Violence and viral suppression among men living with HIV

男性艾滋病毒感染者的暴力和病毒抑制

基本信息

批准号：
10514622
负责人：
Erin M Kahle
金额：
$ 69.26万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-12-01 至 2025-10-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10514622
关键词：
Address Adherence Affect Alberta province Alcohol consumption Behavior Control Biological Markers Bisexual Canada Caring Clinic Clinical Cohort Studies Coupled Couples Cross-Sectional Studies Data Emotional Epidemic Female Frequencies Gays HIV HIV Seropositivity HIV diagnosis Heterosexuals Hospitalization Interruption Intervention Knowledge Link Measures Mediating Mediation Meta-Analysis Methodology Methods Monitor Participant Pathway interactions Patient Self-Report Patients Phase Prevalence Psychosocial Factor Recommendation Reporting Research Research Activity Research Design Risk Risk Behaviors Role Sample Size Sampling Severities Sex Behavior Sexual Partners Shapes Social support United States Victimization Violence Viral Viral Load result Virginia Woman Work access restrictions behavioral response biological adaptation to stress clinical care clinically relevant cohort comparative condoms design experience gender behavior health care availability inattention innovation intimate partner violence male men men who have sex with men minority stress minority stressor perpetrators population based primary outcome prospective recruit resilience secondary outcome sex sexual violence social stigma structural determinants substance use synergism violence victimization

项目摘要

PROJECT SUMMARY/ABSTRACT There is increasing evidence that men who have sex with men (MSM) experience dual epidemics of HIV and intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is underdeveloped. Gay, bisexual and other men who have sex with men (GBMSM) continue to be the risk group most severely affected by HIV in the United States. In parallel, estimated prevalence for receipt of IPV among MSM range from 12% to 78%. Emergent evidences demonstrates associations between the experience of IPV among MSM and the risk of HIV acquisition or participation in risk behaviors that heighten the risk of HIV (i.e. substance use), but the relationship between the experience of IPV for MSM living with HIV and HIV clinical care is less understood. The overwhelming majority of evidence linking IPV and sub-optimal HIV care comes from studies of heterosexual women. A recent meta-analysis showed that women's experience of IPV was associated with 55% lower odds of self-reported adherence and 36% decreased odds of viral suppression. The four studies that have looked at associations between clinical care and IPV for men living with HIV have all been hampered by methodological limitations: cross-sectional study designs with clinic-based populations that limit the ability to draw conclusions as to how IPV affects engagement in HIV care for partnered men living with HIV. We propose an innovative 24-month cohort study of HIV-positive MSM, coupled with nested qualitative data, to identify the pathways and points of intervention between IPV and HIV care for US MSM. The proposed research activities include a prospective 24-month cohort of 300 HIV-positive partnered MSM (>18 years) recruited through a combination of online and venue-based recruitment methods in Atlanta, GA and Detroit, MI. The cohort study will employ a measure of IPV developed specifically to capture IPV as experienced by MSM, and will consider the experience of IPV (victimization, perpetration and bidirectional IPV), and severity and frequency of IPV as drivers of engagement in HIV care. Biomarkers of viral load and adherence to ARV will be collected from all participants. The overall aim of the proposed activities is to provide new knowledge of how victimization or perpetration of IPV shapes engagement in HIV care and is associated with the ability to achieve and maintain viral suppression.

项目概要/摘要越来越多的证据表明，男男性行为者 (MSM) 经历了艾滋病毒和艾滋病毒的双重流行。亲密伴侣暴力 (IPV)，但对这两种流行病之间的协同作用的了解还不够不发达。同性恋、双性恋和其他男男性行为者 (GBMSM) 仍然是高危人群美国是受艾滋病毒影响最严重的国家。与此同时，估计接受 IPV 的流行率 MSM 范围从 12% 到 78%。新出现的证据表明 IPV 经历之间存在关联 MSM 之间的艾滋病毒感染风险或参与增加艾滋病毒风险的危险行为（即物质使用），但 HIV 感染 MSM 的 IPV 经历与 HIV 临床之间的关系护理较少被理解。绝大多数证据表明 IPV 与次优 HIV 护理存在关联来自对异性恋女性的研究。最近的一项荟萃分析表明，女性的 IPV 经历与自我报告的依从性降低 55% 的几率降低 55% 以及病毒抑制的几率降低 36% 相关。这四项研究探讨了男性艾滋病毒感染者的临床护理与 IPV 之间的关系受到方法学限制的阻碍：基于临床人群的横断面研究设计限制了能够就 IPV 如何影响艾滋病毒感染者伴侣参与艾滋病毒护理得出结论。我们提出一项针对 HIV 阳性 MSM 的创新性 24 个月队列研究，并结合嵌套定性数据，以确定美国 MSM 的 IPV 和 HIV 护理之间的干预途径和点。拟议的研究活动包括招募 300 名 HIV 阳性的 MSM（> 18 岁）进行为期 24 个月的前瞻性队列研究在佐治亚州亚特兰大和密歇根州底特律，通过在线和现场招聘相结合的方式。这队列研究将采用专门开发的 IPV 测量方法来捕获 MSM 所经历的 IPV，以及将考虑 IPV 的经历（受害、犯罪和双向 IPV）以及严重程度和 IPV 的频率作为参与艾滋病毒护理的驱动因素。病毒载量和抗逆转录病毒疗法依从性的生物标志物将从所有参与者收集。拟议活动的总体目标是提供关于如何 IPV 的受害或实施影响了艾滋病毒护理的参与度，并与实现这一目标的能力相关并维持病毒抑制。