Abstract

Overthepastdecade,HIVinfectionshaveincreasedby87%amongyoungmenwhohavesexwithmen (YMSM)ofcolor.ReversingthistrendwillrequiretheuseofHIVpre-exposureprophylaxis(PrEP).However, increasingPrEPaccessalonewillnotchangethefaceoftheepidemic.AsPrEPefficacyishighlycorrelated withlevelsofadherence,andnoevidencebasedinterventionsyetexisttosupportPrEPadherence,itwillbe crucialtoidentifyfactorsassociatedwithimprovedadherencetoPrEPinYMSM.Socialsupporthasbeen describedasafacilitatorofadherenceinqualitativedatafromPrEPtrials.Understandinghowsocialsupport operatesinthePrEP-adherencerelationshipisessentialpriortodevelopingpotentialsocialsupport-based interventionstooptimizePrEPadherence.However,nostudieshaveyetformallyanalyzedthepotential associationbetweensocialsupportandPrEPadherenceamongYMSM. InresponsetothecriticalneedforresearchdelineatingtheroleofsocialsupportinPrEPadherencefor YMSM,weproposethefollowingspecificaims:1)todiscoverthemesrelatedtoidentificationandutilizationof HIVpre-exposureprophylaxis(PrEP)-relatedsupportandsocialsupportnetworkstructurewithinsocialsupport networksofYMSMofcolorreceivingPrEP;?and2)todeterminetheassociationbetweensocialsupportand currentandsustainedadherencetoPrEPamongacohortofYMSMofcolor.Toachieveaim1,wewillconduct amixedmethodsqualitativeandnetworkanalyticstudyusingin-depthinterviewsandsociogramstoexplore themesofhowparticipantsidentifyPrEP-relatedsupportfigures,howsocialsupportisstructured,andthe waysinwhichsupportfiguresmayfacilitatePrEPadherence.
For aim2, wewilluseacross-sectionalstudy designtotestforanassociationbetweensocialsupport,asmeasuredwithawell-validatedmulti-dimensional surveyinstrument,andcurrentPrEPadherenceusinganovelurineassaytodetecttenofovir;?anda longitudinalcohortdesigntotestforanassociationbetweensocialsupportasmeasuredaboveandsustained PrEPadherenceusingpharmacyrefilldata.TheproposedresearchisbothinnovativeandrelevanttotheNIH HIV/AIDSpriorityofsupportingresearchtodevelopmethodsofPrEPdeliverythatmitigateadherenceissues. Theproposedresearchwillrequireskillsinepidemiology,biostatistics,qualitativeresearchmethods,and networkanalytics.TheKirschstein-NRSAIndividualPostdoctoralFellowshipwillthusbeessentialtothe successofthisresearchbyprovidingfundingfortheapplicanttocompletequalitativemethodsand introductorynetworkanalyticscoursesthroughtheMastersofScienceinHealthPolicyResearchandprovide asecondyearofcoursesinadvancedtopicsinepidemiologyandnetworksunderthesupervisionofahighly qualified,multidisciplinarymentorshipteamwhowillguidethecandidateinhercareerdevelopment.The longer-termobjectivesoftheapplicantaretocompletedataanalysis,disseminateresultsthrough presentationsandpublication,andusetheresultsasafoundationforafutureKawardapplication.

Public Health Relevance

WhileHIVpre-exposureprophylaxis(PrEP)hasemergedasanessentialtooltoreversethedramaticincrease innewHIVinfectionsamongYMSMofcolorintheUnitedStates,harnessingitspreventativebenefitwill requireidentificationandutilizationoffacilitatorsofadherence,suchassocialsupport.Throughourproposed study,weaimtobuildthefoundationforpotentialsocialsupport-basedinterventionstoimprovePrEP adherencebyconductingaqualitativeandnetworkanalysesexploringhowPrEP-relatedsocialsupportfigures areidentifiedandhowPrEP-relatedsupportmanifestsinsocialsupportnetworksofYMSMofcolor.In addition,weaimtoanalyzewhethercurrentandsustainedPrEPadherencediffersbasedonthemagnitudeof socialsupportusingawell-validatedsurveyinstrument,anovelurineassaytodetecttenofovirconcentration, andpharmacyrefillrecords.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32MH111341-02
Application #
9377504
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Stoff, David M
Project Start
2017-03-02
Project End
2019-03-01
Budget Start
2018-03-02
Budget End
2019-03-01
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost

  Institution

Name
Children's Hospital of Philadelphia
Department
Type
DUNS #
073757627
City
Philadelphia
State
PA
Country
United States
Zip Code
19104

  Publications

Lazar, Nellie Riendeau; Salas-Humara, Caroline; Wood, Sarah M et al. (2018) Missed Opportunities for HIV Screening Among a Cohort of Adolescents With Recently Diagnosed HIV Infection in a Large Pediatric Hospital Care Network. J Adolesc Health 63:799-802
Wood, Sarah; Ratcliffe, Sarah; Gowda, Charitha et al. (2018) Impact of insurance coverage on HIV transmission potential among antiretroviral therapy-treated youth living with HIV. AIDS 32:895-902
Wood, Sarah M; Lowenthal, Elizabeth; Lee, Susan et al. (2017) Longitudinal Viral Suppression Among a Cohort of Adolescents and Young Adults with Behaviorally Acquired Human Immunodeficiency Virus. AIDS Patient Care STDS 31:377-383
Wood, Sarah M; Schott, Whitney; Marshal, Michael P et al. (2017) Disparities in Body Mass Index Trajectories From Adolescence to Early Adulthood for Sexual Minority Women. J Adolesc Health 61:722-728
Wood, Sarah M; Lee, Susan; Barg, Frances K et al. (2017) Young Transgender Women's Attitudes Toward HIV Pre-exposure Prophylaxis. J Adolesc Health 60:549-555