Increasing engagement and improving HIV care outcomes via stigma reduction in an online social networking intervention among racially diverse young men who have sex with men and transgender women

通过在线社交网络干预减少男男性行为和跨性别女性的种族不同的年轻男性的耻辱感，提高参与度并改善艾滋病毒护理结果

• 批准号: 10372060
• 负责人: Jose Arturo Bauermeister
• 金额: $ 72.08万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-16 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10372060
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affect; Age; Anti-Retroviral Agents; Behavior; Behavior assessment; Behavioral; Biological Markers; Black race; Caring; Communities; Continuity of Patient Care; Data; Elements; Enrollment; Epidemic; Ethnic Origin; Face; Feedback; Gender; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; Human immunodeficiency virus test; Individual; Intervention; Latino; Length; Logistics; Measures; Mediating; Methods; Nature; Not Hispanic or Latino; Outcome; Outcome Measure; Participant; Patient Recruitments; Persons; Population; Race; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Sampling; Schedule; Sexual and Gender Minorities; Sexuality; Site; Social Environment; Social Network; Social support; Source; Structure; Technology; Testing; Time; United States; Viral; Viral Load result; Well in self; Work; Youth; arm; care outcomes; design; ethnic diversity; experience; improved; innovation; intersectionality; intervention effect; men who have sex with men; online intervention; online version; patient engagement; peer; primary outcome; racial diversity; randomized trial; recruit; research study; response; sexual minority; social; social networking website; social stigma; theories; transgender women; transgender women who have sex with men; transmission process; treatment arm; trial design; young men who have sex with men

ABSTRACT Multiple stigmas related to sexuality, race, and HIV infection negatively impact HIV testing, engagement in HIV care, and consistent viral suppression (VS) among young Black or Latino men who have sex with men and transgender women (YBLMT). At present, few interventions have addressed the effects of intersectional stigma among HIV-infected and uninfected populations. In response to RFA-MH-18-606, this study tests whether an online intervention tailored for intersectional stigma amelioration can elicit online social support, promote intervention engagement, and mitigate the impact of multiple stigmas on HIV-related outcomes. We will recruit and enroll 1,050 young (ages 15-29), racially and ethnically diverse men who have sex with men and transgender women affected by HIV across the United States. Using a HIV-status stratified randomized trial design, participants will be assigned into one of three conditions (information-only control, a researcher-driven social network intervention, or a peer-driven social network intervention). Behavioral assessments will occur at baseline, 3, 6, 9 and 12 months; biomarkers (viral load) are scheduled for baseline, 6 and 12 months. The primary outcome is stratified by HIV status and defined as successful engagement in care (consistent VS for HIV-positive participants and routine testing for HIV-negative participants). The specific aims are: 1) Test whether an online intervention that promotes user-generated content and engagement to address intersectional stigma is associated with improvements in the HIV prevention and care continuum (HIV testing, antiretroviral adherence, VS) as compared to an information-only control arm; 2) Explore whether user engagement, as measured by quantitative and qualitative paradata, mediates the intervention’s stigma- and HIV care-related outcomes; and, 3) Examine how changes in intersectional stigma and improvements across the HIV care continuum vary between the researcher-driven vs. peer-driven social network intervention conditions. Our research study is innovative given its focus on intersectional stigma as a key target of intervention, and its ability to assess how different kinds of online social network structures influence participants’ engagement over time, reduce experiences of intersectional stigma, and improve successful engagement in care. This research addresses a critical need to reduce the effects of multiple stigmas in a priority population using an intervention delivered through a highly appealing, widely-utilized technology. If effective, this form of stigma amelioration via online support can be broadly disseminated to reduce HIV transmission and improve care among YBLMT.

