PS23-003 - A Community-based Assessment of Preferences for Long-Acting Antiretroviral Therapy Options Among Cis-gender Black Women across Six Ending the HIV Epidemic Jurisdictions in the South

项目摘要 在美国遏制艾滋病毒流行的努力受到以下因素的阻碍：非最佳获取途径和遵守 抗逆转录病毒疗法(ART)，特别是在美国南部顺式性别的黑人艾滋病毒携带者(CgBWH)中 与男性和白人相比，她们的护理联系、参与度和病毒抑制较低，死亡率较高 女性同龄人。长效(LA)抗逆转录病毒疗法有可能改变艾滋病毒治疗格局，但 由于多层次的挑战和缺乏量身定制的方法，LA可注射(LAI)ART的使用率一直较低 关键群体，包括CgBWH。为了帮助填补这一空白，在过去的六年里，我们的多学科团队领导了 关于洛杉矶女性艺术兴趣、偏好、障碍和促进者的混合方法研究。然而，这些 数据是在洛杉矶ART批准之前收集的，对假设使用提出了质疑，不包括年轻女性或 关注南方。为了实现结束艾滋病毒流行(EHE)倡议的“治疗”支柱，我们必须开发新的 为CgBWH优化和定制护理联系和ART坚持策略的方法。这项建议建立了 在我们现有的多站点研究基础设施和强大的学术与社区合作伙伴关系上 探索批准洛杉矶ART时代的南方CgBWH偏好和实施挑战；它 将整合利益相关者的需求和价值，共同创建用于教育、推荐和链接的原型工具 针对CgBWH量身定做的HIV治疗。我们将利用这项研究进行治疗和生殖结局(STAR) 基础设施，目前在包括城市和农村EHE在内的六个南方地点注册1200 CgBWH 优先辖区(AL、FL、GA、MS、NC、DC)。为了推进这项工作，我们将使用综合框架 用于实施研究和以人为本的设计，为我们的数据收集、分析和 开发教育、推荐和链接原型工具包，以支持CgBWH LA ART的访问和使用。 在目标1中，我们将检查CgBWH的偏好、促进者以及洛杉矶ART采用和新颖交付的障碍 正在进行的洛杉矶STAR艺术调查(n=1200 CgBWH)和对120名不同CgBWH的纵向采访 通过坚持，洛杉矶的艺术使用，年龄和乡村。在目标2中，我们将确定公平扩大洛杉矶ART规模的战略 CgBWH通过采访包括社区组织在内的60名艾滋病毒服务提供者 (CBOS)因角色、洛杉矶ART可获得性、资金和乡村而异。在目标3中，我们将使用以人为中心的设计 通过在四个社区组织(两个农村、两个城市)举办的一系列3次讲习班，整合妇女和儿童权利中心的声音 和艾滋病毒服务提供商，并反复开发洛杉矶ART教育、转诊和联系工具，这些工具是量身定做的， 对于CgBWH和一系列交付地点来说，这是可以接受和可行的。鉴于我们已建立的学术界 研究基础设施，洛杉矶抗逆转录病毒治疗规划的临床领导能力，以及艾滋病毒和妇女健康方面的专业知识， 定性方法和实施科学，我们有能力迅速实施这种混合方法 研究并向所有利益攸关方传播知识，从而解决艾滋病毒热点地区的EHE“治疗”支柱问题。

PROJECT ABSTRACT Efforts to curb the HIV epidemic in the United States (US) are impeded by suboptimal access and adherence to antiretroviral therapy (ART), particularly among cis-gender Black women with HIV (CgBWH) in the Southern US who have lower care linkage, engagement, and viral suppression, and higher mortality, than their male and White female peers. Long-acting (LA) ART has the potential to transform the HIV treatment landscape, but the uptake of LA-injectable (LAI) ART has been low due to multi-level challenges and the lack of tailored approaches for key groups, including CgBWH. To help fill this gap, over the past six years our multidisciplinary team has led mixed methods research on women’s LA ART interest, preferences, barriers, and facilitators. However, these data were collected prior to LA ART approval, queried hypothetical use, and did not include young women or focus on the South. To realize the Ending the HIV Epidemic (EHE) initiative “Treat” pillar, we must develop novel approaches to optimize and tailor care linkage and ART adherence strategies for CgBWH. This proposal builds on our existing multisite research infrastructure and robust academic-community partnerships to explore Southern CgBWH preferences and implementation challenges in the era of approved LA ART; it will integrate stakeholders’ needs and values to co-create prototype tools for education, referral, and linkage to HIV treatment tailored to CgBWH. We will leverage the Study for Treatment And Reproductive Outcomes (STAR) infrastructure, that is currently enrolling 1200 CgBWH in six Southern sites including urban and rural EHE priority jurisdictions (AL, FL, GA, MS, NC, DC). To advance this work, we will use the Consolidated Framework for Implementation Research and Human-centered design to inform our data collection, analyses and the development of educational, referral, and linkage prototype toolkits to support CgBWH LA ART access and use. In Aim 1 we will examine CgBWH preferences, facilitators, and barriers to LA ART uptake and novel delivery via an ongoing LA ART survey in STAR (n=1200 CgBWH) and longitudinal interviews with 120 CgBWH who vary by adherence, LA ART use, age, and rurality. In Aim 2 we will identify strategies to equitably scale up LA ART for CgBWH through interviews with 60 HIV service providers including from community-based organizations (CBOs) that vary by role, LA ART availability, funding, and rurality. In Aim 3 we will use human-centered design approaches via a series of 3 workshops across four CBOs (2 rural, 2 urban) to integrate the voices of CgBWH and HIV service providers and iteratively develop LA ART educational, referral and linkage tools that are tailored, acceptable and feasible for CgBWH and a range of delivery sites. Given our established academic-community research infrastructure, clinical leadership in LA ART programming, and expertise in HIV and women’s health, qualitative methods and implementation science, we are well-positioned to rapidly implement this mixed methods study and disseminate knowledge to all stakeholders, thus addressing the EHE “Treat” pillar in HIV hotspots.