A Pilot Randomized Control Trial of the Motivational Interviewing to Increase PrEP Uptake Intervention Among Black Women in the United States.

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES AIDS patient care and STDs Pub Date : 2024-11-01 Epub Date: 2024-10-17 DOI:10.1089/apc.2024.0189
Sannisha K Dale, Victoria Petrulla, Ian A Wright
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Abstract

Despite the disproportional impact of HIV, Black individuals are benefiting the least from pre-exposure prophylaxis (PrEP). Motivational interviewing (MI) for PrEP uptake (MI-PrEP) is a two-session culturally tailored intervention incorporating MI strategies to improve PrEP motivation and uptake among cisgender Black women. A pilot randomized control trial was conducted in the Southeastern United States, and 41 women were randomized to MI-PrEP (session 1 with PrEP psychoeducation and MI and session 2 with MI and light case management) or enhanced treatment as usual (ETAU; two sessions of PrEP psychoeducation [videos explaining PrEP]). Women completed one follow-up assessment (1 month after visit 2). Measures captured primary (motivation [via contemplation and readiness ruler] and PrEP uptake via medical records) and secondary outcomes (e.g., PrEP knowledge, barriers to PrEP, and speaking to a provider about PrEP). Difference-in-differences analyses comparing MI-PrEP with ETAU as well as t-tests for within-group changes over time were conducted. Women who completed MI-PrEP (90.5% retained) compared with ETAU (100% retained) had a significantly higher likelihood of speaking to a provider about PrEP (OR = 4.42e7, CI [8.55e6, 2.29e8], DiD = 17.60, se = 0.84, p < 0.001). Within the MI-PrEP group, women had significant increases in PrEP prescription, knowledge, and motivation/contemplation, and significant decreases in financial resources as a PrEP barrier and medical mistrust (MMT). ETAU had within-group increases in PrEP prescription and speaking to a provider, no changes in motivation and MMT, and increases in specific barriers to care (e.g., transportation). MI-PrEP shows promise, and a large-scale study may be beneficial to further assess efficacy and examine implementation.

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在美国黑人妇女中开展动机访谈以提高 PrEP 使用率干预的试点随机对照试验。
尽管艾滋病的影响不成比例,但黑人从暴露前预防疗法(PrEP)中获益最少。针对 PrEP 摄入的动机访谈(MI)(MI-PrEP)是一种结合了动机访谈策略的两节文化定制干预,旨在提高黑人女性的 PrEP 动机和服用率。在美国东南部进行了一项试点随机对照试验,41 名女性被随机分配到 MI-PrEP(第 1 个疗程为 PrEP 心理教育和多元智能,第 2 个疗程为多元智能和轻度个案管理)或常规强化治疗(ETAU;两个疗程的 PrEP 心理教育[解释 PrEP 的视频])。妇女们完成了一次后续评估(第 2 次就诊后 1 个月)。测量指标包括主要结果(动机[通过沉思和准备尺]以及通过医疗记录获得的 PrEP 服用情况)和次要结果(例如,PrEP 知识、PrEP 的障碍以及与医疗服务提供者谈论 PrEP 的情况)。对 MI-PrEP 与 ETAU 进行了差异分析,并对组内随时间的变化进行了 t 检验。完成 MI-PrEP 的女性(90.5% 的保留率)与 ETAU(100% 的保留率)相比,与医疗服务提供者谈论 PrEP 的可能性明显更高(OR = 4.42e7, CI [8.55e6, 2.29e8], DiD = 17.60, se = 0.84, p < 0.001)。在 MI-PrEP 组中,妇女在 PrEP 处方、知识和动机/考虑方面有显著增加,而在作为 PrEP 障碍的财政资源和医疗不信任(MMT)方面则有显著减少。在 ETAU 组内,PrEP 处方和与医疗服务提供者交谈的人数有所增加,动机和 MMT 没有变化,但具体的护理障碍(如交通)有所增加。MI-PrEP显示出良好的前景,大规模的研究可能有利于进一步评估疗效和检查实施情况。
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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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