Brothers building brothers by breaking barriers (B6): A resilience-focused intervention for young Black gay and bisexual men living with HIV

兄弟通过打破障碍建立兄弟（B6）：针对感染艾滋病毒的年轻黑人男同性恋和双性恋男子进行以复原力为重点的干预措施

• 批准号: 10544182
• 负责人: Sophia A. Hussen
• 金额: $ 23.46万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10544182
• 关键词: Address; Age; Area; Belief; Bisexual; Black race; Brothers; Buffers; Caring; Clinical; Collaborations; Communities; Consolidated Framework for Implementation Research; Continuity of Patient Care; Control Groups; County; Development; Discrimination; Disparity; Disparity population; Epidemic; Evaluation; Evidence based intervention; Face; Future; Gays; Geography; Goals; HIV; HIV disparities; HIV/AIDS; Home; Incidence; Individual; Institution; Intervention; Intervention Studies; Lead; Methods; Morbidity - disease rate; NIH Office of AIDS Research; Outcome; Perception; Persons; Positioning Attribute; Prevalence; Prevention Research; Process; Public Health; Race; Randomized; Randomized, Controlled Trials; Research; Research Methodology; Resources; Safety; Series; Sexuality; Site; Social Environment; Social Network; Structural Racism; Structure; Sum; Testing; Translating; United States National Institutes of Health; Viral; Waiting Lists; Work; Youth; acceptability and feasibility; barrier to care; behavior change; care outcomes; community based participatory research; community organizations; design; disparity reduction; effectiveness/implementation trial; efficacy trial; evidence base; homonegativity; improved; intervention effect; medication compliance; men; men who have sex with men; mortality; multidisciplinary; novel; online resource; pilot test; pilot trial; process improvement; promote resilience; psychosocial; racism; recruit; resilience; resilience factor; satisfaction; social; social capital; social stigma; telehealth; theories; therapy design; transmission process; videoconference; young man

PROJECT SUMMARY Young Black gay, bisexual and other men who have sex with men (YB-GBMSM) encounter multilevel barriers to engaging in HIV care, as a direct result of structural and interpersonal racism, homonegativity and HIV stigma. These barriers lead to HIV disparities in which YB-GBMSM have high HIV prevalence and incidence, but suboptimal rates of engagement across the HIV Care Continuum. Resilience at both the individual and community levels can buffer the deleterious effects of stigma and discrimination on HIV care engagement. We have previously developed a culturally-specific resilience-building intervention for YB-GBMSM living with HIV called Brothers Building Brothers by Breaking Barriers (B6). B6 specifically targets intersectional identity affirmation (an individual-level resilience factor) and social capital (a community-level resilience factor) as a strategy for improving engagement in HIV care. The objective of this R34 application is to adapt B6, originally developed as an in-person intervention, for telehealth delivery within the context of a community-based organization (CBO). The rationale for the project is that telehealth delivery and CBO partnership will remove barriers to participation and facilitate scalability and sustainability. Our study will be based in Atlanta, Georgia – an HIV epicenter. This study will pursue three specific aims: (1) to adapt B6 for telehealth delivery, in collaboration with YB-GBMSM, community advisors, and subject matter experts; (2) to conduct a pilot randomized controlled trial (RCT) to evaluate feasibility and acceptability of tele-B6 among YB-GBMSM living with HIV in Atlanta; and (3) to evaluate the process of implementing B6 within the context of our partner CBO. For the first aim, we will use the ADAPT-ITT framework to convert B6 from an in-person to a telehealth intervention (tele-B6). For the second aim, we will test tele-B6 with N=60 YB-GBMSM and examine feasibility and acceptability of the intervention. We will also explore intervention impacts on social capital, identity affirmation, and HIV care engagement. In the third aim, we will utilize the Consolidated Framework for Implementation Research to examine the process of implementing tele-B6 within the structure of our partner CBO. The proposed research is highly significant because of its potential to develop a culturally relevant, scalable intervention for YB-GBMSM, a group who continues to be heavily and disproportionately impacted by HIV.

项目摘要 年轻的黑色同性恋，双性恋和其他与男人发生性关系的男人（YB-GBMSM）遇到多层次障碍 进行艾滋病毒护理，这是结构性和人际种族主义，同性恋和艾滋病毒的直接结果 柱头。这些障碍导致HIV差异，YB-GBMSM患有较高的HIV患病率和事件， 但是在整个HIV护理连续体中的参与率次优率。个人的韧性和 社区层面可以缓解污名和歧视对艾滋病毒护理参与的有害影响。我们 以前曾针对患有艾滋病毒的YB-GBMSM开发了一种文化特定的弹性建设干预措施 打破障碍（B6）被称为兄弟兄弟兄弟。 B6专门针对交叉身份 感情（个人层面的弹性因素）和社会资本（社区质量的弹性因素） 改善参与艾滋病毒护理的策略。该R34应用程序的目的是适应B6，最初是 作为面对面干预开发的，用于基于社区的远程医疗交付 组织（CBO）。该项目的理由是远程医疗交付和CBO合作伙伴关系将消除 参与和设施可伸缩性和可持续性的障碍。我们的研究将位于佐治亚州亚特兰大 - 艾滋病毒震中。这项研究将追求三个具体目标：（1）适应B6进行远程医疗交付，在 与YB-GBMSM，社区顾问和主题专家合作； （2）进行飞行员 随机对照试验（RCT）评估YB-GBMSM Living中Tele-B6的可行性和可接受性 在亚特兰大有艾滋病毒； （3）在我们的合作伙伴CBO的背景下评估实施B6的过程。 为了第一个目标，我们将使用Adapt-ITT框架将B6从面对面转换为远程医疗 干预（Tele-B6）。对于第二个目标，我们将使用n = 60 yb-gbmsm测试tele-b6并检查可行性 和干预的可接受性。我们还将探索干预对社会资本，身份的影响 确认和艾滋病毒护理参与。在第三个目标中，我们将利用合并框架 实施研究以检查我们合作伙伴结构内实施Tele-B6的过程 CBO。拟议的研究非常重要，因为它具有发展具有文化相关性的潜力 YB-GBMSM的可扩展干预措施，该小组继续受到严重和不成比例的影响 艾滋病病毒。