Evaluating the Feasibility and Acceptability of a Latino MSM Focused PrEP Uptake Intervention

项目摘要：在男男性行为者(MSM)中，艾滋病毒的差异依然存在，尤其是 那些移民。美国疾病控制与预防中心估计，拉丁裔男男性同性恋者终身感染艾滋病毒的风险为五分之一，而拉美裔男男性接触者终身感染艾滋病毒的风险为 白人MSM为11。暴露前预防(PrEP)是一种高效预防艾滋病毒的生物医学策略 收购，有可能减少美国拉丁裔MSM中新感染艾滋病毒的人数 包括每天服用一次药物。FDA已经批准了两种以该品牌销售的药物 将日常使用的Truvada®和Descovy®命名为PrEP。疾病控制和预防中心 美国疾病控制与预防中心(CDC)已经建立了对高危候选人实施PrEP的临床指南。当证据显示 表明PrEP在美国的使用率正在上升，拉丁裔MSM之间的吸毒率差异仍然存在，尽管他们 据报道，人们对使用PrEP的兴趣很高。为了解决这一差距，我们提出了一个分两个阶段的项目 制定名为Estoy preparado(我准备好了)的试点PrEP干预措施，以促进启动和遵守 在移民拉丁裔MSM中传播PrEP。该项目将开发一种引人入胜的、根据文化定制的干预措施 使用信息-动机-行为技能(IMB)模型。该项目的具体目标是：目标1： 根据先前研究的数据，该项目将获得反馈、验证和对初始 Estoy preparado干预的内容领域，以促进移民采用和遵守PrEP 拉丁裔MSM；目标2：该项目将进行Estoy preparado的小型随机试点，以评估 干预拉美裔MSM移民的可行性、可接受性和初步影响 预备级联到启蒙。在形成阶段1，该项目将使用创新和新颖的世界咖啡馆 促进与移民LMSM(n≈40)进行社区对话的方法，以验证、修改和完善 初步干预内容包括Estoy preparado试点干预内容。世界咖啡馆是一家强大的 促进建设性小组对话的对话过程，产生的想法和知识可以 付诸实践。该项目还将从一个 由学术和社区专家组成的特定项目干预咨询委员会(IAC)。在……里面 第二阶段，该项目将对80名参与者(40名接受PrEP的参与者)进行小规模随机试验 干预和40名参与者接受标准护理，即PrEP转诊)以确定可行性， 可接受性和初步影响。如果干预显示出希望，研究结果将支持准备工作 一项更大规模的R01疗效试验。

PROJECT ABSTRACT: HIV disparity persist among Latino men who have sex with men (MSM), especially those who are immigrants. The CDC estimates the lifetime HIV risk is 1 in 5 for Latino MSM compared to 1 in 11 for white MSM. Pre-Exposure Prophylaxis (PrEP) is a biomedical strategy highly effective in preventing HIV acquisition, with the potential to reduce the number of new HIV infections among Latino MSM in the U.S. PrEP involves once daily dosing of medications. The FDA has approved two medications, sold under the brand names Truvada® and Descovy® for daily use as PrEP. The Centers for Disease Control and Prevention (CDC) has established clinical guidelines for administering PrEP to high-risk candidates. While evidence indicates that PrEP use is rising in the U.S., disparities persist in uptake among Latino MSM, despite their reported high levels of interest in using PrEP. To address this disparity, we propose a 2-phase project to develop a pilot PrEP intervention called Estoy PrEParado (I'm PrEPared) to facilitate initiation and adherence to PrEP among immigrant Latino MSM. The project will develop an engaging, culturally tailored intervention using the Information-Motivation-Behavioral Skills (IMB) model. The specific aims of the project are: Aim 1: based on data from a prior study, the project will elicit feedback, validation and modification to the initial content areas of the Estoy PrEParado intervention to facilitate PrEP adoption and adherence among immigrant Latino MSM; and Aim 2: the project will conduct a small randomized pilot of Estoy PrEParado to assess the feasibility, acceptability and preliminary impact of the intervention in moving immigrant Latino MSM along the PrEP cascade to initiation. In formative phase 1, the project will use the innovative and novel World Café approach to facilitate a community conversation with immigrant LMSM (n≈40) to validate, modify and refine the initial intervention content areas of the Estoy PrEParado pilot intervention. The World Café is a powerful conversational process for facilitating constructive group dialogue that produces ideas and knowledge that can be put into practice. The project will also elicit feedback and input on the contents of the intervention from a project-specific Intervention Advisory Committee (IAC) comprised of academic and community experts. In phase 2, the project will conduct a small randomized pilot of 80 participants (40 participants receiving the PrEP intervention and 40 participants receiving standard care, i.e., PrEP referrals) to establish feasibility, acceptability and preliminary impact. If the intervention shows promise, the findings will support the preparation of a larger scale R01 efficacy trial.