Budhwani Henna, Kiszla B Matthew, Outlaw Angulique Y, Oster Robert A, Mugavero Michael J, Johnson Mallory O, Hightow-Weidman Lisa B, Naar Sylvie, Turan Janet M
Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States.
School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
JMIR Res Protoc. 2022 Jul 13;11(7):e36655. doi: 10.2196/36655.
African American or Black young men who have sex with men (BYMSM) are at a disproportionate risk for contracting HIV and have high rates of undiagnosed, and therefore untreated, HIV infection. In the southern United States, BYMSM face region-specific hurdles to HIV prevention, such as limited access to care and high levels of racism and intersectional stigma, necessitating HIV testing and pre-exposure prophylaxis interventions that address sociocultural and structural barriers while motivating BYMSM to engage in prevention. Brothers Saving Brothers (BSB) is a motivational interviewing behavioral intervention that successfully and simultaneously increased community-based HIV testing and prevention counseling and education among BYMSM in the midwestern United States.
The aim of this protocol is to detail the process for the adaption of the BSB intervention for midwestern BYMSM to the Kings intervention for southern BYMSM. During the adaptation process, the intervention will be modernized to include rapid HIV testing, as opposed to HIV testing that requires BYMSM to return for test results, pre-exposure prophylaxis, and the provision of structural supports, and for relevance in the southern United States.
Aim 1 is to gather qualitative data through focus groups and in-depth interviews with BYMSM aged 18 to 29 years in Alabama and in-depth interviews with prevention and outreach workers who routinely work with BYMSM in Alabama. NVivo qualitative software (QSR International) will be used for the coding and analysis of the transcripts via a thematic analysis approach. For aim 2, intervention mapping will guide the adaptation process, intervention content, components, and design. Both aims 1 and 2 will leverage the Exploration, Preparation, Implementation, Sustainment implementation science framework, with emphasis on the exploration and preparation phases of this model. By applying these frameworks, the original midwestern BSB intervention will be scientifically adapted to the southern BYMSM Kings intervention.
This study is ongoing as of 2022 and is expected to conclude in 2024, with aims 1 and 2 being completed in 2023. Qualitative data will offer insight into the current real-world experiences and preferences of BYMSM in Alabama. Feedback will be collected through the adaptation process to inform intervention refinement. Institutional review board approvals have been received.
The findings will inform next steps, that is, testing the Kings intervention for feasibility, acceptability, and preliminary effectiveness in a pilot hybrid type 1 effective-implementation randomized controlled trial. The study results will provide insights about important considerations for HIV prevention among BYMSM in the southern United States.
ClinicalTrials.gov NCT03680729; https://clinicaltrials.gov/ct2/show/NCT03680729.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/36655.
与男性发生性关系的非裔美国或黑人青年男性（BYMSM）感染艾滋病毒的风险极高，且未确诊因而未得到治疗的艾滋病毒感染率也很高。在美国南部，BYMSM在艾滋病毒预防方面面临特定区域的障碍，如获得医疗服务的机会有限、严重的种族主义和交叉污名化，因此需要开展艾滋病毒检测和暴露前预防干预措施，以解决社会文化和结构障碍，同时激励BYMSM参与预防工作。“兄弟拯救兄弟”（BSB）是一种动机性访谈行为干预措施，在美国中西部成功且同时增加了BYMSM基于社区的艾滋病毒检测以及预防咨询和教育。
本方案的目的是详细说明将适用于美国中西部BYMSM的BSB干预措施改编为适用于美国南部BYMSM的金斯干预措施的过程。在改编过程中，干预措施将进行现代化改造，纳入快速艾滋病毒检测，而不是要求BYMSM返回获取检测结果的艾滋病毒检测、暴露前预防以及提供结构支持，并使其在美国南部具有相关性。
目标1是通过焦点小组以及对阿拉巴马州18至29岁的BYMSM进行深入访谈，以及对阿拉巴马州经常与BYMSM合作的预防和外展工作人员进行深入访谈来收集定性数据。NVivo定性软件（QSR国际公司）将用于通过主题分析方法对访谈记录进行编码和分析。对于目标2，干预映射将指导改编过程、干预内容、组成部分和设计。目标1和目标2都将利用探索、准备、实施、维持实施科学框架，重点是该模型的探索和准备阶段。通过应用这些框架，将对原有的美国中西部BSB干预措施进行科学改编，以形成适用于美国南部BYMSM的金斯干预措施。
截至2022年，本研究正在进行中，预计2024年结束，目标1和目标2将于2023年完成。定性数据将深入了解阿拉巴马州BYMSM当前的实际经历和偏好。将在改编过程中收集反馈意见，以指导干预措施的完善。已获得机构审查委员会的批准。
研究结果将为下一步行动提供信息，即在1型混合有效性-实施随机对照试验试点中测试金斯干预措施的可行性、可接受性和初步有效性。研究结果将为美国南部BYMSM艾滋病毒预防工作的重要考虑因素提供见解。
ClinicalTrials.gov NCT03680729；https://clinicaltrials.gov/ct2/show/NCT03680729。
国际注册报告识别码（IRRID）：PRR1-10.2196/36655。
