Using Longitudinal Research to Engage African American and Latinx Sexual- and Gender-Minority Youth in the HIV Prevention and Care Continua and Reduce HIV/AIDS-Related Disparities

利用纵向研究让非裔美国人和拉丁裔性少数群体青年参与艾滋病毒预防和护理工作并减少与艾滋病毒/艾滋病相关的差距

• 批准号: 10426196
• 负责人: Jeremy Thomas Goldbach
• 金额: $ 284.74万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10426196
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adherence; Administrative Supplement; African American; Age; Age-Years; Award; Awareness; Black American; Caring; Collaborations; Color; Data; Data Collection; Development; Disease Progression; Drug Screening; Drug usage; Epidemic; Fright; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; Health; Healthcare; Immigration; Infection; Interview; Latino; Latinx; Los Angeles; Major Depressive Disorder; Mental Health; Mental disorders; Methods; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Pediatric Hospitals; Pharmaceutical Preparations; Plasma; Policy Maker; Population; Populations at Risk; Process; Quality of life; Reporting; Research; Research Methodology; Research Personnel; Resources; Risk; Sexual and Gender Minority Youth; Sexually Transmitted Diseases; Surveys; Swab; Testing; Time; Work; Youth; anxious; barrier to care; care systems; cohort; community organizations; comorbidity; drug testing; early childhood; early-career faculty; experience; follow-up; food insecurity; gender minority youth; gender nonconforming; high risk; improved; infection risk; innovation; interest; marijuana use; men; men of color; multi-racial; pre-exposure prophylaxis; prevent; prevention service; psychiatric comorbidity; racial and ethnic; recruit; rectal; retention rate; sexual HIV transmission; social stigma; stem; transgender; translational pipeline; transmission process; uptake; young adult; young man; young men who have sex with men

The U.S. has set a goal to end the HIV epidemic by the year 2030, which can be achieved but only if targeted approaches are implemented with at-risk populations to address known barriers of engagement along the HIV prevention and care continua. Populations of greatest concern include young men who have sex with men (YMSM), especially YMSM of color, who now account for the vast majority of new HIV infections each year. Transgender and gender non-conforming/non-binary youth are also at high risk for HIV acquisition, accounting for an increasing proportion of new infections each year. In 2015, we were awarded a grant from NIDA to establish a new cohort of 448 African American/Black (AA/B) and Latino YMSM, called the Healthy Young Men’s (HYM) Cohort. We also received an administrative supplement to collect two waves of data from a smaller cohort of B/AA and Latinx 108 transgender and gender nonconforming/non-binary youth (TGMY), called the TRUTH Cohort. Both HYM and TRUTH participants were 16 to 24 years of age at the time of recruitment. The overarching aim was to conduct longitudinal research focused on these youths’ engagement in the HIV prevention and care continua in an effort to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities. Mixed methods research is conducted using qualitative interviews, a self- report survey, drug screening, and testing for sexually transmitted infections (STIs) and HIV. Biospecimens (plasma, buffy coat, rectal swabs) are also collected and banked. Analyses performed to date provide clear evidence that participants in both cohorts are at high risk for HIV, drug use, and mental health/psychiatric conditions. Intersectional stigma—i.e., experiences of stigma stemming from multiple, intersecting identities1- 5—also appears to discourage AA/B and Latinx YMSM and TGMY from engaging in care and perhaps may impact their developmental arcs of risk, transmission, and health. Building on this work, we are proposing to longitudinally: i) examine B/L-YMSM’s engagement in the HIV prevention and care continua, as well as their developmental transitions and trajectories in drug use, STI/HIV infection, health, and psychiatric/mental health comorbidities (Aim 1); ii) examine TGMY’s engagement in the HIV prevention and care continua and identify shared and unique transitions and trajectories with respect to TGMY’s use of drugs, infections with STI/HIV, health and psychiatric/mental health comorbidities (Aim 2); and iii) serve as a local and national resource for collaborations and dissemination. We will actively participate in and contribute to the Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO), the Coordinating Center for NIDA’s U01 cohorts. We will also partner with key stakeholders (e.g., community organizations, policy makers) and collaborate with trainees, early career faculty and investigators across the translational spectrum (Aim 3).

美国设定了到 2030 年结束艾滋病毒流行的目标，该目标可以实现，但前提是有针对性 对高危人群实施方法，以解决艾滋病毒参与方面的已知障碍 最受关注的人群包括男男性行为者。 （YMSM），尤其是有色人种 YMSM，他们现在占每年新增艾滋病毒感染者的绝大多数。 跨性别者和性别不合格/非二元青年也面临感染艾滋病毒的高风险，会计 2015 年，我们获得了 NIDA 的资助。 建立一个由 448 名非裔美国人/黑人 (AA/B) 和拉丁裔 YMSM 组成的新群体，称为“健康年轻人” 我们还收到了男子（HYM）队列的行政补充，以收集两波数据。 B/AA 和拉丁裔 108 名跨性别者和性别不合格/非二元青年 (TGMY) 的较小群体， HYM 和 TRUTH 参与者当时年龄均为 16 至 24 岁。 招聘的首要目标是针对这些年轻人的参与进行纵向研究。 参与艾滋病毒预防和护理工作，努力预防新的艾滋病毒感染、减少传播和 减少与艾滋病毒/艾滋病相关的差异。混合方法研究是通过定性访谈（一种自我访谈）进行的。 报告调查、药物筛查以及性传播感染 (STI) 和 HIV 生物样本检测。 （血浆、血沉棕黄层、直肠拭子）也被收集并储存，迄今为止进行的分析提供了明确的信息。 有证据表明，这两个队列的参与者都面临艾滋病毒、吸毒和心理健康/精神病的高风险 交叉耻辱——即源于多重交叉身份的耻辱经历1- 5 — 似乎也阻止 AA/B 和拉丁裔 YMSM 和 TGMY 从事护理工作，也许可能 影响他们的风险、传播和健康的发展弧线 在这项工作的基础上，我们建议： 纵向：i) 检查 B/L-YMSM 对 HIV 预防和护理连续性的参与，以及他们的 吸毒、性传播感染/艾滋病毒感染、健康和精神/心理健康的发展转变和轨迹 合并症（目标 1）；ii) 检查 TGMY 对艾滋病毒预防和护理连续性的参与并确定 TGMY 使用药物、性传播感染/艾滋病毒感染方面的共同且独特的转变和轨迹， 健康和精神/心理健康合并症（目标 2）；以及 iii) 作为地方和国家资源 我们将积极参与合作联盟并为之做出贡献。 产生 NIDA 机会的队列 (C3PNO)，NIDA U01 队列的协调中心。 还与主要利益相关者（例如社区组织、政策制定者）​​合作并与 跨转化领域的实习生、早期职业教师和研究人员（目标 3）。