一种多组分干预措施（可能）提高黑人男同性恋者对 HIV 的感知风险：可行性和初步有效性试点研究。

A Multicomponent Intervention (POSSIBLE) to Improve Perceived Risk for HIV Among Black Sexual Minority Men: Feasibility and Preliminary Effectiveness Pilot Study.

机构信息

Milken Institute School of Public Health, George Washington University, Washington, DC, United States.

University of Tennessee Health Science Center, Memphis, TN, United States.

出版信息

JMIR Hum Factors. 2024 Jun 11;11:e54739. doi: 10.2196/54739.

DOI:10.2196/54739

PMID:38861707

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11200034/

Abstract

BACKGROUND

Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men. Low perceived risk for HIV (PRH) is a key unaddressed PrEP barrier for Black sexual minority men. Peers and smartphone apps are popular intervention tools to promote community health behaviors, but few studies have used these together in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that used an existing smartphone app called PrEPme (Emocha Mobile Health, Inc) and a peer change agent (PCA) to increase PRH as a gateway to PrEP.

OBJECTIVE

This paper aims to describe the feasibility and preliminary impact of POSSIBLE on PRH and willingness to accept a PrEP referral among Black sexual minority men.

METHODS

POSSIBLE was a theoretically guided, single-group, 2-session pilot study conducted among Black sexual minority men from Baltimore, Maryland between 2019 and 2021 (N=69). POSSIBLE integrated a PCA and the PrEPme app that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the community health worker to learn more about PrEP service options.

RESULTS

The average age of participants was 32.5 (SD 8.1, range 19-62) years. In total, 55 (80%) participants were retained for follow-up at month 1. After baseline sessions, 29 (42%) participants were willing to be referred to PrEP services, 20 (69%) of those confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (t=-1.36; P=.17).

CONCLUSIONS

We observed no statistically significant improvement in PRH between baseline and month 1. However, given the high retention rate and acceptability, POSSIBLE may be feasible to implement. Future research should test a statistically powered peer-based approach on PrEP initiation among Black sexual minority men.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04533386; https://clinicaltrials.gov/study/NCT04533386.

摘要

背景

迫切需要增加暴露前预防（PrEP）的使用，以大幅降低黑人男同性恋者中的艾滋病毒感染率。对艾滋病毒的低感知风险（PRH）是黑人男同性恋者使用 PrEP 的一个未得到解决的关键障碍。同伴和智能手机应用程序是促进社区健康行为的流行干预工具，但很少有研究将这些工具结合在多组分策略中。因此，我们设计了一种名为 POSSIBLE 的多组分干预措施，该措施使用了一个名为 PrEPme（Emocha Mobile Health，Inc）的现有智能手机应用程序和一个同伴改变代理人（PCA），以增加 PRH 作为接受 PrEP 的途径。

目的

本文旨在描述 POSSIBLE 对黑人男同性恋者 PRH 和接受 PrEP 转介意愿的可行性和初步影响。

方法

POSSIBLE 是一项基于理论指导的、单组、2 期试点研究，于 2019 年至 2021 年在马里兰州巴尔的摩的黑人男同性恋者中进行（N=69）。 POSSIBLE 综合了 PCA 和 PrEPme 应用程序，允许用户自我监测性行为风险，并与应用程序内的社区健康工作者聊天，以获取 PrEP 服务信息。 PRH 使用 8 项 PRH 量表在基线和随访研究访问前后进行评估。在每次研究访问结束时，PCA 将感兴趣的人转介给社区卫生工作者，以了解更多有关 PrEP 服务选项的信息。

结果

参与者的平均年龄为 32.5（SD 8.1，范围 19-62）岁。共有 55 名（80%）参与者在第 1 个月保留随访。基线阶段后，29 名（42%）参与者愿意接受 PrEP 服务转介，其中 20 名（69%）确认与 PrEP 护理团队预约。PRH 在基线和随访访问之间没有统计学上的显著差异（t=-1.36；P=.17）。