Enhanced COhort methods for HIV Research and Epidemiology (ENCORE) among transgender women in the United States

美国跨性别女性的艾滋病毒研究和流行病学增强队列方法 (ENCORE)

基本信息

批准号：
10537314
负责人：
Sari Reisner
金额：
$ 176.23万
依托单位：
JOHNS HOPKINS UNIVERSITY
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：
2022-08-09 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10537314
关键词：
AIDS prevention Address Adherence Age Alcohol abuse Area Attention Automobile Driving Black race Caring Cessation of life Cities Clinical Trials Communities Coupled Data Development Disease Drug usage Economics Enhancement Technology Enrollment Ensure Epidemic Epidemiology Ethnic Origin Event Formulation Future Gender HIV HIV Seronegativity HIV Seropositivity HIV risk Health Healthcare High Risk Woman Homicide Hybrids Imprisonment Incidence Individual Intervention Latinx Measures Mental Health Mental disorders Methods Modeling Monitor Overdose Participant Patient Self-Report Pattern Persons Policies Population Population Heterogeneity Populations at Risk Prevalence Prevention Prevention Research Prevention strategy Race Reporting Research Research Support Risk Risk Factors Role Sampling Selection Bias Sister Site Social isolation Suicide Technology Testing Time Unemployment United States Vulnerable Populations Work base cohort contextual factors demographics digital distrust effectiveness testing ethnic diversity evidence base experience follow-up health disparity literacy mathematical model men who have sex with men mortality multidisciplinary multilevel analysis national surveillance neglect new technology novel personalized approach pre-exposure prophylaxis preventive intervention psychosocial racial and ethnic recruit scale up sex social social disparities social structure substance use syndemic transgender women trend uptake violence victimization virtual

项目摘要

In the United States, transgender women (TW) are disproportionately impacted by HIV and are prioritized in the US national strategy to end the epidemic. Multiple individual, interpersonal, and structural vulnerabilities fuel the HIV epidemic among TW, as well as fuel syndemic conditions (co-occurring and reinforcing diseases or other health conditions, such as HIV, substance use, and mental health disorder, that are often a consequence of social inequity). National cohorts are critical to monitoring epidemic trends and how major events (e.g., epidemics, policy change, new biomedical interventions) impact HIV and other health conditions; this is particularly important for TW who are often excluded from national surveillance efforts. The objective of this proposal is to use a novel, hybrid “community hub”-supported digital cohort (“hub-supported digital cohort”) model to evaluate HIV incidence, risk factors, and syndemic conditions among TW in the US (N=3,000). In this model, on-the-ground community “hubs” will support enrollment and retention of a racially/ethnically and culturally diverse, nationwide digital cohort. We will refine optimal digital cohort methods while examining the impact of structural and psychosocial syndemic experiences on HIV incidence and parameterizing mathematical models to identify targets for future multi-level combination HIV prevention interventions. The specific aims are: 1) Determine the efficiency and acceptability of using a novel, hub-supported digital cohort model to enroll and retain a sample of racially/ethnically diverse TW for HIV research. 2) Estimate the prevalence and characterize patterns of syndemic experiences among TW. 3) Estimate HIV incidence in TW, followed every 6 months for at least 24 months to identify tailored approaches for combination, multi-disciplinary HIV prevention interventions. 3.1) Examine the effect of syndemic experiences and contextual structural factors on HIV incidence among TW in the US. 3.2) Characterize the PrEP continuum among TW and associations with HIV incidence over time, including uptake of newly emerging formulations, longitudinal patterns of HIV risk and adherence, and the role of syndemic classes and contextual factors in the PrEP continuum PrEP uptake, adherence, and retention. 4.) Develop dynamic models of multi-level combination HIV prevention interventions and scale-up among TW to simulate the impact of evaluated interventions on HIV incidence through 2030, corresponding to the National HIV strategy. There is a need to refine and evaluate hybrid digital cohort models with attention to mitigating selection bias and attrition of vulnerable populations – an area of research particularly important for an epidemic underscored by social and health disparities. Our explicit efforts to develop a hybrid cohort model center on equity to support research participation across diverse populations and provide representative and generalizable data. Study findings will provide critical epidemiologic parameters for future HIV prevention research, provide a platform for exploration of other research questions, and inform the development of evidence-based and acceptable HIV interventions to reduce HIV acquisition among transgender women in the US.

在美国，跨性别妇女（TW）受艾滋病毒的影响不成比例，在美国国家战略结束流行病。多个个人，人际关系和结构脆弱性促进 TW中的HIV流行以及燃料联合疾病（共同发生和增强疾病或其他健康状况，例如艾滋病毒，药物使用和心理健康障碍，通常是社会不平等）。国家队列对于监测流行趋势以及重大事件的方式至关重要（例如流行病，政策变化，新的生物医学干预措施）影响艾滋病毒和其他健康状况；这是对于经常被排除在国家监视工作之外的TW中，尤其重要。这个目的提案是使用一种新颖的混合“社区枢纽”支持的数字队列（“枢纽支持的数字同类”）在美国TW中评估HIV事件，危险因素和联合条件的模型（n = 3,000）。在这个模型，现场社区的“枢纽”将支持大致/种族的注册和保留文化多样的，国有化的数字队列。我们将在检查最佳数字队列方法时完善最佳数字队列方法结构和社会心理联合体验对艾滋病毒事件的影响和参数化数学识别未来多层组合艾滋病毒预防干预措施的目标。具体目的是： 1）确定使用新颖的，枢纽支持的数字队列模型的效率和可接受性来注册和保留艾滋病毒研究的种族/种族多样性的样本。 2）估计患病率和特征 TW之间的联合体验模式。 3）估计TW的艾滋病毒事件，每6个月随后一次至少24个月来确定量身定制的组合方法，多学科HIV预防干预措施。 3.1）检查联合体验经验和上下文结构因素对TW的艾滋病毒入射的影响在美国。 3.2）表征TW之间的准备连续性以及随着时间的推移与HIV事件的关联，包括新兴新兴公式的吸收，艾滋病毒风险和依从性的纵向模式以及角色预备量摄取，依从性和保留率中的联合阶级和上下文因素。 4.）开发多层次组合艾滋病毒预防干预措施的动态模型，并在TW至模拟评估干预措施对2030年的艾滋病毒事件的影响，与国家相对应艾滋病毒策略。有必要完善和评估混合数字队列模型，并注意减轻脆弱人群的选择偏见和属性 - 研究领域对流行病特别重要社会和健康差异强调。我们为开发混合队列模型中心的明确努力支持潜水员人群的研究参与并提供代表和可推广的公平参与数据。研究结果将为未来的HIV预防研究提供关键的流行病学参数，并提供探索其他研究问题的平台，并告知开发循证和可接受的艾滋病毒干预措施减少了美国跨性别妇女的艾滋病毒收购。