Syndemic Development and HIV Risk Among Vulnerable Young Men

弱势年轻男性的流行病发展和艾滋病毒风险

• 批准号: 8427344
• 负责人: Robert Garofalo
• 金额: $ 66.2万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8427344
• 关键词: 19 year old; AIDS prevention; AIDS/HIV problem; Accounting; Address; Adolescence; Adolescent; Affect; Age; Alcohol or Other Drugs use; Automobile Driving; Biological; Categories; Clinical; Computer Assisted; Cross-Sectional Studies; Data; Depression and Suicide; Development; Diagnosis; Drug usage; Early identification; Epidemic; Epidemiology; Exposure to; Face; Family; Gays; Goals; Growth; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV risk; Health; Illicit Drugs; Infection; Influentials; Intervention; Interview; Knowledge; Link; Male Adolescents; Markov Chains; Mental Health; Modeling; Natural History; Participant; Pilot Projects; Population; Prevalence; Prevalence Study; Preventive Intervention; Psychopathology; Readiness; Recruitment Activity; Relative Risks; Reporting; Research; Respondent; Risk; Risk Behaviors; Risk-Taking; Sampling; Sex Orientation; Statistical Models; Stress; Structure; Substance abuse problem; Suicide; System; Target Populations; Testing; Time; Vacuum; Violence; Vulnerable Populations; Youth; base; biopsychosocial; design; emerging adulthood; experience; health disparity; high risk; innovation; male; men; men who have sex with men; peer; prevent; psychosocial; public health priorities; racial/ethnic difference; sexual minority; theories; therapy development; young man; young woman

DESCRIPTION (provided by applicant): While the number of new HIV infections has been relatively stable since late 1990s, the face of the infection has changed. Half of all new infections now occur among youth and substantial disparities exist based on sexual orientation. Recent data from the National HIV/AIDS Reporting System indicate that male-to-male sexual contact accounts for 76-79% of HIV diagnoses among 16-19 year old males, although less is known about the actual prevalence of HIV and related health issues in this population. Disparities also exist in preparedness to prevent HIV among young men who have sex with men (YMSM), with no proven intervention for adolescents in this vulnerable group. The epidemic of HIV among YMSM does not exist in a vacuum. Instead, YMSM experience multiple psychosocial health disparities, including elevated rates of illicit drug use, exposure to violence, and mental health problems such as suicidality. Recent evidence indicates that these health issues represent intertwined epidemics that each contribute to HIV risk among YMSM, a situation referred to as a syndemic. Building on our own research with YMSM, as well as other high risk youth, we are proposing to investigate a syndemic of psychosocial health issues linked to HIV among YMSM ages 16-20. This syndemic includes HIV risk, drug use, internalizing mental health problems, and violence exposure. The overarching goals of this study are twofold: 1) to provide much-needed epidemiological data on the prevalence of HIV and related health issues in order to inform public health priorities; and 2) to collect vital information on risk and protective factors to inform the development of an intervention targeting this vulnerable population. We will accomplish these goals with three primary specific aims: (1) Ascertain the prevalence and clustering of a syndemic of biopsychosocial health problems among YMSM. We will: (a) Recruit a representative sample of 450 ethnically diverse YMSM using Respondent Driven Sampling (RDS); (b) Assess the syndemic components using state-of-the-art approaches; (c) Use the RDS model to calculate unbiased estimators of the prevalence of syndemic components; (d) Test for the clustering of syndemic components. (2) Characterize multiple trajectories of syndemic development by following our YMSM sample longitudinally over a two year period. We will: (a) Assess youth every 6 months during the transition from late adolescence to emerging adulthood, to explore the natural history of syndemic development. (b) Use growth-mixture modeling to characterize groups of youth with different trajectory classes of syndemic development in order to allow for early identification of youth most at risk of HIV acquisition. (3) Determine the importance of YMSM-specific factors in syndemic development so as to guide the development of culturally-relevant HIV prevention interventions for our target population. We will: (a) Test the value of YMSM-specific factors as predictors of trajectory class; (b) Test the incremental value of our theoretical syndemic model for predicting HIV-related sexual risk relative to the IMB model.

