Building mobile HIV prevention and mental health support in low-resource settings

在资源匮乏的地区建立流动艾滋病毒预防和心理健康支持

基本信息

批准号：
10332885
负责人：
Corina Lelutiu-Weinberger
金额：
$ 10万
依托单位：
RBHS-SCHOOL OF NURSING
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-05 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10332885
关键词：
AIDS prevention Address Alcohol abuse Alcohols Behavioral Bisexual Caring Cellular Phone Cognitive Collaborations Communicable Diseases Communities Complex Counseling Country Data Development Eastern Europe Ensure Epidemic European Face Funding Future Gays Gender Geography HIV HIV risk Health Health Personnel Healthcare Healthcare Systems Homelessness Human immunodeficiency virus test Imprisonment Individual Infrastructure Intervention Intervention Studies Interview Knowledge Lesbian Gay Bisexual Transgender Queer Manuals Mental Depression Mental Health Minority Motivation National Institute of Mental Health Needs Assessment Nongovernmental Organizations Outcome Participant Patients Personal Satisfaction Persons Population Privacy Process Protocols documentation Psyche structure Randomized Controlled Trials Reporting Research Research Support Resources Rights Risk Romania Secure Self Efficacy Self-Injurious Behavior Sexual Health Stigmatization Stress Stress and Coping Structure Substance abuse problem Tablets Techniques Testing Text Translating Treatment Efficacy Unemployment United States National Institutes of Health Violence Work acceptability and feasibility anxiety symptoms arm base behavioral health comorbidity condoms depressive symptoms efficacy testing evidence base experience follow-up gender minority handheld mobile device health care availability improved laptop mHealth men motivational enhancement therapy programs response sex skills skills training social stigma stressor theories transgender

项目摘要

Project Summary Transgender and gender diverse (e.g., gender non-binary) (TGD) individuals remain a hidden group in the Central Eastern European (CEE) country of Romania, with few protections, few equal rights, and many unmet needs. Emerging research with TGD persons in the region indicates that TGD Romanians report particularly high rates of HIV, depression, and hazardous alcohol use, primarily driven by the country’s high structural stigma. Romania’s healthcare system has little expertise for addressing these syndemic health threats. No targeted needs assessments or interventions exist to date in order to remedy these adversities and promote the wellbeing of TGD in Romania, or anywhere in CEE – the region with the fastest-growing HIV epidemic in the world. In response, we propose to create and pilot-test the first intervention in CEE to address the sexual, mental, and behavioral health of TGD people. In 2014, with input from the Romanian LGBTQ community, we created the Comunică [Communicate] intervention, which successfully helped reduce gay and bisexual men’s HIV risk and hazardous alcohol use and improve their mental health. The intervention’s theory and techniques are based on motivational interviewing and cognitive behavioral skills training as adapted for minority stress. Live counseling sessions are delivered by text on a secure platform accessed on any mobile device, which is responsive to participants’ high need for mobility and concealment. In this supplement, we propose to now adapt and pilot-test Comunică to address the shared and unique minority stress determinants facing TGD Romanians to reduce HIV risk, depression, and hazardous alcohol use. Our adaptation will be guided by the gender minority stress framework that acknowledges unique TGD stressors, whose impact our intervention intends to modify. In Aim 1 (mos 1-5), we will identify the unique health needs of Romanian TGD individuals and modify the Comunică intervention to address them. We will interview 20 Romanian TGD individuals who report HIV risk, depression, and hazardous alcohol use, and 10 TGD-affirmative health providers to identify TGD-specific health needs and suggested adaptations to Comunică. In Aim 2 (mo 6), we will iteratively modify the Comunică intervention content to address gender minority stress and other TGD-specific determinants of HIV risk, mental health, and hazardous alcohol use. Finally, in Aim 3 (mos 7-12), we will evaluate the new intervention’s feasibility and acceptability in a one-arm trial with 20 TGD Romanians who report HIV risk, depression, and hazardous alcohol use. Data will be collected at baseline and 3-month follow-up. This project builds on our strong NIH-supported research program focused on the health of LGBTQ people in Romania, in order to create the first intervention to address the sexual, mental, and behavioral health of TGD Romanians. By extending our intervention research to at-risk TGD populations, we will ensure more equitable access to our interventions and embed them within a national infrastructure increasingly eager for and capable of reaching the full diversity of the Romanian LGBTQ population to address its currently unmet needs.

项目概要跨性别者和性别多样化（例如，非二元性别）（TGD）个体仍然是社会中的一个隐藏群体中东欧 (CEE) 国家罗马尼亚，保护很少，平等权利很少，许多未得到满足针对该地区 TGD 人群的最新研究表明，TGD 罗马尼亚人的报告尤其突出。艾滋病毒、抑郁症和危险酒精使用率很高，这主要是由于该国的高结构性罗马尼亚的医疗保健系统缺乏解决这些综合症健康威胁的专业知识。迄今为止存在有针对性的评估或干预措施，以纠正这些逆境并促进罗马尼亚或中东欧任何地方的 TGD 的福祉——该地区是艾滋病毒流行增长最快的地区作为回应，我们建议在中东欧地区创建并试点第一个干预措施，以解决性、 2014 年，根据罗马尼亚 LGBTQ 群体的意见，我们对 TGD 人群的心理和行为健康进行了研究。创建了 Comunică [沟通] 干预措施，成功帮助减少了同性恋和双性恋男性艾滋病毒风险和危险饮酒并改善他们的心理健康干预的理论和技术。基于动机访谈和针对少数群体压力的认知行为技能培训。现场咨询课程通过任何移动设备访问的安全平台上的文本形式进行，响应参与者对移动性和隐蔽性的高度需求，我们现在提出建议。调整并试点 Comunică，以解决 TGD 面临的共同且独特的少数群体压力决定因素罗马尼亚人减少艾滋病毒风险、抑郁症和危险酒精使用的指导方针是：性别少数压力框架，承认独特的 TGD 压力源，其影响我们的干预在目标 1（mos 1-5）中，我们将确定罗马尼亚 TGD 个人的独特健康需求并修改 Comunică 干预措施以解决这些问题。我们将采访 20 名罗马尼亚 TGD 人士。报告 HIV 风险、抑郁症和危险饮酒情况，以及 10 名 TGD 肯定的医疗服务提供者来识别 TGD 特定的健康需求和对 Comunică 的建议调整在目标 2 (mo 6) 中，我们将迭代修改。 Communică 干预内容旨在解决性别少数压力和其他 TGD 特定决定因素最后，在目标 3（第 7-12 条）中，我们将评估新的目标。在一项对 20 名报告 HIV 风险的 TGD 罗马尼亚人进行的单臂试验中，干预措施的可行性和可接受性，该项目将在基线和 3 个月的随访中收集数据。建立在我们强大的 NIH 支持的研究计划的基础上，该计划专注于罗马尼亚 LGBTQ 人群的健康，为了制定第一个干预措施来解决 TGD 罗马尼亚人的性、心理和行为健康问题。通过将我们的干预研究扩展到高危 TGD 人群，我们将确保更公平地获得我们的服务干预措施并将其嵌入日益渴望并有能力实现的国家基础设施中罗马尼亚 LGBTQ 人口的全面多样性，以满足其目前未得到满足的需求。