Violence and viral suppression among men living with HIV

男性艾滋病毒感染者的暴力和病毒抑制

• 批准号: 10304206
• 负责人: Rob B. Stephenson
• 金额: $ 69.77万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2025-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10304206
• 关键词: Address; Adherence; Affect; Alberta province; Alcohol consumption; Behavior; Biological Markers; Bisexual; Canada; Caring; Clinic; Clinical; Cohort Studies; Coupled; Cross-Sectional Studies; Data; Emotional; Epidemic; Female; Frequencies; Gays; HIV; HIV Seropositivity; HIV diagnosis; Heterosexuals; Hospitalization; Interruption; Intervention; Knowledge; Link; Measures; Mediating; Mediation; Meta-Analysis; Methodology; Methods; Monitor; Participant; Pathway interactions; Patient Self-Report; Patients; Phase; Prevalence; Recommendation; Reporting; Research; Research Activity; Research Design; Risk; Risk Behaviors; Role; Sample Size; Sampling; Severities; Sex Behavior; Shapes; Social support; United States; Victimization; Violence; Viral; Viral Load result; Virginia; Woman; Work; base; behavioral response; biological adaptation to stress; clinical care; clinically relevant; cohort; comparative; condoms; design; experience; gender behavior; health care availability; inattention; innovation; intimate partner violence; male; men; men who have sex with men; minority stress; minority stressor; perpetrators; population based; primary outcome; prospective; psychosocial; recruit; resilience; secondary outcome; sex; sexual violence; social stigma; substance use; synergism; violence victimization

PROJECT SUMMARY/ABSTRACT There is increasing evidence that men who have sex with men (MSM) experience dual epidemics of HIV and intimate partner violence (IPV), yet understanding of the synergies between these two epidemics is underdeveloped. Gay, bisexual and other men who have sex with men (GBMSM) continue to be the risk group most severely affected by HIV in the United States. In parallel, estimated prevalence for receipt of IPV among MSM range from 12% to 78%. Emergent evidences demonstrates associations between the experience of IPV among MSM and the risk of HIV acquisition or participation in risk behaviors that heighten the risk of HIV (i.e. substance use), but the relationship between the experience of IPV for MSM living with HIV and HIV clinical care is less understood. The overwhelming majority of evidence linking IPV and sub-optimal HIV care comes from studies of heterosexual women. A recent meta-analysis showed that women's experience of IPV was associated with 55% lower odds of self-reported adherence and 36% decreased odds of viral suppression. The four studies that have looked at associations between clinical care and IPV for men living with HIV have all been hampered by methodological limitations: cross-sectional study designs with clinic-based populations that limit the ability to draw conclusions as to how IPV affects engagement in HIV care for partnered men living with HIV. We propose an innovative 24-month cohort study of HIV-positive MSM, coupled with nested qualitative data, to identify the pathways and points of intervention between IPV and HIV care for US MSM. The proposed research activities include a prospective 24-month cohort of 300 HIV-positive partnered MSM (>18 years) recruited through a combination of online and venue-based recruitment methods in Atlanta, GA and Detroit, MI. The cohort study will employ a measure of IPV developed specifically to capture IPV as experienced by MSM, and will consider the experience of IPV (victimization, perpetration and bidirectional IPV), and severity and frequency of IPV as drivers of engagement in HIV care. Biomarkers of viral load and adherence to ARV will be collected from all participants. The overall aim of the proposed activities is to provide new knowledge of how victimization or perpetration of IPV shapes engagement in HIV care and is associated with the ability to achieve and maintain viral suppression.

项目摘要/摘要 越来越多的证据表明，与男性发生性关系的男人（MSM）经历了艾滋病毒和 亲密的伴侣暴力（IPV），但是对这两个流行病之间的协同作用的理解是 欠发达。同性恋，双性恋和其他与男性发生性关系的男人（GBMSM）继续成为风险群体 在美国受艾滋病毒的严重影响。同时，在接收IPV的估计患病率 MSM范围从12％到78％。紧急证据证明了IPV的经验之间的关联 在MSM中，艾滋病毒获取或参与风险行为的风险增加了艾滋病毒的风险（即 使用物质），但是IPV经验MSM患有艾滋病毒的经验与艾滋病毒临床之间的关系 关心不了解。将IPV和亚最佳HIV护理联系起来的绝大多数证据来了 来自异性妇女的研究。最近的一项荟萃​​分析表明，妇女对IPV的经验是 与自我报告的依从性和36％降低病毒抑制的几率相关的55％相关。这 四项研究了临床护理与IPV之间针对艾滋病毒男性的关联的研究都是 受方法上的局限性阻碍：基于诊所的人群的横断面研究设计 关于IPV如何影响艾滋病毒伴侣男性的艾滋病毒护理参与的能力。 我们建议对HIV阳性MSM进行创新的24个月队列研究，并加上嵌套的定性数据 为US MSM确定IPV和HIV护理之间的干预途径和干预点。拟议的研究 活动包括招募300个HIV阳性合作伙伴（> 18年）的前瞻性24个月队列 通过在佐治亚州亚特兰大和密歇根州底特律的在线和基于场地的招聘方法的结合。这 队列研究将采用专门为捕获MSM经历的IPV的量度，并 将考虑IPV（受害，犯罪和双向IPV）的经验，以及严重性和 IPV的频率是艾滋病毒护理中参与的驱动力。病毒载荷和遵守ARV的生物标志物将是 从所有参与者那里收集。拟议活动的总体目的是提供有关如何 IPV的受害或进行IPV造型在艾滋病毒护理中的参与，与实现的能力有关 并保持病毒抑制。