Jamaica CARES Project: Connecting HIV/AIDS Resources to Engage Jamaican Sexual and Gender Minorities

牙买加 CARES 项目：连接艾滋病毒/艾滋病资源以吸引牙买加性少数群体

基本信息

批准号：
10480973
负责人：
Orlando Omar Harris
金额：
$ 20.12万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-01 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10480973
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Advocacy Affect Anti-Retroviral Agents Anxiety Appointment Automobile Driving Behavior Therapy Caribbean region Caring Clinic Clinical Communities Complex Consult Cross-Sectional Studies Data Development Discrimination Drops Educational workshop Epidemic Evaluation Feedback Focus Groups Foundations Gender General Population Goals Grant HIV HIV Infections Health Health Personnel Health behavior change High Prevalence Homo Human Rights Immunologics Individual Intervention Intervention Trial Interview Jamaica Jamaican K-Series Research Career Programs Knowledge Laws Measurement Measures Medical Mental Depression Mental Health Mentors Mentorship Methods Modeling Nurses Outcome Participant Pathway interactions Patient Self-Report Personal Satisfaction Persons Policies Population Positioning Attribute Prevalence Prevention Property Provider Psychologist Psychology Psychometrics Randomized Reading Reporting Research Research Activity Research Methodology Research Personnel Resource-limited setting Resources Risk Same-sex Scientist Services Sex Behavior Sexual Health Sexual and Gender Minorities Sexuality Social Workers Surveys Sustainable Development Symptoms System Target Populations Testing Theory of Change Time Training Training Activity Trauma Treatment outcome United Nations United States Violence Viral Viral Load result acceptability and feasibility base care outcomes clinical research site cognitive interview design experience feasibility testing formative assessment global health health disparity implementation barriers implementation facilitators improved indexing innovation insight instrument intersectionality intervention mapping longitudinal analysis low and middle-income countries male meetings men who have sex with men patient health information perceived discrimination pilot test prevention service programs public health relevance racism randomized trial skills social health determinants social stigma social structure sodomy success theories therapy design therapy development transgender women transphobia treatment services

AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Advocacy Affect Anti-Retroviral Agents Anxiety Appointment Automobile Driving Behavior Therapy Caribbean region Caring Clinic Clinical Communities Complex Consult Cross-Sectional Studies Data Development Discrimination Drops Educational workshop Epidemic Evaluation Feedback Focus Groups Foundations Gender General Population Goals Grant HIV HIV Infections Health Health Personnel Health behavior change High Prevalence Homo Human Rights Immunologics Individual Intervention Intervention Trial Interview Jamaica Jamaican K-Series Research Career Programs Knowledge Laws Measurement Measures Medical Mental Depression Mental Health Mentors Mentorship Methods Modeling Nurses Outcome Participant Pathway interactions Patient Self-Report Personal Satisfaction Persons Policies Population Positioning Attribute Prevalence Prevention Property Provider Psychologist Psychology Psychometrics Randomized Reading Reporting Research Research Activity Research Methodology Research Personnel Resource-limited setting Resources Risk Same-sex Scientist Services Sex Behavior Sexual Health Sexual and Gender Minorities Sexuality Social Workers Surveys Sustainable Development Symptoms System Target Populations Testing Theory of Change Time Training Training Activity Trauma Treatment outcome United Nations United States Violence Viral Viral Load result acceptability and feasibility base care outcomes clinical research site cognitive interview design experience feasibility testing formative assessment global health health disparity implementation barriers implementation facilitators improved indexing innovation insight instrument intersectionality intervention mapping longitudinal analysis low and middle-income countries male meetings men who have sex with men patient health information perceived discrimination pilot test prevention service programs public health relevance racism randomized trial skills social health determinants social stigma social structure sodomy success theories therapy design therapy development transgender women transphobia treatment services

