MyPEEPS Mobile Plus: A Multi-Level HIV Prevention Intervention for Young MSM

项目摘要 男男性行为者（MSM），特别是年轻的黑人和拉丁美洲男男性行为者，艾滋病毒感染率最高 在美国（US）的诊断，说明需要有效的艾滋病毒预防工具，这些 人口。为了应对年轻男男性接触者（YMSM）中艾滋病毒流行的迅速蔓延，我们的研究小组采用了 针对不同YMSM的理论驱动、组水平、循证MyPEEPS干预（R34 MH 079707; PI： Garofalo）转化为移动健康干预措施MyPEEPS移动的，以克服面对面小组的挑战 干预MyPEEPS移动的是一种性健康干预，通过对等化身提供， 背景和性风险情景是来自YMSM形成性研究的复合材料， 确定了影响性健康的个人，家庭和关系挑战。MyPEEPS移动的 试验数据显示了有效性、可行性、可接受性和参与者高满意度的证据13-18 岁的尽管结果非常有希望，但迄今为止， 在我们的样本中，这项研究的成功率非常低（3%），我们将其部分归因于缺乏信息 MyPEEPS移动的中的PrEP内容以及我们研究参与者的年龄非常小（13-18岁）， PrEP在数据收集时未获得批准。作为回应，我们的研究小组建议扩大 MyPEEPS移动的开发MyPEEPS移动的Plus，一种由MyPEEPS组成的多层次干预 添加PrEP内容的移动的（基于专家咨询和青年反馈）+ PrEP电子同行导航 克服YMSM中PrEP启动，坚持和持久性的挑战。同行导航是 一项以证据为基础的、广泛推荐的干预措施，以帮助青年和男男性行为者获得艾滋病毒相关护理 结果，有证据表明种族/少数民族YMSM可接受PrEP。 解决了未能开始或维持PrEP使用的常见原因，包括低感知风险、结构性或 护理参与的后勤障碍和预期的副作用。相对于个人和群体艾滋病毒 预防计划，具有数字和虚拟组件的行为干预可以具有广泛的影响力， 呈现出独特的潜力，可以快速扩大向非常庞大和隐藏的群体提供服务的规模。因此，我们建议 进行随机对照试验，以测试MyPEEPS移动的Plus（多水平干预）的有效性 包括MyPEEPS移动的+ PrEP E-Peer导航），以促进启动、依从性和 PrEP的持续性和YMSM中HIV风险行为的减少。基于我们团队展现出的能力 招收大量年轻的种族和民族多样化的YMSM和丰富的经验， 移动的健康干预措施，拟议的研究将测试这种扩大的，多层次的移动的艾滋病毒的疗效 预防干预强调PrEP。如果有效，它将增加PrEP启动，坚持， 持续性和降低整体艾滋病毒的风险在不同的YMSM在美国。

PROJECT SUMMARY Men who have sex with men (MSM), especially young Black and Latino MSM, have the highest rates of HIV diagnoses in the United States (US), illustrating the need for efficacious HIV prevention tools for these populations. In response to the burgeoning HIV epidemic in young MSM (YMSM), our study team adapted the theory-driven, group-level, evidence-based MyPEEPS intervention for diverse YMSM (R34MH079707; PI: Garofalo) into an mHealth intervention, MyPEEPS Mobile, to overcome challenges of an in-person group intervention. MyPEEPS Mobile is a sexual health intervention delivered through peer avatars whose personal backgrounds and sexual risk scenarios are composites derived from formative research among YMSM, which identified personal, family-based, and relational challenges influencing sexual health. The MyPEEPS Mobile Trial data have shown evidence of efficacy, feasibility, acceptability, and high satisfaction by participants 13-18 years of age. Despite very promising results, pre-exposure prophylaxis (PrEP) initiation to date over the course of the study has been extremely low in our sample (3%), which we partially attribute to a dearth of information on PrEP content in MyPEEPS Mobile and the very young age (13-18 years) of our study participants, for whom PrEP was not approved at the time of data collection. In response, our study team proposes to expand MyPEEPS Mobile to develop MyPEEPS Mobile Plus, a multi-level intervention comprised of MyPEEPS Mobile with added PrEP content (based upon expert advisory and youth feedback) + PrEP E-Peer Navigation to overcome the challenges of PrEP initiation, adherence, and persistence among YMSM. Peer navigation is an evidence-based, widely recommended intervention for reaching youth and MSM for HIV-related care outcomes, with evidence of acceptability among racial/ethnic minority YMSM for PrEP. Peer navigation addresses common reasons for failing to begin or maintain PrEP use, including low perceived risk, structural or logistic barriers to care engagement, and anticipated side effects. Relative to in-person and group-based HIV prevention programs, behavioral interventions with digital and virtual components can have vast reach and present unique potential to rapidly scale delivery to very large and hidden groups. Therefore, we propose to conduct a randomized controlled trial to test the efficacy of MyPEEPS Mobile Plus (a multi-level intervention comprised of MyPEEPS Mobile + PrEP E-Peer Navigation) for promoting initiation, adherence, and persistence of PrEP and decreased HIV risk behavior in YMSM. Building upon our team’s demonstrated ability to enroll large numbers of young racially and ethnically diverse YMSM and extensive experience developing mobile health interventions, the proposed study will test the efficacy of this expanded, multi-level mobile HIV prevention intervention emphasizing PrEP. If efficacious, it will increase PrEP initiation, adherence, and persistence and decrease overall HIV risk in diverse YMSM in the US.