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Principal Investigator: RENATA A SANDERS
Organization: CHILDREN'S HOSP OF PHILADELPHIA
Fiscal Year: 2024
Award: $674,186
Funding agency: National Institute on Drug Abuse
Project Summary/Abstract
To end the HIV epidemic, we need integrated care models that address HIV and PrEP care, and co-existing
substance use (SU) disorders that disrupt uptake and consistent use of effective interventions. The overarching
goal of this R01 proposal is to conduct a randomized controlled trial to assess the ability of a
Collaborative Care Prevention, Treatment, Navigation, Engagement, Resource (PrTNER) intervention to
increase initiation of preexposure prophylaxis (PrEP) (for those at-risk for HIV) and decrease viral load
(for those living with HIV) among young Black and Latino men who have sex with men (YBLMSM) through
engagement in SU treatment. The Collaborative Care (CC) PrTNER is a multi-component intervention
developed by members of our research team specifically for YBLMSM aged 15 to 24 who are at-risk for or living
with HIV. This model moves beyond the individual to consider the broader context in which, substance use, and
HIV risk are (re)produced.
Enhanced models that integrate SU treatment into HIV and PrEP primary care services (using a collaborative
care approach that incorporates feedback from a psychiatrist and support from a peer coach) are needed to
address the nuance of substance use in this population. We, therefore, are proposing to conduct a randomized
trial to evaluate an integrated collaborative care model (CC PrTNER) using the following aims:
Specific Aim 1: To compare the proportion of YBLMSM with co-existing SU at risk for HIV infection who initiate
(start or restart) PrEP over the 12 months in the CC PrTNER arm versus standard of care (SOC).
Specific Aim 2: To compare the proportion of YBLMSM with co-existing SU living with HIV infection who are
HIV virally suppressed at 12 months in the Collaborative Care PrTNER arm versus SOC.
Specific Aim 3: To compare the effect of CC PrTNER versus SOC on non-tobacco SU in YLBMSM with co-
existing SU and examine the effect of change in SU on PrEP uptake and HIV viral suppression.
This proposal directly addresses goals 1, 2, and 4 of the 2022 National HIV/AIDS Strategy to End the HIV
Epidemic through: prevention, treatment, and addressing co-existing SU disorders through comprehensive
integrated care delivery. It further can transform the adolescent, health department and Ryan White care settings
serving YBLMSM through harmonization of PrEP, HIV and SU treatment care delivery and implementation of a
collaborative care model to address the multi-level barriers that impede uptake and adherence.
Terms: <AAMSM><AIDS Virus><AIDS prevention><AIDS/HIV><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adherence><Adolescent><Adolescent Youth><African American MSM><African-American men who have sex with men><Alcohol Chemical Class><Alcohol Drinking><Alcohol consumption><Alcohols><Anal Sex><Anti-Retroviral Agents><BMSM><Baltimore><Black><Black race><Cannabis><Caring><Communication Disorders><Communication impairment><Communicative Disorders><County><Decision Making><Eligibility><Eligibility Determination><Epidemic><EtOH drinking><EtOH use><Feedback><Geography><Goals><HIV><HIV Infections><HIV Prevention><HIV risk><HIV/AIDS><HIV/AIDS prevention><HTLV-III Infections><HTLV-III-LAV Infections><Health><High-Risk Sex><Hispanic><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Illicit Drugs><Individual><Intervention><Intervention Strategies><LAV-HTLV-III><Latino><Link><Lymphadenopathy-Associated Virus><MSM><Marijuana><Modeling><Participant><Pattern><Philadelphia><Population><PrEP><Prevalence><Prevention><Protocol Screening><Psychiatrist><Randomization trial><Randomized, Controlled Trials><Reporting><Research><Research Resources><Resources><Risk><Risk Factors><Substance Use Disorder><THC co-use><THC use><Tetrahydrocannabinol co-use><Tetrahydrocannabinol use><Time><Unprotected Sex><Unsafe Sex><Viral><Viral Burden><Viral Load><Viral Load result><Virus-HIV><Work><aged><alcohol ingestion><alcohol intake><alcohol product use><alcohol use><alcoholic beverage consumption><alcoholic drink intake><anal intercourse><anal intercourse without condom><anal sex without condom><anti-retroviral><antiretroviral therapy><antiretroviral treatment><arm><black MSM><black men who have sex with men><cannabis use><care delivery><collaborative care><condomless anal intercourse><condomless anal sex><condomless intercourse><condomless sex><condoms><disparities in race><disparity due to race><disparity in ethnic><effective intervention><ethanol consumption><ethanol drinking><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><ethnic based disparity><ethnic disadvantage><ethnic disparity><ethnic inequality><ethnic inequity><ethnicity disparity><experience><falls><illicit drug use><inequality due to race><inequity due to race><integrated care><integrated model of care><interventional strategy><juvenile><juvenile human><marihuana><marijuana use><medication non-adherence><medication nonadherence><member><men having sex with men><men who have sex with men><men who have sex with other men><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><multiple substance use><multisubstance use><peer coaching><peer instruction><peer led team learning><peer mentoring><peer teaching><poly substance use><polysubstance use><pre-exposure prophylaxis><pressure><primary care services><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial disparity><racial inequality><racial inequity><racially unequal><randomized control trial><randomized trial><reduced substance use><reduction in substance use><sex><sexual minority men><standard of care><substance use><substance use and disorder><substance use reduction><substance use treatment><substance using><unprotected anal intercourse><unprotected anal sex><unprotected intercourse><unsafe anal intercourse><unsafe anal sex><uptake>