scholarly journals Small Randomized Controlled Trial of the New Passport to Wellness HIV Prevention Intervention for Black Men Who Have Sex With Men (BMSM)

2020 ◽  
Vol 32 (4) ◽  
pp. 311-324
Author(s):  
Nina T. Harawa ◽  
Katrina M. Schrode ◽  
Charles McWells ◽  
Robert E. Weiss ◽  
Charles L. Hilliard ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Peer Support ◽  
Social Determinants ◽  
Controlled Trial ◽  
Post Exposure Prophylaxis ◽  
Sti Prevention ◽  
Hiv Prevention Intervention ◽  
Sex With Men ◽  
Exposure Prophylaxis

We developed and tested Passport to Wellness (PtW), a client-centered intervention to improve engagement in HIV/STI prevention and services to improve social determinants of health among Black men who have sex with men (BMSM) using incentives and peer support. We assessed PtW's impact on HIV/STI screening and pre/post-exposure prophylaxis (PrEP/PEP) knowledge/uptake using a randomized trial that compared the full intervention to one lacking peer support. We compared changes within groups surveyed at baseline and 6 months. We enrolled 80 eligible BMSM, among 399 screened. Among retained participants (34 peer-supported; 27 comparison), overall increases were observed in HIV (30% to 87% p < .001) and STI (28% to 80% p < .001) testing within the prior 6 months, as well as in PrEP and PEP awareness, and PrEP use. Statistically significant between group differences were not observed. Tailored prevention planning, incentives, and addressing social determinants may help move Black MSM along the HIV prevention continuum.

scholarly journals A Mobile Intervention to Improve Uptake of Pre-Exposure Prophylaxis for Southern Black Men Who Have Sex With Men: Protocol for Intervention Development and Pilot Randomized Controlled Trial

10.2196/15781 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e15781
Author(s):  
Anne-Emilie Rouffiac ◽  
Laura Whiteley ◽  
Larry Brown ◽  
Leandro Mena ◽  
Lacey Craker ◽  
...  
Keyword(s):  
Black Men ◽  
Controlled Trial ◽  
Cost Effective ◽  
Text Messages ◽  
Southern United States ◽  
Structural Barriers ◽  
Randomized Controlled ◽  
Youtube Videos ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background The uptake of pre-exposure prophylaxis (PrEP) has been slow for young black men who have sex with men (BMSM) living in the southern United States. This is a significant issue because 8 of the 10 states with the highest rates of new HIV infections are in the South. Jackson, Mississippi (MS), the site of this project, has the second highest AIDS diagnosis rate in the nation and the highest rate of HIV infection for young, urban BMSM. This study will develop and test an engaging, interactive, and cost-effective mobile messaging intervention to improve engagement in PrEP care for BMSM aged 18 to 35 years living in Jackson, MS. Objective The goals of this mixed methods study are to (1) conduct qualitative interviews with young BMSM in Jackson, MS, to understand individual, community, and structural barriers affecting engagement in PrEP-related care, (2) assemble a PrEP mobile messaging intervention that includes text messages with publicly available internet content (websites and YouTube videos) that provide factual information, motivational materials, and behavioral skills related to PrEP and HIV prevention, and (3) evaluate the preliminary efficacy of the intervention in a randomized controlled study with PrEP-eligible BMSM receiving care in STI/HIV testing clinics in Jackson, MS. Methods This research protocol will be conducted in 2 phases. A development phase will involve in-depth interviews (n=30) with PrEP-eligible BMSM who receive care in STI/HIV testing clinics in MS. These interviews will allow researchers to select the texted material that will be sent out during the intervention. The second phase will consist of an unblinded, small, randomized controlled trial among 66 new participants to examine the preliminary efficacy of the intervention compared with enhanced standard of care (ESC) on attendance at a PrEP services appointment (the first step in initiating PrEP care) and receipt of a PrEP prescription, based on self-report and electronic medical records. The free, publicly available material will be sent to PrEP-eligible BMSM in 8 to 16 interactive text messages over 4 weeks. Study assessments will occur at enrollment and at 4- and 16-weeks postenrollment and can be completed online or in person. All participants will be recruited from a local clinic. Results Institutional review board approval was received on January 16, 2017, and research activities, subsequently, began in February 2018. Recruitment for the study concluded in November 2019. In total, 65 participants were randomized with 33 being assigned to the intervention and 32 to ESC. Collection of follow-up data is ongoing. Conclusions This PrEP mobile messaging intervention aims to increase uptake of PrEP by BMSM in the southern United States. This intervention uses interactive, tailored text messaging and appealing free Web content (publicly accessible educational websites and YouTube videos) to promote linkage to PrEP care and increase HIV preventative behaviors. A cost-effective PrEP mobile messaging intervention has great potential to improve information about PrEP, improve motivation to use PrEP, and decrease stigma and structural barriers that often prevent engagement in PrEP-related medical care. Trial Registration ClinicalTrials.gov NCT03308097; https://clinicaltrials.gov/ct2/show/NCT03308097 International Registered Report Identifier (IRRID) DERR1-10.2196/15781

