Addressing Key Issues in HIV Self-Testing Program Implementation for Black and Latino Men Who Have Sex with Men in the US South

摘要 美国南部的黑人和拉丁裔男性同性恋者（BLMSM）感染艾滋病毒的比例最高 率在国内。在男男性行为者中增加艾滋病毒检测可能会减少新的艾滋病毒感染 虽然这一人群中的感染率很高，但南方BLMSM的定期检测率很低。艾滋病毒自检 (HST)或自我管理艾滋病毒筛查设备是增加艾滋病毒检测的有效策略 在与男性发生性关系的男性中。然而，在美国南部的卫生环境中实施HST， 有限公司实施的一个可能障碍是计划规划者对BLMSM如何在 南方更喜欢访问HST和他们会支付多少。例如，虽然宅急送和同行 交付是成功增加美国其他地方BLMSM中HST使用的两种策略， 研究人员还没有确定南方的BLMSM更喜欢哪种策略， 为每种策略支付相应的意愿。此外，总体上对促进者和 从公共卫生实施决策者的角度来看，启动HST计划的障碍 部门，艾滋病毒/性病检测诊所，以及美国南部的社区组织。在这 博士前奖学金，我将在几个州的BLMSM（N=300）中进行离散选择实验 在美国南部（路易斯安那州，密西西比，格鲁吉亚，佛罗里达），以得出这一人口的相对偏好， 几个HST交付策略和估计的美元金额，他们将支付每个程序。的 我将通过离散选择实验评估的交付策略是在药店零售购买， 送货上门和同行送货。我还将进行艾滋病毒预防的半结构化访谈（N=30） 在美国南部为BLMSM服务的各种卫生组织的计划决策者， 促进者和障碍的HST实施。通过增加对HST实施的了解， 从患者和提供者的角度来看，该项目将为启动 HST方案旨在减少艾滋病毒感染率最高的人群之一， 美方

ABSTRACT Black and Latino men who have sex with men (BLMSM) in the US South have the highest HIV infection rates in the country. Increasing HIV testing among men who have sex with men may decrease new HIV infections in this population, yet rates of regular testing among BLMSM in the South are low. HIV self-testing (HST), or the self-administration of an HIV screening device, is an effective strategy to increase HIV testing among men whohave sex with men. However, HST implementation within health settings in the US South is limited. One possible barrier to implementation is program planners’ limited knowledge of how BLMSM in the South prefer to access HST and how much they would pay. For example, although home delivery and peer delivery are two strategies that successfully increase HST use among BLMSM elsewhere in the US, researchers have yet to determine which of these strategies BLMSM in the South prefer and their corresponding willingness to pay for each strategy. In addition, little overall is known about facilitators and barriers to initiating HST programs from the perspectives of implementation decisionmakers at public health departments, HIV / STD testing clinics, andcommunity-based organizations in the US South. In this predoctoral fellowship, I will conduct a discrete choice experiment among BLMSM (N=300) in several states in the US South (Louisiana, Mississippi, Georgia, Florida) to elicit this population’s relative preferences for several HST delivery strategies and an estimated dollar amount they would pay for each program. The delivery strategies I will evaluate through the discrete choice experiment are retail purchase at drugstores, home delivery, and peer delivery. I will also conduct semi-structured interviews (N=30) with HIV prevention program decisionmakers at various health organizations serving BLMSM in the US South to understand facilitators and barriers to HST implementation. By increasing the knowledge of HST implementation outcomes from the perspectives of patients and providers, this project will build a roadmap for the initiation of HST programs to decrease HIV incidence among one of the most disproportionately impacted populations in the US.