措施，以促进秘鲁利马变性人女性(TW)遵守PrEP：1)形成性研究。为了优化PrEP遵守干预的内容，我们将进行半结构化采访和焦点小组。结果将用于改进PrEP依从性干预。2)对秘鲁TW基于社交网络的PrEP遵守干预进行公开评估。干预模式将由5-10个太瓦的小组进行试点。数据将用于最终确定试点随机对照试验(RCT)的研究设计和评估工具。3)在秘鲁为TW开展基于社交网络的PrEP遵守干预试点RCT。我们计划将8个基于社交网络的TW集群随机分为基于网络的PrEP依从性干预或标准化的PrEP依从性咨询。主要结果将是遵守PrEP。干预将结合个人咨询、小组研讨会、基于社交媒体的网络互动和实用的支持工具来促进TW对PrEP的遵守。个人咨询：参与者将完成两次每两周一次的咨询会议，讨论PrEP的使用和艾滋病毒预防。个人咨询的目标是将PrEP作为艾滋病毒预防工具，并作为全面艾滋病毒预防战略的一部分，解决遵守PrEP的基本问题。小组工作坊。小组讲习班将建立对预防艾滋病方案作为全面预防艾滋病毒核心组成部分的共识，解决遵守预防方案的重要性，制定支持遵守方案的实用战略，并在同龄人小组内制定和维持预防艾滋病毒和遵守方案的规范。每两周一次的维护会议将解决与PrEP的使用和遵守相关的持续问题。社交网络互动。干预的社交网络部分将包括用于教育、激励和促进参与者网络中关于遵守PrEP的讨论的结构化社交媒体平台，用于阐明和加强网络中新制定的社会规范的非结构化参与者生成的互动，以及用于支持日常遵守的实用工具。准备使用。参与者将在6个月的研究期内每天获得Truvada。评估程序、时间和措施。将有三个主要评估点：基线、短期结果(3个月)和长期结果(6个月)。干预的主要结果将是比较干预组和对照组的PrEP依从性。研究结果将用于支持NIH资助的一项R01提案，该提案使用TW和社交媒体技术的社交网络来生成、实施和加强遵守PrEP、性风险行为和艾滋病毒预防的新社会规范。

DESCRIPTION (provided by applicant): The effectiveness of Pre-Exposure Prophylaxis (PrEP) for reducing HIV transmission is strongly dependent on adherence, which is influenced by individual, social, and structural factors. We propose a social network-based intervention to promote PrEP adherence among transgender women (TW) in Lima, Peru: 1) Formative research. To optimize content for a PrEP adherence intervention, we will conduct semi- structured interviews and focus groups. Results will be used to refine the PrEP adherence intervention. 2) To conduct an open evaluation of a social network-based PrEP adherence intervention for TW in Peru. The intervention model will be piloted with a small group of 5-10 TW. Data will be used to finalize the study design and assessment tools for a pilot randomized controlled trial (RCT). 3) To conduct a pilot RCT of a social network-based PrEP adherence intervention for TW in Peru. We plan to randomize 8 social network-based clusters of TW that to either a network-based PrEP adherence intervention or standardized PrEP adherence counseling. The primary outcome will be PrEP adherence. The intervention will use a combination of individual counseling, group workshops, social media-based network interactions, and practical support tools to promote PrEP adherence among TW. Individual Counseling: Participants will complete two biweekly counseling sessions addressing PrEP use and HIV prevention. The goals of individual counseling are to introduce PrEP as an HIV prevention tool and address basic issues of PrEP adherence as part of a comprehensive HIV prevention strategy. Group Workshops. Group workshops will establish a common understanding of PrEP as a central component of comprehensive HIV prevention, address the importance of PrEP adherence, develop practical strategies to support adherence, and generate and maintain norms of HIV prevention and PrEP adherence within the peer group. Biweekly maintenance meetings will address ongoing issues related to PrEP use and adherence. Social Network Interactions. The social network component of the intervention will include structured social media platforms to educate, motivate, and promote discussions of PrEP adherence within the participant network, unstructured participant-generated interactions to articulate and reinforce newly developed social norms within the network, and practical tools to support daily adherence. PrEP Use. Participants will be provided with daily Truvada for the 6-month study period. Assessment Procedures, Timing and Measures. There will be three major assessment points: baseline, short-term outcome (3 month), and long-term outcome (6 month). The primary outcome of the intervention will be a comparison of PrEP adherence in the intervention and control groups. Findings will be used to support an NIH-funded R01 proposal using social networks of TW and social media technologies to generate, implement, and reinforce new social norms of PrEP adherence, sexual risk behavior, and HIV prevention.