PrEP and substance use among sexual minority young adults

性少数年轻人的 PrEP 和药物使用

基本信息

批准号：
9902389
负责人：
Ryan J Watson
金额：
$ 19.04万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9902389
关键词：
AIDS prevention Accounting Address Affect African American Alcohol consumption Alcohol or Other Drugs use Alcohols Area Attention Bisexual Caring Characteristics Civil Rights Collaborations Color Communities Connecticut Continuity of Patient Care Data Data Collection Data Set Disclosure Drug usage Enrollment Epidemic Ethnic Origin Evidence based intervention Fibrinogen Foundations Future Geography Goals HIV HIV Infections HIV risk Health Heterosexuals Hispanics Human Rights Incidence Individual Infection Institution Intervention Interview Investigation Knowledge Latino Lesbian Gay Bisexual Transgender Queer Maps Marijuana Measures Mentorship Minority Modeling New England Outcome Participant Pattern Pharmaceutical Preparations Population Prevention Research Prevention program Prevention strategy Qualitative Methods Race Recording of previous events Reporting Request for Applications Research Research Personnel Risk Role Sample Size Sex Orientation Sexuality Societal Factors Stress Structure Surveys Time Training Universities Victimization Vulnerable Populations Work base career career development cohort contextual factors experience follow-up health disparity high risk sexual behavior male member misuse of prescription only drugs novel novel strategies pre-exposure prophylaxis prescription opioid misuse programs sexual identity sexual minority sexual role skill acquisition social factors substance use prevention symposium therapy development tool uptake young adult young men who have sex with men

项目摘要

This application requests support and training for a New/Early Stage Investigator in research independence to conduct HIV and substance use prevention research. The PI and mentorship team will explore sexual identity, sexual identity disclosure, and minority stress as it relates to pre-exposure prophylaxis (PrEP) linkage to care and substance use experiences among African American and Hispanic/Latino young men who have sex with men (AA/HL YMSM). Substance use compounds HIV risk and disrupts the PrEP care continuum. This proposal is focused on AA/HL YMSM because of the high incidence of HIV infection among these populations and disproportionately high rates of substance use. PrEP is a key approach to addressing the HIV epidemic, but uptake is unequal across populations at elevated risk for HIV. Furthermore, the PI has found that rates of substance use are increasing among sexual minority YMSM. Research has largely failed to consider the role of interpersonal, community, and societal factors that thwart PrEP uptake and exacerbate substance use among AA/HL YMSM. A robust training plan is proposed that includes three core areas for skill development: (1) HIV- related intervention development; (2) qualitative methods to gain in-depth understanding of perspectives and experiences of minorities with substance use; and (3) content expertise in HIV prevention, problem substance use, and minority stress. The plan involves a mentorship team of six HIV and substance use prevention scholars, individualized trainings, coursework, and professional conferences. Career goals include a subsequent R01 application and the creation of a sexuality-focused niche in HIV and substance use prevention. Career development will take place at the University of Connecticut in collaboration with leading institutions and centers in New England. Based on our preliminary work, we propose three studies that explore the role of sexual identity and disclosure in PrEP and substance use experiences across the PrEP care continuum. We will address three specific aims. Specific Aim 1: Informed by a minority stress model, evaluate PrEP uptake and substance use among YMSM in a national cohort. We will collect new national data (N = 3,000 18 to 29-year-old AA/HL YMSM) to evaluate how diverse interpersonal, community, and societal factors affect PrEP uptake and substance use. Specific Aim 2: Define the PrEP care continuum for YMSM with and without substance use (from Aim 1). We will do so via four biyearly follow-up surveys (N = 300) over 24 months from participants in areas of high HIV incidence. Specific Aim 3: Perform semi-structured interviews among YMSM for future sexuality-informed PrEP/SU interventions (N = 30). How multiple barriers are related to substance use and PrEP uptake will be explored. Additionally, using the ADAPT-ITT model and based on previous findings, the we will identify the modifiable characteristics among current interventions that can be applied to prevention programs targeting YMSM. This project has the potential to systematically address the lack of attention to sexuality in interventions that focus on high rates of HIV and substance use.

该申请要求为研究独立性的新/早期调查员提供支持和培训进行艾滋病毒和药物使用预防研究。 PI和指导团队将探索性身份，性别身份披露和与暴露前预防（PREP）联系的少数压力与与之发生性关系的非裔美国人和西班牙裔/拉丁裔年轻人之间的吸毒经验男人（AA/HL YMSM）。物质使用化合物艾滋病毒风险并破坏预备护理连续体。这由于这些人群中艾滋病毒感染的高发病率，提案的重点是AA/HL YMSM 并不成比例的物质使用率。准备是解决艾滋病毒流行的关键方法，但是，在艾滋病毒风险较高的人群中，吸收不平等。此外，PI发现性少数族裔YMSM中的药物使用正在增加。研究基本上未能考虑人际关系，社区和社会因素阻碍了吸收和加剧药物的使用 AA/HL YMSM。提出了一项强大的培训计划，其中包括三个用于技能发展的核心领域：（1）HIV- 相关干预发展；（2）对观点的深入了解和少数族裔使用药物的经历；（3）预防艾滋病毒的内容专业知识，问题物质使用和少数群体压力。该计划涉及由六名艾滋病毒和药物使用预防的指导团队学者，个性化培训，课程和专业会议。职业目标包括随后的R01应用以及在艾滋病毒和药物使用中以性为中心的利基市场的创建预防。职业发展将在康涅狄格大学与领先新英格兰的机构和中心。基于我们的初步工作，我们提出了三项探索的研究性认同和披露在准备护理中的准备和药物使用经验中的作用连续。我们将解决三个具体目标。特定目的1：由少数族裔压力模型告知，评估国家队列中YMSM中YMSM中的药物吸收和物质使用。我们将收集新的国家数据（n = 3,000 18至29岁的AA/HL YMSM）评估人际关系，社区和社会的多样性因素会影响准备吸收和使用物质。特定目的2：定义使用YMSM的准备执行连续性并且没有使用物质（来自AIM 1）。我们将通过24次双年度后续调查（n = 300）这样做来自艾滋病毒高发病率的参与者几个月。特定目标3：进行半结构化访谈在YMSM中，未来的性行为PREP/SU干预措施（n = 30）。多个障碍如何相关将探讨吸收物质的用途和准备吸收。此外，使用Adapt-Itt模型并基于以前的发现，我们将确定当前干预措施之间的可修改特征应用于针对YMSM的预防计划。该项目有可能系统地解决干预措施中缺乏对性行为的关注，这些干预措施集中在高度的艾滋病毒和吸毒率上。