描述（由申请人提供）：虽然自1990年代后期以来，新的HIV感染的数量相对稳定，但感染的面孔已经改变。现在，所有新感染的一半现在都发生在青年中，并且基于性取向存在实质性差异。国家艾滋病毒/艾滋病报告系统的最新数据表明，男性到男性的性接触占16-19岁男性中艾滋病毒诊断的76-79％，尽管对该人群中的艾滋病毒和相关健康问题的实际患病率较少。在预防与男性发生性关系的年轻男性中，还没有对这个脆弱群体中的青少年进行的差异。 YMSM中HIV的流行不存在于真空中。取而代之的是，YMSM经历了多种社会心理健康差异，包括升高非法药物使用率，暴露暴露和心理健康问题，例如自杀性。最近的证据表明，这些健康问题代表了交织在一起的流行病，每种流行病都会导致YMSM中的艾滋病毒风险，这种情况被称为联合性。在我们与YMSM以及其他高风险青年的研究的基础上，我们建议调查与16-20岁YMSM YMSM有关的与HIV相关的社会心理健康问题的集团。该集团包括艾滋病毒风险，药物使用，内部精神健康问题和暴力暴露。这项研究的总体目标是双重的：1）提供有关艾滋病毒及相关健康问题患病率的急需的流行病学数据，以便为公共卫生的重点提供信息； 2）收集有关风险和保护因素的重要信息，以告知针对该脆弱人群的干预措施的发展。我们将以三个主要的特定目的来实现这些目标：（1）确定YMSM中生物心理健康问题集团的患病率和聚类。我们将：（a）使用受访者驱动的采样（RDS）募集450种种族不同YMSM的代表性样本； （b）使用最先进的方法评估联合成分； （c）使用RDS模型来计算联合成分患病率的无偏估计量； （d）测试联合成分的聚类。 （2）通过在两年内纵向遵循YMSM样品来表征多个辛迪克发育的轨迹。我们将：（a）从青春期晚期到新兴成年期的过渡期间每6个月评估年轻人，以探索联合发展的自然历史。 （b）使用生长混合建模来表征具有不同轨道发展轨迹类别的青年群体，以便早日鉴定最有可能获得HIV的青年。 （3）确定YMSM特异性因素在联合发展中的重要性，以指导对我们的目标人群的培养文化预防干预措施的发展。我们将：（a）测试YMSM特异性因素作为轨迹类别的预测因子的值； （b）测试我们的理论集团模型的增量值，以预测与IMB模型相对于IMB模型的性风险。

项目成果

Management of a Concealable Stigmatized Identity: A Qualitative Study of Concealment, Disclosure, and Role Flexing Among Young, Resilient Sexual and Gender Minority Individuals.

• DOI: 10.1080/00918369.2016.1236574
• 发表时间: 2017
• 期刊: Journal of homosexuality
• 影响因子: 2.6
• 作者: Bry LJ;Mustanski B;Garofalo R;Burns MN
• 通讯作者: Burns MN

The Role of Geographic and Network Factors in Racial Disparities in HIV Among Young Men Who have Sex with Men: An Egocentric Network Study.

• DOI: 10.1007/s10461-014-0955-0
• 发表时间: 2015-06
• 期刊: AIDS AND BEHAVIOR
• 影响因子: 4.4
• 作者: Mustanski, Brian;Birkett, Michelle;Kuhns, Lisa M.;Latkin, Carl A.;Muth, Stephen Q.
• 通讯作者: Muth, Stephen Q.

The MyPEEPS randomized controlled trial: a pilot of preliminary efficacy, feasibility, and acceptability of a group-level, HIV risk reduction intervention for young men who have sex with men.

• DOI: 10.1007/s10508-014-0347-6
• 发表时间: 2015-02
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Hidalgo MA;Kuhns LM;Hotton AL;Johnson AK;Mustanski B;Garofalo R
• 通讯作者: Garofalo R

Prevalence and patterns of smoking, alcohol use, and illicit drug use in young men who have sex with men.

• DOI: 10.1016/j.drugalcdep.2014.05.005
• 发表时间: 2014-08-01
• 期刊: DRUG AND ALCOHOL DEPENDENCE
• 影响因子: 4.2
• 作者: Newcomb, Michael E.;Ryan, Daniel T.;Greene, George J.;Garofalo, Robert;Mustanski, Brian
• 通讯作者: Mustanski, Brian

Impact of religiosity on the sexual risk behaviors of young men who have sex with men.

• DOI: 10.1080/00224499.2014.910290
• 发表时间: 2015
• 期刊: Journal of sex research
• 影响因子: 3.6
• 作者: Garofalo R;Kuhns LM;Hidalgo M;Gayles T;Kwon S;Muldoon AL;Mustanski B
• 通讯作者: Mustanski B