University of Chicago, Chicago, IL.
NORC at the University of Chicago, Chicago, IL; and.
J Acquir Immune Defic Syndr. 2021 Jan 1;86(1):31-37. doi: 10.1097/QAI.0000000000002518.
We tested preliminary efficacy of a peer change agent type I network intervention to increase pre-exposure prophylaxis (PrEP) linkage to care among network members connected to young Black men who have sex with men.
Parent study is a pragmatic randomized controlled trial with 110 weeks of total follow-up. Interim midpoint analyses are performed here using participant data before crossover assignment at 55 weeks.
We randomly assigned 423 participants in Chicago to receive the network intervention, an opinion leader workshop with telephonic booster sessions, versus a time-matched control from 2016 to 2018. The consolidated surrogate outcome was PrEP referral and linkage to clinical care among network members connected to study participants and was collected from independent administrative data.
Each study participant in the trial (n = 423) had on average 1822 network contacts who could be eligible for PrEP referral and linkage. During the 55-week observation period, PrEP referral was most likely to occur within 3 days of an intervention session compared to control [odds ratio (OR) 0.07 (0.02-0.013); P = 0.007] resulting in 1-2 referrals of network members per session. Network members with referral or linkage were more likely to be connected to study participants in the intervention arm than the control condition [aOR 1.50 (1.09-2.06); P = 0.012].
A peer change agent type I network intervention is preliminarily effective at diffusing PrEP through a network of individuals highly susceptible to HIV over 55 weeks. This low-intensity intervention demonstrated network-level impact among populations that have experienced limited PrEP care engagement in the United States.
我们测试了一种同伴变革代理人 I 型网络干预措施的初步效果，该措施旨在通过与男男性行为者联系的网络成员增加暴露前预防（PrEP）与护理的联系。
主要研究是一项实用随机对照试验，总随访期为 110 周。这里使用的是在 55 周时交叉分配前的参与者数据进行的中期分析。
我们随机分配了 423 名芝加哥参与者接受网络干预措施，即与电话强化课程相结合的意见领袖研讨会，与 2016 年至 2018 年期间的时间匹配对照。综合替代结局是研究参与者联系的网络成员中 PrEP 的转介和与临床护理的联系，从独立的行政数据中收集。
试验中的每位研究参与者（n = 423）平均有 1822 个网络联系人，他们有资格接受 PrEP 的转介和联系。在 55 周的观察期内，与对照相比，干预期间发生 PrEP 转介的可能性最大[优势比（OR）0.07（0.02-0.013）；P = 0.007]，每次干预导致 1-2 名网络成员的转介。有转介或联系的网络成员更有可能与干预组的研究参与者有关，而不是对照组[调整后的优势比（aOR）1.50（1.09-2.06）；P = 0.012]。
在 55 周的时间里，一种同伴变革代理人 I 型网络干预措施初步有效地通过一群极易感染 HIV 的个体网络传播 PrEP。这种低强度的干预措施在美国经历了有限的 PrEP 护理参与的人群中显示出了网络层面的影响。
