Modeling perceptions of social location and decision-making to develop targeted messaging promoting HIV care engagement and ART adherence among women living with HIV in the South

对社会位置和决策的认知进行建模，以制定有针对性的信息，促进南方艾滋病毒感染妇女的艾滋病毒护理参与和抗逆转录病毒治疗依从性

• 批准号: 10325299
• 负责人: Courtney Ellis Caiola
• 金额: $ 21.8万
• 依托单位: EAST CAROLINA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10325299
• 关键词: Address; Adherence; Affect; Anti-Retroviral Agents; Bass; Caring; Chronic Disease; Collaborations; Communities; Computer software; Data; Decision Making; Development; Disease Progression; Epidemic; Face; Focus Groups; Funding; Future; Gender; Geographic Locations; Goals; HIV; Health; Individual; Intervention; Interview; Link; Location; Maps; Marketing; Meta-Analysis; Methodology; Methods; Modeling; North Carolina; Outcome; Patients; Population; Positioning Attribute; Prevention; Process; Public Health; Race; Reporting; Research; Research Priority; Risk; Rural; Self Management; Sexual Partners; Social Hierarchy; Social Perception; Subgroup; Survey Methodology; Surveys; United States; Variant; Viral; Voice; Woman; Women' s Health; Work; antiretroviral therapy; base; cis-female; contextual factors; efficacy testing; health management; improved; innovation; mathematical model; novel; preservation; prevent; resilience; social; social determinants; social health determinants; social stigma; sociodemographic group; three-dimensional modeling; transgender women; urban area; vector; viral transmission

PROJECT ABSTRACT/SUMMARY Women living with HIV (WLWH) in the South have the lowest rates of viral suppression among women in all regions in the United States (US). To date, HIV care engagement and antiretroviral (ART) adherence interventions aimed at decreasing viral suppression disparities for WLWH in the South are few in number and have failed to consider the women's diverse social locations. Social location, a key concept in intersectional frameworks, refers broadly to contextual factors and the position people occupy in a social hierarchy based on their intersecting identities and social determinants of health like gender-, race/ethnic-, and class inequities; geographic location; and HIV-related stigma. Guided by an intersectional framework, the overall objective of this application is to develop targeted HIV care engagement and ART adherence messaging for WLWH from diverse social locations in the South. Specifically, this project is to be implemented in rural and non-rural regions of North Carolina, one of the nine southern states that continues to drive the US epidemic and has a substantial percentage (46%) of people most impacted by HIV living outside large urban areas. The specific aims are to: 1) determine the social locations and decision-making processes for HIV care engagement and ART adherence as reported by WLWH in the South; 2) develop highly targeted messages to enhance engagement in HIV care and ART adherence for WLWH in the South; and 3) assess the comprehensibility, acceptability and personal relevance of the targeted HIV care engagement and ART adherence messaging. For the first aim, in-depth interviews (n=36) will be conducted with cis and transgender WLWH from diverse social locations in the South to inform the development of perceptual mapping surveys. For the second aim, perceptual mapping surveys will be administered to cis and transgender WLWH (n=108), analyzed, and used to create perceptual maps generated from multidimensional scaling software. Perceptual mapping and vector message modeling is a novel method that produces mathematical, three-dimensional models, resulting in the development of highly targeted messages. For the third aim, focus groups (n=30) will be conducted to assess the comprehensibility, acceptability, and personal relevance of the targeted messaging. The proposed research is innovative in its conceptual orientation to addressing the intersecting identities and social determinants of health for WLWH in the South and novel application of perceptual mapping and vector modeling method. The proposed research is significant because it is expected to provide highly targeted HIV care engagement and ART adherence messages aimed at decreasing viral suppression disparities for WLWH in the South.

项目摘要/摘要 南方患艾滋病毒（WLWH）的妇女在所有人中，妇女的病毒抑制率最低 美国地区（美国）。迄今为止，HIV护理参与和抗逆转录病毒（ART）依从性 旨在减少南部WLWH病毒抑制差异的干预措施的数量很少，并且 未能考虑妇女多元化的社会地点。社会位置，交叉路口的关键概念 框架，广泛指的是上下文因素和人们在社会等级中占据的位置 他们相交的身份和健康的社会决定因素，例如性别，种族/种族和阶级不平等； 地理位置；和与HIV相关的污名。以相交框架为指导，是 该应用程序是为了开发有针对性的艾滋病毒护理参与和WLWH的艺术依从性消息传递 南部的各种社会地点。具体而言，该项目将在农村和非农村中实施 北卡罗来纳州的地区是九个南部州之一，该州继续推动美国流行病，并有一个 大部分（46％）受艾滋病毒影响最大的人居住在大型城市以外。具体 目的是：1）确定艾滋病毒护理参与的社会地点和决策过程 WLWH在南方报道的艺术依从性； 2）开发针对性的消息以增强 南部参与WLWH的艾滋病毒护理和艺术依从性； 3）评估可理解性， 有针对性的艾滋病毒护理参与和艺术依从性消息的可接受性和个人相关性。 为了第一个目标，将对不同的访谈（n = 36）与cis和跨性别WLWH进行。 南方的社会地点，以告知感知映射调查的发展。为了第二个目标 感知映射调查将对顺式和变性WLWH进行（n = 108），分析并使用 创建由多维缩放软件生成的感知图。感知映射和向量 消息建模是一种新的方法，可产生数学，三维模型，从而导致 开发高度针对性的消息。对于第三个目标，将进行焦点小组（n = 30）以评估 目标消息传递的可理解性，可接受性和个人相关性。提议 研究在概念取向方面具有创新性，以解决相交的身份和社会 南方WLWH健康的决定因素以及知觉映射和矢量的新颖应用 建模方法。拟议的研究很重要，因为它有望提供高度针对性的艾滋病毒 护理参与和艺术依从性信息旨在减少WLWH病毒抑制差异 在南部。