Y2Prevent: Preventing Drug Use and HIV through Empowerment, Social Support and Mentorship

Y2Prevent：通过赋权、社会支持和指导预防吸毒和艾滋病毒

• 批准号: 9757740
• 负责人: Michele D. Kipke
• 金额: $ 25.6万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9757740
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adolescence; Adopted; Adoption; Adult; African American; Age; Aggressive behavior; Alcohol consumption; Alcohols; Anal Sex; Area; Behavior; Behavior Therapy; Buffers; Caring; Caucasians; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Consent; Data; Development; Diagnosis; Diffuse; Discrimination; Drug Addiction; Drug Screening; Drug usage; Early Intervention; Economics; Education; Exercise; Exposure to; Family; Feedback; Frequencies; Funding; Future; Generations; Goals; HIV; HIV Infections; HIV risk; Health; Hispanics; Home environment; Homophobia; Human immunodeficiency virus test; Illicit Drugs; Incidence; Individual; Intention; Intervention; Knowledge; Latino; Lead; Life; Literature; Low income; Maintenance; Manuals; Measures; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Minority; Modeling; NIH Program Announcements; National Institute of Drug Abuse; Neighborhoods; Outcome; Participant; Performance; Pharmacotherapy; Population; Prevention; Prevention strategy; Preventive Intervention; Primary Prevention; Protocols documentation; Reporting; Research; Resources; Risk; Risk Behaviors; Safe Sex; Schools; Self Efficacy; Seroprevalences; Sexual Partners; Sexually Transmitted Diseases; Social support; Stress; Structure; Testing; Tobacco; Unsafe Sex; Vision; Work; Workplace; Youth; alcohol misuse; base; condoms; drug abuse prevention; empowerment; evidence base; experience; health care service utilization; health disparity; high risk; illicit drug use; improved; infection risk; inner city; innovation; member; men; novel; operation; positive youth development; pre-exposure prophylaxis; programs; protective behavior; racial and ethnic; racial minority; racism; resilience; response; satisfaction; sex; sexual minority; sexual risk behavior; skills; social; social capital; social disparities; social exclusion; social skills; success; theories; therapy design; trend; violence exposure; violence victimization; young adult; young man; young men who have sex with men

ABSTRACT African Americans represent only 14% of the population, but account for 44% of all new HIV infections reported yearly. The situation is particularly grave for Black/African American young men who have sex with men (AAYMSM), with seroprevalence rates of 19% for ages 15-22 and 26% for ages 23-29 among AAYMSM. These health outcomes are influenced by important social and structural factors, including violence and victimization, homophobia, discrimination, institutional racism, and economic and social marginalization. These experiences are significantly associated with illicit drug use, alcohol misuse, transactional sex work, and HIV risk behaviors. In response to this crisis, we are proposing to create a new theoretically driven, youth- centered intervention designed to build the capacity of AAYMSM to overcome these barriers to health. With this revised R34 application, we propose to further refine and pilot test an intervention, called Young Men's Adult Identity Mentoring (YM-AIM). Adapted from an existing CDC Diffusing Effective Behavioral Intervention, YM-AIM is a theory-driven, group-level intervention designed to help AAYMSM develop a healthy vision for their future (or “possible future self”) by defining a set of short- and long-term goals in the areas of education, health, family and intimate relationships. We propose to further strengthen and refine YM-AIM by adding a youth mentoring/support component, called Youth Initiated Mentoring (YIM). YIM uses a positive youth development framework to: a) build social capital to achieve immediate and long-term goals, b) build social support, c) identify and engage natural mentors in one's networks to address structural barriers, and d) develop relationships with supportive adults. We will integrate these two models into a single intervention called Y2Prevent. We will then work to further adapt, tailor, and evaluate Y2Prevent as an intervention to reduce illicit drug use and HIV/STI risk among AAYMSM. This intervention will emphasize: a) biomedical HIV prevention strategies for primary prevention, b) HIV/STI testing and treatment referral, c) drug screening and treatment referral, and d) positive youth development and future planning. We will conduct formative research to inform the adaptation/tailoring followed by a piloting of the new intervention to assess the feasibility, acceptability, and the preliminary efficacy. Our proposed positive youth development and resilience theory provide a strong, innovative framework for examining how AAYMSM with significant exposure to syndemic health and social disparities respond to engagement with prevention and treatment resources. The proposed intervention is intended to promote resilience, build social skills and assets among AAYMSM to help them recognize and overcome individual, social and structural barriers leading to risk, and adopt and maintain protective behaviors, such as safer sex, PrEP/PEP use, HIV/STI testing and healthcare utilization. The findings will inform the development of an R01 application that will propose a larger-scale, multi-city efficacy trail in a subsequent R01 application.

摘要非裔美国人仅占人口的14％，但占所有新艾滋病毒的44％ 感染每年报告。对于拥有 与男性发生性行为（AAYMSM），15-22岁的血清阳性率为19％，在23-29岁之间的26％ aaymsm。这些健康结果受到重要的社会和结构性因素的影响，包括暴力 以及受害，恐惧症，歧视，制度种族主义以及经济和社会边缘化。 这些经历与非法吸毒，滥用酒精，交易性工作以及 艾滋病毒风险行为。为了应对这一危机，我们建议创建一种新的理论驱动力，青年 - 集中的干预措施旨在建立AAYMSM来克服这些健康障碍的能力。和 这项修订的R34应用程序，我们建议进一步完善和试点测试一种干预措施，称为年轻人 成人身份指导（YM-aim）。改编自现有的CDC区分有效行为干预， YM-aim是一种理论驱动的小组级干预措施，旨在帮助AAYMSM建立健康的愿景 他们的未来（或“可能的未来自我”）通过在教育领域定义一组短期和长期目标， 健康，家庭和亲密关系。我们建议通过添加一个 青年心理/支持组成部分，称为青年启动指导（YIM）。 Yim使用一个积极的青年 开发框架至：a）建立社会资本以实现即时和长期目标，b）建立社会 支持，c）在网络中识别并吸引自然导师以解决结构性障碍，d） 与支持成年人建立关系。我们将将这两个模型整合到单一干预措施中 称为y2privent。然后，我们将努力进一步适应，量身定制和评估y2ppivent作为干预措施 在AAYMSM中降低非法药物使用和HIV/STI风险。这种干预将强调：a）生物医学艾滋病毒 预防初级预防，b）HIV/STI测试和治疗转诊，c）药物筛查和 治疗推荐以及d）积极的青年发展和未来的计划。我们将进行格式研究 告知适应/裁缝，然后进行新干预措施进行试验以评估可行性， 可接受性和初步效率。我们提出的积极的青年发展和韧性理论 提供一个强大的创新框架，用于检查AAYMSM如何显着暴露于联合体 健康和社会差异对预防和治疗资源的参与产生了反应。提议 干预旨在促进弹性，在AAYMSM之间建立社交技能和资产来帮助他们 公认并克服个人，社会和结构性障碍，导致风险，并采用和维护 保护行为，例如安全性，PREP/PEP使用，HIV/STI测试和医疗保健利用。这 调查结果将为R01应用程序的开发提供信息，该应用程序将提出更大范围的多城市效率 在随后的R01申请中进行跟踪。