The Collaborative Care PrTNER (Prevention, Treatment, Navigation, Engagement, Resource) Project

项目总结/摘要 为了结束艾滋病毒的流行，我们需要解决艾滋病毒和PrEP护理问题的综合护理模式， 物质使用（SU）障碍，破坏吸收和持续使用有效的干预措施。总体 本R 01提案的目标是进行一项随机对照试验，以评估 协作护理预防、治疗、导航、参与、资源（PrTNER）干预， 增加暴露前预防（PrEP）的启动（针对HIV风险人群）并降低病毒载量 (for与男性发生性关系的年轻黑人和拉丁美洲男子（YBLMSM）， 参与SU治疗。协作护理（CC）PrTNER是一种多组分干预 由我们的研究团队成员专门为15至24岁的YBLMSM开发，他们有风险或生活在 感染了艾滋病毒这个模型超越了个人，考虑了更广泛的背景，物质使用， 艾滋病毒风险（再）产生。 将SU治疗整合到艾滋病毒和PrEP初级保健服务中的增强模式（使用合作 护理方法，包括从精神科医生的反馈和同伴教练的支持）， 解决这个人群中药物使用的细微差别。因此，我们建议进行一项随机 一项旨在评估综合协作护理模式（CC PrTNER）的试验，目的如下： 具体目标1：比较YBLMSM与同时存在的SU中有HIV感染风险的人群的比例， （开始或重新开始）在CC PrTNER组与标准治疗（SOC）的12个月PrEP。 具体目标2：比较YBLMSM与同时存在的SU艾滋病毒感染者的比例， 在协作护理PrTNER组与SOC中，12个月时HIV病毒得到抑制。 具体目标3：比较CC PrTNER与SOC对YLBMSM中非烟草SU的影响， 现有的SU，并检查SU的变化对PrEP摄取和HIV病毒抑制的影响。 该提案直接涉及2022年国家艾滋病毒/艾滋病战略的目标1，2和4，以消除艾滋病毒/艾滋病。 流行通过：预防，治疗，并通过综合解决共存的SU疾病 综合护理服务。它还可以进一步改变青少年，卫生部门和瑞安白色护理设置 通过协调PrEP，HIV和SU治疗护理服务和实施 协作护理模式，以解决阻碍吸收和坚持的多层次障碍。

Project Summary/Abstract To end the HIV epidemic, we need integrated care models that address HIV and PrEP care, and co-existing substance use (SU) disorders that disrupt uptake and consistent use of effective interventions. The overarching goal of this R01 proposal is to conduct a randomized controlled trial to assess the ability of a Collaborative Care Prevention, Treatment, Navigation, Engagement, Resource (PrTNER) intervention to increase initiation of preexposure prophylaxis (PrEP) (for those at-risk for HIV) and decrease viral load (for those living with HIV) among young Black and Latino men who have sex with men (YBLMSM) through engagement in SU treatment. The Collaborative Care (CC) PrTNER is a multi-component intervention developed by members of our research team specifically for YBLMSM aged 15 to 24 who are at-risk for or living with HIV. This model moves beyond the individual to consider the broader context in which, substance use, and HIV risk are (re)produced. Enhanced models that integrate SU treatment into HIV and PrEP primary care services (using a collaborative care approach that incorporates feedback from a psychiatrist and support from a peer coach) are needed to address the nuance of substance use in this population. We, therefore, are proposing to conduct a randomized trial to evaluate an integrated collaborative care model (CC PrTNER) using the following aims: Specific Aim 1: To compare the proportion of YBLMSM with co-existing SU at risk for HIV infection who initiate (start or restart) PrEP over the 12 months in the CC PrTNER arm versus standard of care (SOC). Specific Aim 2: To compare the proportion of YBLMSM with co-existing SU living with HIV infection who are HIV virally suppressed at 12 months in the Collaborative Care PrTNER arm versus SOC. Specific Aim 3: To compare the effect of CC PrTNER versus SOC on non-tobacco SU in YLBMSM with co- existing SU and examine the effect of change in SU on PrEP uptake and HIV viral suppression. This proposal directly addresses goals 1, 2, and 4 of the 2022 National HIV/AIDS Strategy to End the HIV Epidemic through: prevention, treatment, and addressing co-existing SU disorders through comprehensive integrated care delivery. It further can transform the adolescent, health department and Ryan White care settings serving YBLMSM through harmonization of PrEP, HIV and SU treatment care delivery and implementation of a collaborative care model to address the multi-level barriers that impede uptake and adherence.