scholarly journals 863. Increasing PrEP Uptake: A Diffusion-Based Network Intervention for HIV Prevention Among Young Black Men Who Have Sex With Men

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S21-S22
Author(s):  
Matthew Ferreira ◽  
Lindsay Young ◽  
John Schneider
Keyword(s):  
Hiv Prevention ◽  
Hiv Infection ◽  
Black Men ◽  
Controlled Trial ◽  
Biomedical Intervention ◽  
Network Intervention ◽  
Sex With Men ◽  
Hiv Negative ◽  
Peer Leader

Abstract Background Advances in biomedical prevention strategies provide new opportunities for reducing HIV incidence among young black men who have sex with men (YBMSM). Pre-exposure prophylaxis (PrEP) is for HIV-negative individuals and has been shown to be up to 99% effective in preventing HIV infection when taken as prescribed by CDC clinical practice guidelines. Several studies, however, have documented low rates of PrEP uptake among YBMSM. Methods PrEP Chicago is a randomized controlled trial peer leader intervention designed to promote uptake of PrEP for HIV prevention among YBMSM. Participants (n = 423) were recruited using respondent-driven sampling (RDS) and randomized to either an intervention (n = 209) or control (n = 214) condition. Eligibility criteria included: aged 18–35, identifies as a person of color, assigned male sex at birth, had sex with a man in the past 12 months, had an active Facebook profile, and resided in Chicago. The intervention includes a half-day, small group PrEP, and peer leader training workshop followed by monthly check-in booster calls. Approximately 12 months after their initial baseline visit, participants return to complete follow-up data collection and switch conditions, giving year 1 control participants the opportunity to learn about PrEP. Results The number of HIV-negative intervention participants on PrEP at baseline vs. 12-month follow-up (PrEP Chicago Study, Chicago, 2016–2018). A total of 341 participants (80.6%) returned at 12 months. Of 209 intervention participants at baseline, 176 (84.2%) completed a follow-up survey at 12 months. At baseline, 13 (13.3%) of 98 HIV-negative intervention participants indicated that they were currently taking PrEP. At 12 months, this number grew to 25 (32.5%) of 77 HIV-negative intervention participants, indicating that they were currently taking PrEP. A total of 21 participants reported initiating PrEP during their time in the intervention. Conclusion PrEP is a valuable biomedical intervention for preventing HIV infection in those at risk. PrEP Chicago, a network intervention designed to promote uptake of PrEP among YBMSM, shows promising results for PrEP adoption among this community. Disclosures All authors: No reported disclosures.

scholarly journals Comparing Provider and Client Preferences for HIV Prevention Services in South Africa among Men Who Have Sex with Men

