Identifying and Engaging Urban HIV infected and uninfected YSMSM in care

识别城市艾滋病毒感染者和未感染者 YSMSM 并让他们参与护理

• 批准号: 10214911
• 负责人: DAVID D. CELENTANO
• 金额: $ 15.94万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10214911
• 关键词: 2019-nCoV; AIDS prevention; Address; Adherence; Adolescent; Affect; Alcohol or Other Drugs use; Baltimore; Birth; COVID-19; COVID-19 pandemic; Caring; Cessation of life; Cities; Communities; Cross-Sectional Studies; Data; Data Collection; Diagnosis; Distress; Economics; Enrollment; Epidemic; Face; Female; Funding; Grant; HIV; HIV Infections; Health; Health Food; Housing; Inequality; Infection; Interview; Life; Lung; Marijuana; Medical; Mental Health; Methods; Minority Groups; Misinformation; National Institute of Drug Abuse; Occupations; Parents; Participant; Persons; Philadelphia; Population; Population Density; Prevention; Provider; Reporting; Risk; Risk Behaviors; Sampling; Schools; Sex Differences; Sexual and Gender Minorities; Structure; Time; Tobacco smoke; United States; Viral; Washington; Youth; aged; comorbidity; coping mechanism; design; ethnic minority population; experience; health seeking behavior; infection rate; infection risk; male; marijuana use; pandemic disease; pre-exposure prophylaxis; prevent; psychosocial; racial minority; racism; service providers; sex; social; social health determinants; treatment services; uptake

ABSTRACT Current data suggest a disproportionate burden of COVID-19 illness and death among racial and ethnic minority groups.1,2 In multiple urban cities across the United States (U.S.) Black and Latinx persons are disproportionately impacted by COVID-19 illness and death.1,3-5 Disproportionate rates are likely the result of concomitant comorbidities, and adverse social determinants of health, including high rates of substance use (SU), mental health, structural racism, high population density, inadequate housing, and poor access to healthy foods.6,7 The same social determinants of health that predispose communities to COVID-19 illness, contribute to high rates of HIV in Black and Latinx sexual and gender minority youth (aged 15-24 ) (SGMY). COVID-19 will likely worsen social and economic inequalities, which predispose Black and Latinx SGMY to SU and to HIV. Exacerbated inequalities will also like result in further disruption of the HIV prevention and treatment cascades.8 The national strategy, Ending the HIV Epidemic (EHE), seeks to diagnose, treat and prevent onward infection in communities hardest hit by HIV, particularly Black and Latinx SGMY. High rates of substance use12 in BLSGMY has been identified as a key factor in treatment and prevention non-engagement, 13-15 and increased substance use may occur during the COVID-19 pandemic as a coping mechanism. SARS-CoV-2, which causes COVID-19, preferentially attacks the lungs, making YBLSGMY who smoke tobacco or marijuana, particularly at-risk.16-19 We will use a sequential explanatory mixed methods design, inclusive of cross-sectional surveys among 200 PUSH participants (both assigned male and female participants) (aim 1) and qualitative data of 48 participants and their service providers (aims 2-3), to understand potential ways in which the COVID-19 epidemic has affected personal life circumstances, risk behaviors, and health seeking behaviors; community barriers to COVID-19 prevention and treatment; and coping mechanisms to address psychosocial distressed experienced during this time. Specific Aim 1: Using a cross-sectional survey among 200 Black and Latinx SGMY enrolled in PUSH to characterize the psychosocial (including school closures, job loss, mental health and SU) disruptions and access barriers to HIV prevention, treatment and substance treatment services due to COVID-19. Specific Aim 2: Qualitatively describe how psychosocial disruptions due to COVID-19 alters BLSGMY’s access to HIV prevention, treatment and substance treatment services and the coping mechanisms used to address disruptions. Specific Aim 3: Identify potential community barriers to COVID-19 treatment and prevention among BLSGMY and their service providers and how such experiences of medical mistrust and misinformation impact experiences of social disruption in BLSGMY. Potential barriers will be explored using paired depth interviews of BLSGMY and their providers. This supplement allows the team to better understand how the COVID-19 pandemic contributes to limited access for HIV prevention, treatment and substance treatment services, and how potential community barriers and assigned sex at birth modifies this relationship.