抽象的 与性、种族和艾滋病毒感染相关的多重耻辱对艾滋病毒检测和艾滋病毒参与产生负面影响 对与男性发生性关系的年轻黑人或拉丁裔男性进行护理和病毒持续抑制（VS） 目前，很少有干预措施能够解决交叉耻辱的影响。 为了回应 RFA-MH-18-606，本研究测试了 HIV 感染者和未感染者是否存在差异。 为改善交叉耻辱量身定制的在线干预可以引发在线社会支持，促进 干预参与，并减轻多重耻辱对艾滋病毒相关结果的影响。 并招募 1,050 名年轻（​​15-29 岁）、不同种族和族裔的男性，他们与男性发生性关系， 使用艾滋病毒状况分层随机试验对美国各地受艾滋病毒影响的跨性别女性进行研究。 设计中，参与者将被分配到三种条件之一（纯信息控制、研究人员驱动的控制） 社交网络干预，或同伴驱动的社交网络干预）将发生在 基线、3、6、9 和 12 个月；生物标志物（病毒载量）安排在基线、6 和 12 个月。 主要结局按 HIV 状况分层，并定义为成功参与护理（一致 VS HIV 阳性参与者和 HIV 阴性参与者的常规检测）具体目标是： 1) 检测。 是否可以通过在线干预来促进用户生成的内容和参与度来解决 交叉耻辱与艾滋病毒预防和护理连续体的改善有关（艾滋病毒检测、 与纯信息控制臂相比，抗逆转录病毒依从性，VS) 2) 探索用户是否 通过定量和定性参数衡量的参与度可以调节干预措施的污名和污名 3）检查交叉污名的变化和跨领域的改进 研究人员驱动与同伴驱动的社交网络干预之间的艾滋病毒护理连续性有所不同 我们的研究是创新的，因为它把交叉污名作为一个关键目标。 干预及其评估不同类型的在线社交网络结构如何影响的能力 随着时间的推移，参与者的参与度，减少交叉耻辱的经历，并提高成功率 这项研究解决了减少多重耻辱影响的迫切需要。 使用通过极具吸引力、广泛使用的技术进行干预的优先人群。 这种通过在线支持改善耻辱的形式是有效的，可以广泛传播，以减少艾滋病毒 传播并改善 YBLMT 之间的护理。

项目成果

Structural-Level Racial-, Sexual Orientation-, and HIV-Related Discrimination and Subsequent Criminal Justice Involvement Among Young, Black, Men Who Have Sex With Men in North Carolina.

北卡罗来纳州年轻黑人男男性行为者中结构性种族、性取向和艾滋病毒相关歧视以及随后的刑事司法介入。

• DOI: 10.1037/sah0000290
• 发表时间: 2023
• 期刊: Stigma and health
• 影响因子: 3
• 作者: Philbin,MorganM;Menza,TimothyW;Legrand,SaraH;Muessig,KathrynE;Hightow-Weidman,Lisa
• 通讯作者: Hightow-Weidman,Lisa

The influence of client-provider relationships on teenage women's subsequent use of contraception.

客户-提供者关系对少女随后使用避孕措施的影响。

• DOI: 10.2105/ajph.75.1.33
• 发表时间: 1985
• 期刊: American journal of public health
• 影响因子: 12.7
• 作者: Nathanson,CA;Becker,MH
• 通讯作者: Becker,MH

Sexual Empowerment Among Young Black Men Who Have Sex with Men.

• DOI: 10.1080/00224499.2020.1809614
• 发表时间: 2021-05
• 期刊: Journal of sex research
• 影响因子: 3.6
• 作者: Choi SK;Boynton MH;Ennett S;Muessig K;Bauermeister J;LeGrand S;Hightow-Weidman L
• 通讯作者: Hightow-Weidman L

A Scoping Review of HIV Pre-exposure Prophylaxis Stigma and Implications for Stigma-Reduction Interventions for Men and Transwomen Who Have Sex with Men.

• DOI: 10.1007/s10461-020-03135-2
• 发表时间: 2021-07
• 期刊: AIDS AND BEHAVIOR
• 影响因子: 4.4
• 作者: Rosengren-Hovee, A. Lina;Lelutiu-Weinberger, Corina;Woodhouse, E. Wilbur;Sandanapitchai, Priyadharshiny;Hightow-Weidman, Lisa B.
• 通讯作者: Hightow-Weidman, Lisa B.

A Multidimensional Model of Sexual Empowerment Among Young Black Men Who have Sex with Men: A Latent Profile Analysis.

• DOI: 10.1007/s10461-020-03031-9
• 发表时间: 2021-03
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Choi SK;Bauermeister J;Muessig K;Ennett S;Boynton MH;Hightow-Weidman L
• 通讯作者: Hightow-Weidman L