Adapting, Pilot Testing a Behavioral Intervention to Incorporate Advances in HIV Prevention for Black Young MSM in Alabama

项目总结 这个为期5年的导师研究科学家发展奖K01-的总体目标是支持河南 布赫瓦尼，博士，公共卫生硕士，成为艾滋病毒预防领域的独立研究员。拟议中的项目 寻求解决阿拉巴马州的艾滋病毒危机，在那里，发生性行为的黑人年轻男性中未被诊断出艾滋病毒的比率 男性(YMSM，18-29岁)的比例超过20%。该项目将改编和测试行为干预措施，以促进 在社区进行艾滋病毒快速检测，提供符合文化背景的预防教育，提供社会结构 支持并推荐符合条件的参与者进行暴露前预防(PrEP)。四个培训目标是 提出了与三个具体目标步调一致的建议。目标1包括强化培训和指导 社会理论中的计划，包括交叉性理论和新兴男性气概理论。目标2包括-- 关于定性研究方法的深入培训，包括如何进行焦点小组、深入访谈和 定性数据分析。目标1将在目标2之后进行，目的是阐明经验、信念、 以及与黑人基督教青年会提供和利用艾滋病毒检测和预防服务有关的预测因素 定性研究方法，即与艾滋病毒外展工作人员的深度访谈，黑人青年男性接触者的焦点小组， 与关键分组成员(例如，跨性别妇女)进行深入访谈，以了解适应情况 兄弟会拯救兄弟会(BSB)的干预。目标3包括授课和实践培训，内容包括如何 使用经过验证的框架，如干预地图，科学地调整艾滋病毒行为干预措施。目标 2调整BSB干预措施，以包括两种艾滋病毒预防工具(快速检测和PrEP)，以解决 结构性障碍，并为阿拉巴马州的黑人YMSM所接受。目标4包括综合培训 以及实施科学领域的指导。目标3，总结拟议的研究报告和 K01项目，是在#年进行适应干预的混合类型1有效性-实施试点研究 候选人将a)评估改编的BSB(ABSB)的可接受性和可行性；b)初步估计 对艾滋病毒预防成果的影响；以及c)收集关于实际执行情况的数据。这些目标将是 通过与两个以社区为基础的组织合作实现，这两个组织因其艾滋病毒而备受尊敬 学习社区的预防工作。这一严格的项目包括在候选人家中进行强化培训 阿拉巴马大学伯明翰分校(UAB)和其他知名机构提供非常 在UAB找不到具体培训；参与青少年医学艾滋病毒/艾滋病试验网络 干预措施(ATN)；具有少数民族、青年、 和MSM健康；以及深思熟虑的研究战略，以应对重大威胁、高未诊断率 在阿拉巴马州的黑人青年男女同性恋者中，艾滋病毒和艾滋病毒预防服务，包括PrEP，参与不足。这个 建议的指导和培训与研究结果的结合将最终导致候选人的 实现独立并制定全面的、实施科学的R01提案，以测试aBSB。

PROJECT SUMMARY The overall goal of this 5-year Mentored Research Scientist Development K01-Award is to support Henna Budhwani, PhD, MPH become an independent investigator in the field of HIV prevention. The proposed project seeks to address the HIV crisis in Alabama, where rates of undiagnosed HIV in black young men who have sex with men (YMSM, 18-29 years) exceed 20%. This project will adapt and test a behavioral intervention to promote HIV rapid testing in the community, deliver culturally appropriate prevention education, offer sociostructural supports, and refer eligible participants for pre-exposure prophylaxis (PrEP). Four training objectives are proposed that are in lockstep with three specific aims. Objective 1 includes an intensive training and mentoring plan in social theory including theories of intersectionality and emerging masculinities. Objective 2 includes in- depth training on qualitative research methods including how to conduct focus groups, in-depth interviews, and qualitative data analysis. Aim 1, which will be conducted after Objective 2, is to elucidate experiences, beliefs, and predictors related to delivery and utilization of HIV testing and prevention services by black YMSM using qualitative research methods, namely in-depth interviews with HIV outreach staff, focus groups with black YMSM, and in-depth interviews with members of key sub-groups (e.g. transgender women) to inform the adaptation of the Brothers Saving Brothers (BSB) intervention. Objective 3 includes didactic and hands-on training on how to scientifically adapt HIV behavioral interventions using validated frameworks, such as intervention mapping. Aim 2 is to adapt the BSB intervention to include two HIV prevention tools (rapid testing and PrEP), to address structural barriers, and to be acceptable to black YMSM in Alabama. Objective 4 includes comprehensive training and mentoring in the field of implementation science. Aim 3, which concludes the proposed research study and K01 project, is to conduct a hybrid type 1 effectiveness-implementation pilot study of the adapted intervention in which the candidate will a) assess acceptability and feasibility of adapted BSB (aBSB); b) preliminarily estimate effects on HIV prevention outcomes; and c) collect data on real-world implementation. These aims will be accomplished by collaborating with two community-based organizations that are well-respected for their HIV prevention work in study communities. This rigorous project includes intensive training at the candidate's home university, the University of Alabama at Birmingham (UAB) and from other prominent institutions that offer very specific training not found at UAB; engagement within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN); comprehensive mentoring from senior HIV researchers with expertise in minority, youth, and MSM health; and a thoughtful research strategy that addresses significant threats, high rates of undiagnosed HIV and insufficient engagement with HIV prevention services, including PrEP, in black YMSM in Alabama. The combination of the proposed mentoring and training with study findings will culminate in the candidate's attainment of independence and development of a full-scale, implementation science R01 proposal to test aBSB.