Intervention to increase access to PEP to prevent HIV infection among Black MSM

 描述(由申请者提供)：在美国，黑人MSM感染艾滋病毒的比率严重不成比例。高危社区艾滋病毒预防的一个关键组成部分是增加获得和接受生物医学艾滋病毒预防的机会，包括接触前和暴露后预防(PrEP/PEP)。尽管疾病控制和预防中心(CDC)在15年前发布了第一份PEP指南，但暴露后有感染艾滋病毒风险的人没有充分利用PEP。在黑人男男性接触者的“PEP瀑布”过程中，成功的PEP治疗存在许多障碍。关于PEP级联和障碍的研究很少，几乎没有专门针对黑人MSM的研究。在黑人MSM中增加对PEP的接触和吸收，有可能减少艾滋病毒发病率的种族差异。为了解决这一差距，我们建议评估旨在提高艾滋病毒感染高危黑人MSM对PEP的认识、需求和获得的多成分干预的可接受性和可行性。这项干预包括三个部分：1)社交媒体活动，以增加黑人MSM对PEP的需求；2)24小时帮助热线，将患者与及时的临床护理联系起来；以及3)PEP倡导者干预，模仿同伴健康导航，以确保获得药物并保持参与。这项研究将分为三个阶段。在第一阶段，我们将进行形成性研究，为媒体活动和PEP倡导者的干预提供信息。在第二阶段，我们将把形成性研究的结果转化为跨相关社交和印刷媒体的最佳消息传递，并将PEP倡导者的干预标准化。在第三阶段，为了评估媒体活动的影响，我们将评估社交媒体指标和拨打帮助热线的电话。为了评估PEP倡导者干预措施的可接受性、可行性和初步影响，我们将在暴露后1周和3个月在临床研究现场对前50名符合条件的求助热线呼叫者和所有使用PEP的患者进行调查，以描述以下结果：PEP摄取和完成、PEP护理参与度、事件HIV和性传播感染、HIV检测、PrEP使用、性风险行为、选定的心理社会因素和卫生服务的接受。

 DESCRIPTION (provided by applicant): Black MSM in the US are affected by HIV at severely disproportionate rates. A key component of HIV prevention for communities at risk is increasing access to and uptake of biomedical HIV prevention, including pre- and post-exposure prophylaxis (PrEP/PEP). PEP is underutilized by those at risk for HIV acquisition after exposure, despite the fact that Centers for Disease Control and Prevention (CDC) issued the first PEP guidelines over 15 years ago. Numerous barriers to successful PEP treatment exist along the "PEP cascade" for Black MSM. Research on the PEP cascade and barriers is sparse, with almost none focused solely on Black MSM. Increasing access to and uptake of PEP among Black MSM has the potential to reduce racial disparities in HIV incidence. To address this gap, we propose to evaluate the acceptability and feasibility of a multi- component intervention designed to increase awareness of, demand for, and access to PEP among Black MSM at high risk of HIV infection. The intervention has three components: 1) a social media campaign to increase demand for PEP among Black MSM; 2) a 24-hour helpline to link patients to timely clinical care; and 3) a PEP advocate intervention, modeled on peer health navigation, to ensure medication access and sustain engagement. The research will involve three phases. In Phase 1, we will conduct formative research to inform the media campaign and the PEP advocate intervention. In Phase 2, we will translate the results of the formative research into optimal messaging across relevant social and print media and standardize the PEP advocate intervention. In Phase 3, to assess impact of the media campaign, we will evaluate social media metrics and calls to the helpline. To assess the acceptability, feasibility and preliminary impact of the PEP advocate intervention, we will survey the first 50 eligible helpline callers and all patients accessing PEP at the clinical study site at 1-week and 3-months post exposure to describe the following outcomes: PEP uptake and completion, PEP care engagement, incident HIV and STIs, HIV testing, PrEP use, sexual risk behavior, select psychosocial factors and receipt of health services.