2017 ◽  
Vol 16 (6) ◽  
pp. 562-571 ◽  
Author(s):  
John Shaver ◽  
Patrick Sullivan ◽  
Aaron Siegler ◽  
Alex de Voux ◽  
Nancy Phaswana-Mafuya ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Service Providers ◽  
Post Exposure Prophylaxis ◽  
Care Providers ◽  
Prevention Services ◽  
Sex With Men ◽  
Exposure Prophylaxis

Combination prevention efforts are now recommended toward reducing HIV incidence among men who have sex with men (MSM). Understanding the perceptions of both MSM and service providers is critical to informing the development of prevention packages and ultimately improving intervention effectiveness. This study assessed the preferences of MSM and health service providers in the administration of HIV-prevention efforts. Qualitative data were gathered from a series of separate MSM and health care provider focus groups in 2 South African cities. Participants discussed HIV-prevention services and MSM client experiences within South Africa and identified the 3 most important clinic characteristics and 3 most important HIV-prevention services for MSM clients. Priorities indicated by both MSM and health care providers were confidentiality of visit, friendly staff, and condoms, while discrepancies existed between MSM and providers regarding provider consistency and the provision of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) and lubricant as prevention methods. Effective interventions must address these discrepancies through the design of intervention and provider training to optimally accommodate MSM.

The PrEP Up Pharmacies Study: Protocol for integrating and disseminating pre-exposure prophylaxis (PrEP) screening and dispensing in community pharmacies for Black men who have sex with men in Atlanta, Georgia (Preprint)

2021 ◽  
Author(s):  
Natalie D. Crawford ◽  
Kristin R.V. Harrington ◽  
Daniel Alohan ◽  
Patrick S. Sullivan ◽  
David P. Holland ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Racial Minority ◽  
High Poverty ◽  
Pilot Phase ◽  
Pharmacy Staff ◽  
Delivery Model ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Pilot Intervention

BACKGROUND Black men who have sex with men (BMSM) suffer from alarmingly high rates of HIV in the United States. Pre-exposure prophylaxis (PrEP) can reduce risk of HIV infection by 99% among MSM, yet profound racial disparities in the uptake of PrEP persist. Low PrEP uptake in BMSM is driven by poor access to PrEP including inconvenient locations of PrEP-prescribing physicians and distrust of physicians and stigma, which limit communication about PrEP and its side effects. Previous work indicates that offering HIV prevention services in pharmacies located in high poverty, racial minority neighborhoods is feasible and can reduce stigma because pharmacies offer a host of less stigmatized health services (e.g. vaccinations). We present a protocol for a pharmacy PrEP model that seeks to address challenges and barriers to pharmacy-based PrEP specifically for BMSM. OBJECTIVE To develop a sustainable pharmacy PrEP delivery model that can be implemented to increase PrEP access in high poverty, racial minority neighborhoods for BMSM. METHODS This study design is a pilot intervention to test a pharmacy PrEP delivery model among pharmacy staff and BMSM. We will examine the PrEP delivery model’s feasibility, acceptability and safety, and gather early evidence of its impact and cost with respect to PrEP uptake. A mixed methods approach will be performed including three study phases: 1) a completed formative phase with qualitative interviews from key stakeholders; 2) a completed transitional pilot phase to assess customer eligibility and willingness to receive PrEP in pharmacies during COVID-19; and 3) a planned pilot intervention phase which will test the delivery model in two Atlanta pharmacies in high poverty, racial minority neighborhoods. RESULTS Data from the formative phase showed strong support of pharmacy-based PrEP delivery among BMSM, pharmacists and pharmacy staff. Important factors were identified to facilitate implementation of PrEP screening and dissemination in pharmacies. During the transitional pilot phase, we identified 81 individuals who would have been eligible for the pilot phase. CONCLUSIONS Pharmacies have proven to be a feasible source for offering PrEP for White MSM, but have failed to reach the most at-risk, vulnerable population – BMSM. Increasing PrEP access and uptake will reduce HIV incidence and racial inequities in HIV. Translational studies are required to build further evidence and scale pharmacy-based PrEP services specifically for populations that are disconnected from HIV prevention resources.

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