Investigating the Impact of Substance Use, Intimate Partner Violence, and COVID-19 on HIV Care Engagement among Young Black Sexual Minority Men with HIV in the US South

调查药物使用、亲密伴侣暴力和 COVID-19 对美国南部感染艾滋病毒的年轻黑人性少数男性的艾滋病毒护理参与度的影响

• 批准号: 10431827
• 负责人: Erik D. Storholm
• 金额: $ 24.58万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10431827
• 关键词: 2019-nCoV; Acute; Address; Advocacy; Age; Alcohols; Attention; Black American; Black race; Buffers; COVID-19; COVID-19 impact; COVID-19 morbidity; COVID-19 mortality; COVID-19 pandemic; Caring; Child Abuse; Chronic; Cohort Studies; Communities; Continuity of Patient Care; Coping Skills; Data; Development; Dimensions; Disasters; Economics; Elements; Emotional; Employment; Equation; Ethnic group; Etiology; Event; Exposure to; Family; Financial Hardship; Future; Grant; HIV; HIV Seronegativity; HIV Seropositivity; HIV risk; Heterogeneity; Home; Housing; Imprisonment; Infection; Intervention; Lead; Learning; Light; Link; Literature; Location; Measurement; Measures; Mediating; Mental Health; Mental Health Services; Methamphetamine; Modeling; Natural Disasters; Outcome; Persons; Play; Prevalence; Quarantine; Research; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Social support; Stress; Substance abuse problem; Surveys; Technology; Terrorism; Testing; Texas; Time; Transportation; United States; Viral; Virus; Work; base; cohort; condomless anal sex; design; economic impact; experience; health economics; health inequalities; improved; innovation; intimate partner violence; minority stress; pandemic disease; psychologic; psychosocial; psychosocial stressors; racial and ethnic; recruit; reduced substance use; resilience; severe weather; sexual minority men; sexually active; social; social structure; stressor; substance use; syndemic; theories; therapy development; transmission process

SUMMARY/ABSTRACT Among sexual minority men, young Black sexual minority men are the most disproportionately impacted by HIV, with the majority of new infections among sexual minority men occurring among this group. Intimate partner violence (IPV) is one of the most understudied factors that may exacerbate these disparities. Little is known about the impact of substance use and IPV on HIV care continuum (CC) outcomes and HIV transmission risk behaviors among young Black sexual minority men with HIV (YBSMM+). Both IPV and substance use leading to IPV may help explain poorer CC engagement among YBSMM+ and are likely to be exacerbated by the COVID-19 pandemic, which is having devastating health and economic impacts. The COVID-19 pandemic is also likely to interfere with CC engagement and viral suppression. The research that we propose is designed to overcome these gaps and limitations, and to identify modifiable intervention targets for strengthening the CC during times of acute psychosocial and economic stress. We propose to use existing data and to collect new data from the United Black Element+ project (UBE+; R01 MH102171). We will use structural equation modeling to explore the associations between substance use and IPV and their impact on HIV care engagement, viral suppression, condomless anal sex, and to determine if distinct forms of resilience (global resiliency, coping skills, and social support) buffer associations between these relationships among YBSMM+ in the U.S. South. This study can shed new light on the associations between substance use, IPV and CC outcomes and risk and will support the submission of an intervention development grant (R34) to develop a resiliency and advocacy-based intervention that reduces the impact of substance use and IPV on CC engagement and retention among YBSMM+. The project’s focus on the role that resiliency factors may play in moderating harmful effects of substance abuse and IPV among YBSMM+ is innovative. This research can inform the development and adaptation of substance use, IPV, and CC interventions for YBSMM+.

摘要/摘要 在性少数群体中，年轻的黑人性少数族裔男性受艾滋病毒影响最大， 性少数族裔男性中的大部分新感染发生在这一群体中。亲密伴侣 暴力（IPV）是可能加剧这些分布的最了解的因素之一。关于 药物使用和IPV对HIV护理连续体（CC）结果和HIV传播风险行为的影响 年轻的黑人性少数民族艾滋病毒（YBSMM+）。 IPV和物质使用都可能有助于解释 CC在YBMMM+之间的参与度较差，并且很可能会因患有COVID-19的大流行而加剧 毁灭性的健康和经济影响。 COVID-19大流行还可能干扰CC参与度 和病毒抑制。我们提出的研究旨在克服这些差距和局限性，并 确定可修改的干预目标，以加强急性社会心理和经济时期 压力。我们建议使用现有数据并从United Black Element+ Project（UBE+; R01）收集新数据 MH102171）。我们将使用结构方程建模来探索物质使用与IPV之间的关联和 它们对艾滋病毒护理参与，病毒抑制，无避孕套肛交的影响，并确定是否不同的形式 这些关系之间的弹性（全球弹性，应对技巧和社会支持）之间的缓冲关系 YBSMM+在美国南部。这项研究可以为物质使用，IPV和CC之间的关联提供新的启示。 成果和风险，并将支持提交干预开发补助金（R34）以发展弹性 以及基于倡导的干预措施，以减少物质使用和IPV对CC参与和保留的影响 在ybsmm+中。该项目的重点是弹性因素可能在调节有害影响方面发挥的作用 YBSMM+中的药物滥用和IPV具有创新性。这项研究可以告知发展和适应 YBSMM+的物质使用，IPV和CC干预措施。