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项目摘要

PROJECT SUMMARY/ABSTRACT Jamaica’s HIV/AIDS epidemic among sexual and gender minorities is the most severe in the Caribbean in terms of its breadth and consequences. HIV prevalence among men who have sex with men is estimated at 33% and 51% among transgender women, which is significantly higher than the 1.8% observe in the general population. Intersectional stigma (often related to intersecting identities) and violence are key drivers of poor mental health and HIV care engagement, leading to higher rates of depression, anxiety, and low viral suppression (21%). The goals of the proposed research are to 1) gain and understanding of the influences and mechanisms by which intersectional stigma and violence impact mental health and engagement in HIV care; and 2) refine our conceptual framework to aid in intervention development that assists sexual and gender minorities to engage in HIV care. Candidate: I am a nurse-scientist with a background in health behavior change theory and social determinants of health in the context of HIV. I am applying for a K23 Career Development Award to obtain training, mentorship, and research experience to become an expert and independent investigator in theory-based, behavioral intervention design to improve the health of sexual and gender minorities in the Caribbean and in other low-resource settings. Mentoring: I have put together an exceptional mentoring team with extensive experience in intersectional stigma measurement research, mental health, and HIV treatment and prevention in resource-limited settings like Jamaica. Drs. Sheri Weiser and Carol Dawson-Rose will serve as co-Primary mentors and bring complementary expertise in HIV treatment and prevention, trauma, conceptual model framework refinement, and development and implementation of behavioral interventions in resource-limited settings. My co-mentors, scientific advisor, and collaborator round out my team to bring specific content and methods expertise and are based both in the United States and Jamaica, including: Dr. Mallory Johnson (clinical psychologist, intervention design and evaluation; feasibility implementation, ART adherence); Dr. Tor Neilands (psychology, quantitative methods, design and analysis of longitudinal data); Dr. Sharlene Jarrett (clinical psychologist, mental health and HIV treatment in the Jamaican context); Carmen Logie (clinical social worker, intersectionality and mixed methods research); Dr. Jae Sevelius (clinical psychologist, intersectional stigma measurements, cognitive interviewing, and gender affirmation); Dr. Anita Stewart (psychologist, measurement adaptation and testing expert); and Dr. Mark Padilla (medical anthropologist, Caribbean sexualities researcher). Training: I propose to obtain training in acquiring foundational knowledge in measures of intersectional stigma (adaptation and testing), advanced quantitative training to collect and analysis skills, and to attain expertise in developing, piloting, and evaluating HIV behavioral interventions. Training will be achieved through mentoring meetings, coursework, workshops, mentored direct readings and primary research in Jamaica. Research: The goals of the proposed research are to 1) identify the pathways between intersectional stigma, violence, mental health and HIV care engagement among Jamaican sexual and gender minorities living with HIV; 2) develop and manualize a multi-level intervention that addresses intersectional stigma, violence, and poor mental health in order to optimize HIV care engagement among Jamaican sexual and gender minorities living with HIV; and 3) pilot test the multi- level intervention for acceptability and feasibility among sexual and gender minorities living with HIV and their healthcare provider. We will plan for a full-scale testing of the intervention in a planned R01 submission in year 5. Summary: The recently announced Ending the HIV Epidemic (EtHE) by the DHHS and under Sustainable Development Goal 3 of the United Nations Program on HIV/AIDS highlight the pressing need for research to address disparities among SGM and other key populations in the quest to halt HIV infections globally by 2030. The proposed research and training activities will position me to conduct innovative, high-impact research to address intersectional stigma, violence and mental health among SGM living with HIV in low-resource settings to improve HIV treatment engagement.

项目摘要/摘要性别和性别少数群体中牙买加的艾滋病毒/艾滋病流行是加勒比地区最严重的其广度和后果的条款。估计与男性发生性关系的男性中的艾滋病毒患病率跨性别妇女中的33％和51％，显着高于一般观察到的1.8％人口。交叉污名（通常与相交的身份有关）和暴力是穷人的关键驱动力心理健康和艾滋病毒护理参与，导致抑郁症，动画和病毒率低的速度更高抑制（21％）。拟议研究的目标是1）增益和理解影响和交叉污名和暴力影响艾滋病毒护理中的心理健康和参与的机制； 2）完善我们的概念框架以帮助开发干预措施，以帮助性别和性别少数群体从事艾滋病毒护理。候选人：我是一个具有健康行为背景的护士科学家在艾滋病毒背景下，改变健康的理论和社会决定者。我正在申请K23职业获得培训，指导和研究经验的发展奖，以成为专家基于理论的，行为干预设计的独立研究者，以改善性和性健康的健康加勒比地区和其他低资源环境中的性别少数群体。指导：我把具有丰富经验的卓越心理团队在交叉污名测量研究，心理在牙买加等资源有限的环境中，健康，艾滋病毒治疗和预防。博士。 Sheri Weiser和卡罗尔·道森·罗斯（Carol Dawson-Rose）将担任联合主导者，并带来艾滋病毒治疗方面的完整专业知识预防，创伤，概念模型框架的完善以及开发和实施在资源有限的设置中采取行为干预措施。我的联合顾问，科学顾问和合作者回合我的团队带来特定的内容和方法专业知识，并在美国和牙买加，包括：Mallory Johnson博士（临床心理学家，干预设计和评估；可行性实施，艺术依从性）； Tor Neilands博士（心理学，定量方法，设计和分析纵向数据）； Sharlene Jarrett博士（牙买加的心理健康和艾滋病毒治疗临床心理学家语境）;卡门·洛吉（Carmen Logie）（临床社会工作者，交叉性和混合方法研究）； Jae Sevenlius博士（临床心理学家，交叉污名测量，认知访谈和性别肯定）；博士 Anita Stewart（心理学家，测量适应和测试专家）；和马克·帕迪拉（Mark Padilla）博士（医学人类学家，加勒比性研究人员）。培训：我建议接受培训相交污名（适应和测试），高级定量的测量中的基础知识培训以收集和分析技能，并获得开发，试点和评估艾滋病毒的专业知识行为干预。培训将通过心理会议，课程，讲习班，在牙买加指导了直接阅读和主要研究。研究：拟议研究的目标是到1）确定交叉污名，暴力，心理健康和艾滋病毒护理参与之间的途径在牙买加性和性别少数群体中，患有艾滋病毒； 2）开发和手动多层次解决交叉污名，暴力和心理健康状况不佳的干预措施，以优化艾滋病毒牙买加性和性别少数群体与艾滋病毒的性别互动； 3）试验测试多与艾滋病毒及其性别的性别少数群体之间的可接受性和可行性及其可接受性的级别干预医疗服务提供方。我们将计划全年对计划中的R01提交中的干预措施进行全面测试 5.摘要：最近宣布的DHHS及其可持续性结束了HIV流行病（ETHE）联合国艾滋病毒/艾滋病计划的发展目标3强调了对研究的紧迫需求解决SGM和其他关键人群之间的分布，以期在2030年停止全球感染。拟议的研究和培训活动将使我有能力进行创新的高影响力研究在低资源环境中，艾滋病毒居住的SGM中的SGM中的污名，暴力和心理健康改善艾滋病毒治疗的参与。