Examining Social Ecological and Network Factors to Assess Epidemiological Risk in a Large National Cohort of Cisgender Women

检查社会生态和网络因素以评估全国大型顺性别女性群体的流行病学风险

• 批准号: 10543645
• 负责人: Amy Kristen Johnson
• 金额: $ 298.4万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-18 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10543645
• 关键词: AIDS prevention; Advocate; Alcohol consumption; Algorithms; Anxiety; Behavior; Behavioral; Big Data; Biological Markers; Black race; Centers for Disease Control and Prevention (U.S.); Characteristics; Cohort Analysis; Community Networks; Contraceptive Agents; Crime; Data; Data Sources; Databases; Development; Diagnosis; Discrimination; Disease Surveillance; Domestic Violence; Eligibility Determination; Epidemiology; Ethnic Origin; Exposure to; Focus Groups; Frequencies; Funding; Gender; Geographic Locations; Geography; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; HIV risk; Heterosexuals; Hispanic; Homelessness; Incidence; Income; Individual; Individual Differences; Inequality; Intervention; Interview; Knowledge; Latinx; Literature; Longitudinal cohort study; Measures; Mediating; Mental Depression; Methods; Motivation; Neighborhoods; Participant; Pathway Analysis; Policies; Population; Poverty; Predictive Value; Prevalence; Prevention; Prevention approach; Prevention strategy; Principal Investigator; Public Health; Public Policy; Race; Research; Research Design; Risk; Risk Factors; Sampling; Science; Self Efficacy; Sexual Partners; Sexually Transmitted Diseases; Social Network; Technology; United States; United States National Institutes of Health; Woman; abortion; cis-female; cohort; digital; epidemiologic data; epidemiology study; ethnic diversity; experience; flexibility; health care availability; health care service; high risk; improved; infection rate; injection drug use; innovation; intimate partner violence; knowledgebase; male; men who have sex with men; multilevel analysis; open source; payment; peer; pre-exposure prophylaxis; racial diversity; recruit; response; seroconversion; sexual violence; social; social health determinants; social media; social stigma; substance use; surveillance data; transmission process; uptake; women of color

PROJECT SUMMARY While HIV prevention strategies have improved and HIV incidence rates continue to decrease in the United States (US), a critical need remains to strengthen and advance prevention science where declines appear to have stalled, particularly among cisgender women of color. The most recent surveillance data from the Centers for Disease Control and Prevention demonstrate that as of 2019, about 7,000 of all new HIV diagnoses were identified among cisgender women (hereafter simply referred to as “women”). Traditional demographic and behavioral risk factors are insufficient to identify women who are vulnerable to HIV infection. Recent research on the use of risk algorithms to determine pre-exposure prophylaxis (PrEP) eligibility demonstrated poor predictive power for women in contrast to good predictive value among men who have sex with men. Identifying women who are vulnerable to HIV infection is crucial for the development and deployment of tailored prevention approaches. While the mode of HIV acquisition for women is well known, with heterosexual contact (85%) identified as the most frequent mode of HIV transmission among women, followed by 15% due to injection drug use, less is known about the social-ecological factors (e.g., community, network, geospatial, and policy factors) associated with HIV seroconversion. Broadly, several factors beyond individual behavior have been associated with increased risk for HIV acquisition among women in the US such as gender inequality, income, exposure to domestic and sexual violence, homelessness, and sex partner’s characteristics. Nonetheless, identifying the combination of characteristics that predict seroconversion among women and establish them as candidates for PrEP has been challenging. To overcome this gap and in response to RFA-AI-21-058, we propose to harness innovative digital methods to establish a knowledgebase for women living in the US who are behaviorally vulnerable to HIV. The knowledgebase will consist of a national cohort of 1,800 women from whom we will collect HIV and sexually transmitted infections (STIs) incidence data and social and sexual network data, paired with open-source big data to contextualize HIV risk among women vulnerable to HIV infection. Our study team has extensive experience in using digital approaches to recruit study participants (through electronic methods and geospatial analytics). Capitalizing on our expertise, we will use the developed knowledgebase to identify theoretically-driven correlates of HIV seroconversion, STI incidence, and predictors of PrEP uptake. Findings will increase our understanding of women’s vulnerabilities to HIV infection, enhance identification of PrEP eligibility, and inform interventions to decrease the incidence of HIV and STIs among women living in the US.

项目概要 尽管美国的艾滋病毒预防策略有所改善，艾滋病毒发病率持续下降 各州（美国），仍然迫切需要加强和推进预防科学，因为预防科学的下降似乎是 中心的最新监测数据已经停滞不前，特别是在有色人种的顺性别女性中。 疾病控制和预防中心表明，截至 2019 年，所有新诊断的艾滋病毒患者中约有 7,000 例是通过 在顺性别女性（以下简称“女性”）中被识别为传统人口和性别。 行为风险因素不足以识别易受艾滋病毒感染的女性。 关于使用风险算法来确定暴露前预防 (PrEP) 资格的研究表明效果不佳 与男性发生性行为的男性的良好预测值相比，女性的预测能力更强。 识别易受艾滋病毒感染的女性对于制定和部署艾滋病毒预防措施至关重要 虽然女性感染艾滋病毒的方式是众所周知的，但异性恋者感染艾滋病毒的方式却是众所周知的。 接触（85%）被认为是女性中最常见的艾滋病毒传播方式，其次是由于接触（15%） 对于注射吸毒，人们对社会生态因素（例如社区、网络、地理空间、 与艾滋病毒血清转化相关的因素包括个人行为之外的几个因素。 与美国女性感染艾滋病毒的风险增加有关，例如性别 不平等、收入、遭受家庭暴力和性暴力、无家可归和性伴侣的 然而，确定预测血清转化的特征组合。 女性并让她们成为 PrEP 的候选人一直是一项挑战，并且在这方面。 响应 RFA-AI-21-058，我们建议利用创新的数字方法建立知识库 针对生活在行为上容易感染艾滋病毒的美国女性，该知识库将包括一个 我们将从全国 1,800 名女性中收集艾滋病毒和性传播感染 (STI) 数据 发病率数据以及社交和性网络数据，与开源大数据相结合，以了解艾滋病毒风险 我们的研究团队在使用数字技术方面拥有丰富的经验。 招募研究参与者的方法（通过电子方法和地理空间分析）。 我们的专业知识，我们将利用开发的知识库来识别艾滋病毒的理论驱动相关性 研究结果将增加我们对血清转化、STI 发病率和 PrEP 摄取的预测因素的了解。 女性易受艾滋病毒感染的脆弱性，加强对 PrEP 资格的识别，并为干预措施提供信息 降低美国女性艾滋病毒和性传播感染的发病率。