抽象的 当前的数据表明，在种族和少数民族中，COVID-19的疾病和死亡的伯宁比例不成比例 组。1,2在美国的多个城市城市（美国）黑人和拉丁人的人数不成比例 受到199疾病和死亡的影响。1,3-5不成比例的率很可能是伴随的结果 合并症和健康的不利社会决定者，包括高物质使用率（SU），精神 健康，结构性种族主义，人口密度高，住房不足以及无法获得健康食品的机会。6,7 同样的社会决定者，使社区易受社区的疾病，这有助于高 黑人和拉丁文性和性别少数族裔青年（15-24岁）（SGMY）的艾滋病毒率。 Covid-19将 社会和经济不平等的可能性较差，使黑人和拉丁语sgmy易于su和艾滋病毒。 加剧的不平等也将喜欢进一步破坏HIV预防和治疗级联。88 结束艾滋病毒流行（EHE）的国家战略试图诊断，治疗和防止感染 社区受艾滋病毒，尤其是黑人和拉丁语sgmy的最大打击。 blsgmy中的物质使用率高。 已被确定为治疗和预防不参与的关键因素，13-15并增加了底物 在199大流行期间，可能会发生使用作为应对机制。 SARS-COV-2，导致COVID-19， 优先攻击肺部，使吸烟或大麻吸烟的Yblsgmy，尤其是在风险中。16-19我们 将使用连续挖掘的混合方法设计，包括200次推动的横截面调查 参与者（分配男性和女性参与者）（AIM 1）和48名参与者的定性数据 他们的服务提供商（目标2-3），以了解COVID-19的潜在方式影响 个人生活环境，风险行为和寻求健康行为； COVID-19的社区障碍 预防和治疗；以及应对在此期间经历的社会心理困扰的机制 时间。特定目标1：使用200个黑色和拉丁语SGMY中的横截面调查。 表征社会心理（包括关闭学校，失业，心理健康和SU）和访问 预防HIV，治疗和药物治疗服务的障碍，导致COVID-19。具体目标2： 定性地描述了COVID-19引起的社会心理破坏如何改变Blsgmy的艾滋病毒的机会 预防，治疗和物质治疗服务以及用于解决中断的应对机制。 特定目标3：确定BLSGMY中Covid-19的潜在社区障碍 以及他们的服务提供商以及这种医疗错误和错误信息的经历如何影响 Blsgmy社会中断的经历。将使用配对深度访谈探索潜在的障碍 Blsgmy及其提供商的著作。这种补充使团队能够更好地了解COVID-19 大流行有助于预防艾滋病毒，治疗和药物治疗服务的机会有限，以及 潜在的社区障碍和出生时分配性别如何改变这种关系。

项目成果

Dismantling Barriers and Transforming the Future of Pre-Exposure Prophylaxis Uptake in Young Black and Latinx Sexual Minority Men and Transgender Women.

消除障碍并改变年轻黑人和拉丁裔性少数男性和跨性别女性接受暴露前预防的未来。

• DOI: 10.1089/apc.2021.0222
• 发表时间: 2022
• 期刊: AIDS patient care and STDs
• 影响因子: 4.9
• 作者: Shorrock,Fiona;Alvarenga,Aubrey;Hailey-Fair,Kimberly;Vickroy,Wil;Cos,Travis;Kwait,Jennafer;Trexler,Constance;Wirtz,AndreaL;Galai,Noya;Beyrer,Chris;Celentano,David;Arrington-Sanders,Renata
• 通讯作者: Arrington-Sanders,Renata