BOUNCE: Development of a trauma-informed mHealth + peer support intervention to promote PrEP uptake among men who have sex with men

Johns Hopkins University, Baltimore MD

Investigators

Abstract

PROJECT SUMMARY/ABSTRACT HIV pre-exposure prophylaxis (PrEP) uptake has progressed slowly for gay, bisexual, and other men who have sex with men (MSM) in the United States, a population disproportionately burdened by HIV. Addressing trauma and related sequelae may help optimize PrEP uptake in this population, as MSM are disproportionately exposed to trauma, particularly interpersonal violence, much of which is motivated by prejudice. Interpersonal violence carries the highest conditional risk of any trauma exposure for developing posttraumatic stress disorder (PTSD), risk which is further amplified when the violence is motivated by prejudice. Substance use often occurs in response to trauma exposure and may co-occur with PTSD symptomology. There is limited but compelling evidence to suggest that violent trauma exposure, PTSD symptomology, and substance use may negatively affect PrEP uptake. However, research with large MSM-only samples that examines these pathways (with temporal ordering) is lacking, as are trauma-informed PrEP interventions for MSM. This K01 will provide the candidate, Dr. John Mark Wiginton, with the expertise, skills, and opportunities necessary to examine prejudice-motivated interpersonal violence and PrEP uptake pathways among MSM using latent class mediation (Research Aim 1); apply these findings, along with qualitative data from community-engaged research with local MSM and stakeholders, toward development of a novel trauma- informed mHealth + peer support intervention (called BOUNCE) targeting PrEP and coping self-efficacy, peer/social support, and resilience factors (safety, autonomy, trust, trauma awareness) to support PrEP uptake among MSM (Research Aim 2); and conduct usability testing and a proof-of-concept pilot of BOUNCE to assess feasibility, acceptability, and PrEP uptake. Dr. Wiginton will utilize UCSD’s training infrastructure to build his professional independence and further cultivate his competence to develop and test trauma-informed HIV prevention interventions tailored to sexual and gender minorities, particularly those who are multiply-marginalized, to improve HIV disparities and broader sexual health and psychosocial wellness in these populations. Dr. Wiginton seeks training to build his topical and theoretical expertise in trauma exposure, PTSD symptomology, associated substance use, and health behavior impacts (Training Aim 1); gain knowledge and experience conducting community-engaged research (Training Aim 2); develop expertise in designing trauma-informed mHealth + peer support interventions (Training Aim 3); build competence in early-phase clinical trial methods and approaches to evaluate behavioral interventions (Training Aim 4); and foster personal and professional development skills (Training Aim 5). With this award, Dr. Wiginton will gain not only exceptional training, but also valuable data, from which to build his research independence with a competitive future R34/R01 to test BOUNCE more rigorously.