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 非裔美国人仅占总人口的 14%，但占所有新发艾滋病毒感染者的 44% 每年都会报告感染病例，对于患有这种疾病的黑人/非裔美国年轻人来说，情况尤其严重。 与男性发生性关系 (AAYMSM)，15-22 岁人群的血清阳性率为 19%，23-29 岁人群的血清阳性率为 26% AAYMSM。这些健康结果受到重要的社会和结构因素的影响，包括暴力。 以及受害、仇视同性恋、歧视、制度性种族主义以及经济和社会边缘化。 这些经历与非法药物使用、酗酒、性交易和性工作​​密切相关 为了应对这场危机，我们建议创建一个新的理论驱动的青年行为。 旨在建立 AAYMSM 克服这些健康障碍的能力的集中干预措施。 在这个修订后的 R34 应用程序中，我们建议进一步完善和试点测试一项名为“年轻人”的干预措施 成人身份指导 (YM-AIM) 改编自现有的 CDC 扩散有效行为干预， YM-AIM 是一种理论驱动的团体层面的干预措施，旨在帮助 AAYMSM 制定健康的愿景 通过在教育领域制定一系列短期和长期目标来规划他们的未来（或“可能的未来的自己”）， 我们建议通过增加一个项目来进一步加强和完善 YM-AIM。 青年指导/支持部分，称为青年发起指导（YIM），以积极的青年为对象。 发展框架：a) 建立社会资本以实现近期和长期目标，b) 建立社会资本 支持，c) 在网络中识别并吸引自然导师来解决结构性障碍，以及 d) 我们将把这两种模式整合到一个干预措施中。 然后，我们将努力进一步调整、调整和评估 Y2Prevent，将其作为一种干预措施。 减少 AAYMSM 中的非法药物使用和艾滋病毒/性传播感染风险。这项干预措施将强调：a) 生物医学艾滋病毒。 初级预防的预防策略，b) HIV/STI 检测和治疗转诊，c) 药物筛查和 治疗转介，以及 d) 积极的青少年发展和未来规划 我们将进行形成性研究。 为适应/定制提供信息，然后试行新干预措施以评估可行性， 可接受性，以及我们提出的积极青年发展和复原力理论的初步效果。 提供一个强大的创新框架来检查 AAYMSM 如何显着暴露于综合征 健康和社会差异与预防和治疗资源的参与有关。 干预旨在提高 AAYMSM 的适应能力、培养社交技能和资产，以帮助他们 认识并克服导致风险的个人、社会和结构性障碍，并采取和维护 保护行为，例如安全性行为、PrEP/PEP 使用、HIV/STI 检测和医疗保健利用。 研究结果将为 R01 应用程序的开发提供信息，该应用程序将提出更大规模、多城市的功效 在随后的 R01 应用程序中进行跟踪。