Reback Cathy J, Kisler Kimberly A, Fletcher Jesse B
Friends Research Institute, Inc, 6910 Santa Monica Boulevard, Los Angeles, CA, 90038, USA.
Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
AIDS Behav. 2021 Jul;25(Suppl 1):40-51. doi: 10.1007/s10461-019-02554-0.
Transgender women, particularly racial/ethnic minority transgender women, evidence disproportionately high rates of untreated HIV infection and disproportionately low rates of HIV viral suppression. The Alexis Project was a combined peer health navigation (PHN) and contingency management (CM) intervention that targeted HIV milestones associated with advancement along the HIV care continuum. From February 2014 through August 2016, 139 transgender women of color (TWOC) enrolled and received unlimited PHN sessions and an escalating CM rewards schedule for confirmed achievement of both behavioral (e.g., HIV care visits) and biomedical (e.g., viral load reductions and achieved/sustained viral suppression) HIV milestones. Results demonstrated that increased attendance to PHN sessions was associated with significant achievement of both behavioral (coef. range 0.12-0.38) and biomedical (coef. = 0.10) HIV milestones (all p ≤ 0.01); 85% were linked to HIV care, and 83% who enrolled detectable and achieved the minimum 1 log viral load reduction advanced to full viral suppression. The combined PHN and CM intervention successfully promoted advancement along the HIV Care Continuum, with particularly robust effects for behavioral HIV milestones.
跨性别女性，尤其是少数种族/族裔的跨性别女性，未接受治疗的艾滋病毒感染率高得不成比例，而艾滋病毒病毒抑制率则低得不成比例。亚历克西斯项目是一项将同伴健康导航（PHN）和应急管理（CM）相结合的干预措施，针对与艾滋病毒治疗连续过程进展相关的艾滋病毒关键指标。从2014年2月到2016年8月，139名有色人种跨性别女性（TWOC）登记并接受了不限次数的PHN课程，以及一份逐步升级的CM奖励计划，用于确认在行为（如艾滋病毒治疗就诊）和生物医学（如病毒载量降低以及实现/维持病毒抑制）方面达到艾滋病毒关键指标。结果表明，参加PHN课程次数的增加与行为（系数范围为0.12 - 0.38）和生物医学（系数 = 0.10）方面的艾滋病毒关键指标的显著达成相关（所有p≤0.01）；85%的人与艾滋病毒治疗相关联，83%检测出艾滋病毒且实现至少1 log病毒载量降低的参与者进展到完全病毒抑制状态。PHN和CM相结合的干预措施成功促进了艾滋病毒治疗连续过程中的进展，对行为方面的艾滋病毒关键指标产生了特别显著的效果。
