Southwest Health Equity Research Collaborative

西南健康公平研究合作组织

基本信息

批准号：
10457777
负责人：
Julie Ann Baldwin
金额：
$ 74.98万
依托单位：
NORTHERN ARIZONA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2022-09-19
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10457777
关键词：
AIDS prevention Address Adoption Advocate Age Age-Years American Indians Area Bisexual Caring Cherokee Indian Chlamydia Clinic Communities Diagnosis Diagnostic Reagent Kits Disease Education Effectiveness Epidemic Evaluation Familiarity Focus Groups Future Gays Goals Gonorrhea HIV Health Personnel Health Services Health Technology Human immunodeficiency virus test Incidence Individual Infection Intervention Interview Methods Oklahoma Participant Phase Prevalence Prevention Prevention approach Primary Prevention Provider Randomized Records Research Resources Rural Rural Community Secondary Prevention Sexually Transmitted Diseases Surveys Syphilis Syphilis Serodiagnosis Technology Testing Training United States Universities Woman Work base condoms control trial experience health equity informant mHealth member men men who have sex with men parent grant peer peer coaching pre-exposure prophylaxis prevent prevention service prototype recruit risk perception rural Americans rural area screening screening services self testing sex sexual HIV transmission sexual minority social determinants social stigma transmission process trial design uptake

项目摘要

PROJECT SUMMARY In the U.S., incidence rates of HIV and sexually transmitted infections (STIs) are disproportionately high among gay, bisexual, and other men who have sex with men—referred to herein as sexual minority men (SMM)— compared to men who have sex with women only.1,2 Roughly 10% of HIV incidence is attributable to increased transmission due to untreated STIs among SMM,3 64% of syphilis cases occur among SMM,4 and SMM residing in Ending the HIV Epidemic (EHE) priority jurisdictions have nearly 50% greater odds of STIs compared to those residing elsewhere.5 Oklahoma is an EHE priority rural state with above average yearly cases of chlamydia and ranks in the top 10 for gonorrhea and syphilis infections nationwide. Within these Oklahoma communities, those under the age of 24 account for a quarter of new HIV, chlamydia, and gonorrhea infections. Less than 28% of rural Oklahomans have received an HIV test during their lifetime and only 5.7% during the past year, the lowest testing rate among the EHE states.6 Similar to their SMM peers, rural American Indian (AI) men have seen an increase in HIV incidence—where the AI men now account for 9.3% of new infections in Oklahoma compared to 7.8% in 2016.7-9 AI men and SMM living in rural areas of the U.S. are less likely to receive HIV prevention messaging, engage in routine testing, identify HIV testing resources, or receive comprehensive education as compared to their urban counterparts. Rural SMM and AI men in Oklahoma experience many barriers to HIV and STI testing, including worries about HIV-related stigma, low perceptions of risk, difficulty communicating with healthcare providers, and confidentiality concerns,10-15 requiring expansion of prevention and screening services. Our proposed research will specifically focus on two EHE pillars: diagnose (i.e., HIV screening) and prevent (i.e., increase condom use; adoption of Pre-Exposure Prophylaxis). Our specific aims are as follows: AIM 1 – To refine our preliminary intervention strategy in partnership with a Community Advisory Board (CAB) and rural peer mentors. In a 4-month formative phase, we will partner with a CAB to finalize Ending the HIV Epidemic in Rural Oklahoma (e-HERO) components to be included in an initial intervention prototype. AIM 2 – To assess feasibility, acceptability, and preliminary impact of the e-HERO intervention. We will pilot and evaluate the finalized intervention in rural Oklahoma using a randomized control trial design to mimic a future statewide implementation. We will recruit rural SMM (n = 100) and AI men (n = 100) between 17-29 years of age. We will use RE-AIM19 to guide the evaluation, which will entail conducting a convergent mixed-method analysis of surveys (SMM and AI men), HIV/STI testing records, and exit interviews to assess feasibility, acceptability, and preliminary impact of the intervention.

项目摘要在美国，艾滋病毒和性传播感染的发生率（性传播感染）在同性恋，双性恋和其他与男人发生性关系的男人 - 作为性少数人（SMM）引用此处 - 与仅与女性发生性关系的男性相比。1,2大约10％的艾滋病毒事件归因于增加 SMM中未经处理的性传播症引起的传输，梅毒病例中有3个64％发生在SMM，4和SMM中居住在结束艾滋病毒流行（EHE）优先级管辖权的情况下，性传播疾病的几率几乎增加了50％与居住在其他地方的人相比。5俄克拉荷马州是优先级的粗糙状态，年度高于平均水平在全国范围内，衣原体和梅毒感染的前十名。其中俄克拉荷马州的社区，24岁以下的社区占新艾滋病毒，衣原体和淋病感染。不到28％的俄克拉荷马人在一生中接受了艾滋病毒测试，在过去的一年中，只有5.7％，这是EHE州中最低的测试率。6类似于其SMM同行，艰难的美洲印第安人（AI）男子已经看到了艾滋病毒事件的增加 - AI人现在为此解释俄克拉荷马州的新感染中有9.3％，而2016.7-9 AI男子和SMM居住在崎rough的地区美国不太可能接受预防艾滋病毒的消息传递，进行常规测试，识别艾滋病毒测试与城市相比，资源或接受全面的教育。农村SMM和人工智能俄克拉荷马州的男性经历了许多艾滋病毒和性传播感染测试的障碍，包括有关HIV相关污名的奇迹，对风险的看法低，与医疗保健提供者沟通困难以及保密问题，10-15 需要扩大预防和筛选服务。我们提出的研究将特别关注两个 EHE支柱：诊断（即艾滋病毒筛查）并预防（即增加避孕套使用；预防）。我们的具体目的如下：目标1 - 在与社区顾问委员会（CAB）和粗糙的同伴导师合作。在4个月的形成中阶段，我们将与CAB合作，以最终结束俄克拉荷马州农村的HIV流行（E-Hero）要包含在初始干预原型中的组件。目标2 - 评估可行性，可接受性，和E-HERO干预的初步影响。我们将试行并评估最终干预俄克拉荷马州农村使用随机对照试验设计，模仿未来的全州实施。我们将在17-29岁之间招募粗糙的SMM（n = 100）和AI男士（n = 100）。我们将使用Re-Aim19指导评估将需要进行调查的收敛混合方法分析（SMM和AI 男性），HIV/STI测试记录以及退出访谈，以评估可行性，可接受性和初步影响干预。