McMahan Vanessa M, Frank Noah, Buckler Smitty, Violette Lauren R, Baeten Jared M, Banta-Green Caleb J, Barnabas Ruanne V, Simoni Jane, Stekler Joanne D
San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, United States.
Department of Health Services, University of Washington, Seattle, WA, United States.
JMIR Form Res. 2020 Sep 14;4(9):e18118. doi: 10.2196/18118.
Cisgender men who have sex with men (MSM) and transgender people (TGP) who use methamphetamine are disproportionately impacted by HIV acquisition. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV, and interventions that support PrEP persistence and adherence should be evaluated among MSM and TGP who use methamphetamine.
We conducted formative work to inform the development of text messaging and peer navigation interventions to support PrEP persistence and adherence among MSM and TGP who use methamphetamine. In this paper, we describe how the findings from these focus groups and interviews were used to refine the study interventions and protocol for the Hit Me Up! study (HMU!; HIV Prevention in Methamphetamine Users).
Between October 2017 and March 2018, we conducted two focus groups and three in-depth interviews with MSM and TGP who use methamphetamine or who have worked with people who use methamphetamine. During these formative activities, we asked participants about their opinions on the proposed interventions, education and recruitment materials, and study design. We focused on how we could develop peer navigation and text messaging interventions that would be culturally appropriate and acceptable to MSM and TGP who use methamphetamine. Transcripts were reviewed by two authors who performed a retrospective content analysis to describe which specific opinions and recommendations influenced protocol development and the refinement of the interventions.
Overall, participants thought that MSM and TGP would be interested in participating in the study, although they expected recruitment and retention to be challenging. Participants thought that the peer navigator should be someone who is nonjudgmental, has experience with people who use methamphetamine, and is patient and flexible. There was consensus that three text messages per day were appropriate, adherence reminders should be straightforward, all messages should be nonjudgmental, and participants should be able to tailor the timing and content of the text messages. These suggestions were incorporated into the study interventions via the hiring and training process and into the development of the text library, platform selection, and customizability of messages.
It is important to include the opinions and insights of populations most impacted by HIV to develop PrEP interventions with the greatest chance of success. Our formative work generated several recommendations that were incorporated into the interventions and protocol development for our ongoing study.
ClinicalTrials.gov NCT03584282; https://clinicaltrials.gov/ct2/show/NCT03584282.
与男性发生性关系的顺性别男性（MSM）以及使用甲基苯丙胺的跨性别者（TGP）感染艾滋病毒的比例过高。暴露前预防（PrEP）在预防艾滋病毒方面非常有效，应在使用甲基苯丙胺的MSM和TGP中评估支持PrEP持续使用和依从性的干预措施。
我们开展了形成性工作，为开发短信和同伴导航干预措施提供信息，以支持使用甲基苯丙胺的MSM和TGP坚持使用PrEP并保持依从性。在本文中，我们描述了如何利用这些焦点小组和访谈的结果来完善“联系我”研究（HMU!；甲基苯丙胺使用者的艾滋病毒预防）的研究干预措施和方案。
在2017年10月至2018年3月期间，我们对使用甲基苯丙胺或曾与使用甲基苯丙胺的人合作过的MSM和TGP进行了两个焦点小组讨论和三次深入访谈。在这些形成性活动中，我们询问参与者对拟议的干预措施、教育和招募材料以及研究设计的看法。我们重点关注如何开发同伴导航和短信干预措施，使其在文化上适合且为使用甲基苯丙胺的MSM和TGP所接受。两位作者对访谈记录进行了回顾，进行了回顾性内容分析，以描述哪些具体意见和建议影响了方案的制定和干预措施的完善。
总体而言，参与者认为MSM和TGP会有兴趣参与该研究，尽管他们预计招募和留住参与者会具有挑战性。参与者认为同伴导航员应该是一个没有偏见、有与使用甲基苯丙胺的人打交道的经验、有耐心且灵活的人。大家一致认为每天三条短信是合适的，依从性提醒应该简单明了，所有短信都不应带有评判性，并且参与者应该能够调整短信的发送时间和内容。这些建议通过招聘和培训过程纳入了研究干预措施，并纳入了短信库的开发、平台选择和短信的可定制性。
纳入受艾滋病毒影响最严重人群的意见和见解对于开发最有可能成功的PrEP干预措施非常重要。我们的形成性工作提出了一些建议，这些建议已纳入我们正在进行的研究的干预措施和方案制定中。
ClinicalTrials.gov NCT03584282；https://clinicaltrials.gov/ct2/show/NCT03584282 。
