Evaluating the Feasibility and Acceptability of "PrEP-Talk": A PrEP Uptake Intervention for Young Black MSM with their Close Friends

总结 年轻的黑人男男性行为者（YBMSM）处于极高和不成比例的艾滋病毒风险中。减少 YBMSM中的艾滋病毒发病率可能需要更多地采用其他战略 例如暴露前预防（PrEP）。PrEP是FDA批准的HIV药物， 预防艾滋病毒的传播，如果采取适当的。需要采取干预措施， 潜在的个人，社会/文化和结构性障碍，以吸收和坚持PrEP 在YBMSM中帮助遏制艾滋病毒感染。我们的初步研究表明， YBMSM感到担心的是，PrEP是无效的或可能是有毒的，关于被污名化， 如果他们服用PrEP，他们会感染艾滋病毒，以及对获得和副作用的担忧。所以我们 建议“PrEP谈话”，一种干预措施，将使用PrEP顾问（PC）， 向YBMSM提供信息和指导，包括一位亲密朋友（CF）来支持PrEP 吸收和坚持。为了解决这些关键和及时的问题，我们制定了 具体目标如下： 1.开发和手册化“PrEP-Talk”，旨在提高PrEP的吸收率， 在YBMSM中坚持。这将通过定性的形成性研究（3 焦点小组，12-18 YBMSM和CF二人组，N=24-36）;与社区合作 咨询委员会（由了解YBMSM艾滋病毒工作的个人组成）; 并对5个YBMSM和CF二元组（N=10）进行现场干预试验。 2.检查可行性，可接受性和“PrEP- 谈”在YBMSM之间的PrEP吸收和坚持。这将是完成 通过一项随机对照试验（RCT），在30个二元组（YBMSM和CF）中， 干预组30例，对照组30例（N=120）。我们将在以下地点进行评估： 基线、基线后3个月和6个月。我们还将评估PrEP吸收情况 在每次干预会议上进行支持性沟通，并收集尿液样本， 测量所有报告使用的YBMSM的PrEP摄取（初始依从性）生物标志物 的PrEP。 这项拟议的研究意义重大，因为我们的干预可能会增加PrEP的吸收， 坚持，这可能有助于降低YBMSM中的HIV发病率。如果拟议的 干预显示出希望，我们将准备进行一项全面的R 01资助的RCT。

Summary Young Black MSM (YBMSM) are at critically high and disproportionate HIV risk. Reducing HIV incidence rates among YBMSM will likely require increased adoption of additional strategies such as pre-exposure prophylaxis (PrEP). PrEP is a FDA approved medication for HIV that also prevents HIV transmission when taken appropriately. Interventions are needed to address potential individual, social/cultural, and structural barriers to uptake and adherence of PrEP among YBMSM to help curb HIV infections. Our preliminary research suggests that some YBMSM feel concerned that PrEP is not effective or may be toxic, about being stigmatized for having HIV if they take PrEP, as well as concerns about access and side effects. Therefore, we propose “PrEP-Talk”, an intervention that will use a PrEP Counselor (PC) who can provide information and guidance to YBMSM with the inclusion of a close friend (CF) to support PrEP uptake and adherence. In order to address these critical and timely issues, we developed the following specific aims: 1. To develop and manualize “PrEP-Talk,” which aims to increase PrEP uptake and adherence among YBMSM. This will be done through qualitative formative research (3 focus groups with 12-18 YBMSM and CF dyads, N=24-36); partnering with a community advisory board (comprised of individuals knowledgeable about HIV work with YBMSM); and field tests of the intervention with 5 YBMSM and CF dyads (N=10). 2. Examine feasibility, acceptability and indicators of preliminary efficacy of “PrEP- Talk” on PrEP uptake and adherence among YBMSM. This will be accomplished through a pilot randomized controlled trial (RCT) with 30 dyads (YBMSM and CFs) in the intervention and 30 dyads in the control (N=120). We will conduct assessments at baseline, 3-months and 6-months post-baseline. We will also assess PrEP uptake supportive communication at each intervention session and collect urine samples to measure a biomarker of PrEP uptake (initial adherence) from all YBMSM who report use of PrEP. This proposed study is significant because our intervention may increase PrEP uptake and adherence, which may help to reduce HIV incidence among YBMSM. If the proposed intervention shows promise, we will prepare to undertake a full-scale R01-funded RCT.