Young and Healthy Transwomen Study

年轻健康的跨性别女性研究

• 批准号: 9444319
• 负责人: Michele D. Kipke
• 金额: $ 10万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9444319
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affordable Care Act; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Assessment tool; Awareness; Behavior Therapy; Biological; Caring; Clinic; Cohort Studies; Color; Continuity of Patient Care; Data; Development; Diagnosis; Diffusion; Disease; Disease Progression; Disease-Free Survival; Drug Utilization; Drug usage; Ensure; Epidemic; Funding; Future; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Human immunodeficiency virus test; Illicit Drugs; Incidence; Infection; Insurance Coverage; Intervention; Intervention Studies; Latino; Los Angeles; Measures; Medical; Methods; Modeling; Monitor; National Institute of Drug Abuse; Participant; Patients; Population; Predisposition; Prevention; Prevention approach; Prevention strategy; Primary Health Care; Probability; Prophylactic treatment; Quality of life; Randomized; Recruitment Activity; Research; Research Design; Research Priority; Risk; Sampling; Services; Sexually Transmitted Diseases; Site; Specimen; Substance abuse problem; Testing; Time; United States National Institutes of Health; Viral; Viral Load result; Virus; Youth; antiretroviral therapy; black men who have sex with men; care seeking; clinical practice; cohort; design; experience; health care availability; health care service utilization; high risk; human leukocyte antigen testing; improved; member; men; men who have sex with men; microbicide; mobile computing; motivational enhancement therapy; prevent; prevention service; public health relevance; response; retention rate; sex; social media; theories; therapy design; transgender women; transmission process; treatment adherence; uptake; young man; young men who have sex with men

 DESCRIPTION: U01 - Cohort Study with Young Men of Color who have Sex with Men In this fourth decade of the HIV epidemic, we continue to see 50,000 new infections annually in the U.S., particularly among Black/African American and Latino young men who have sex with men (YMSM of color), who now account for 60% of new infections among Black/African American MSM and 45% of new infections among Latino MSM. Black/African American YMSM remain five times more likely to be HIV seropositive, seven times more likely to have an undiagnosed HIV infection, and 45% more likely to be diagnosed with an STI than other YMSM. YMSM of color are also the least likely to seek and remain in HIV/AIDS care, and when they do seek care, they typically already have advanced HIV disease. Among youth who initiate antiretroviral therapy (ART), 54% will achieve viral suppression; unfortunately 57% will not be retained in care and less than 6% will remain virally suppressed. Changing the course of this epidemic is going to require a dramatically different approach to prevention. We are therefore proposing to conduct longitudinal research with a large and diverse cohort of 450 YMSM of color in order to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Building on the HIV Continuum of Care and Prevention paradigm (i.e., seek, test, treat, and retain in care) and the Syndemic Theory of Risk, we will use a mixed-methods study design to collect and analytically triangulate quantitative, qualitative, and biological measures at baseline and every six months. Participants will be recruited from public venues, HIV test sites, and HIV/AIDS clinics using randomized probability and purposeful sampling designs. All participants will be tracked to ensure a retention rate of 90% or better, which is a feasible target given our retention rates of 94% in the Healthy Young Men's (HYM) Study. The specific aims are to 1) better understand and operationally define what linkage, engagement, retention to care (both primary health and HIV/AIDS treatment) and adherence means to HIV- and HIV+ YMSM of color; 2) characterize and monitor over time YMSM of color's use of alcohol and illicit drugs; utilization of HIV testing and prevention services; incidence of HIV and STIs; insurance status and access to health care services, including primary care and HIV/AIDS treatment services; engagement in and utilization of health care and HIV/AIDS treatment services; retention in HIV/AIDS care and adherence to ART; and utilization of biomedical interventions, such as PrEP and PEP; and 3) identify barriers/facilitator of engagement along the HIV Continuum of Care and Prevention. The proposed research builds on close to two decades of NIH-funded research by our team focused on this and other high-risk youth populations.

 描述：U01 - 针对与男性发生性行为的有色人种年轻男性的队列研究 在艾滋病毒流行的第四个十年中，我们在美国每年继续看到 50,000 例新感染病例，特别是在发生性行为的黑人/非裔美国人和拉丁裔年轻男性中男性（有色人种 YMSM）目前占黑人/非裔美国人 MSM 新感染病例的 60%，占拉丁裔 MSM 新感染病例的 45%。与其他有色 YMSM 相比，黑人/非裔美国人 YMSM 的 HIV 血清阳性可能性高出 5 倍，未确诊 HIV 感染的可能性高出 7 倍，被诊断出性传播感染的可能性高出 45%。寻求并继续接受艾滋病毒/艾滋病护理，不幸的是，在开始抗逆转录病毒治疗 (ART) 的青少年中，当他们寻求护理时，他们通常已经患有晚期艾滋病毒疾病。 57% 的患者将不会继续接受治疗，只有不到 6% 的患者将继续受到病毒抑制。因此，我们建议对大量不同人群进行纵向研究。 450 YMSM of color 旨在通过关注成功参与护理和预防范式（即寻求、检测、治疗和保留护理）和流行病风险理论，我们将使用混合方法研究设计来收集和分析基线的三角测量、定量定性和生物测量，每六个月从公共场所招募参与者。 HIV 检测点和 HIV/AIDS 诊所将采用随机概率和有目的的抽样设计来跟踪所有参与者，以确保 90% 或更高的保留率，考虑到我们健康年轻人的保留率为 94%，这是一个可行的目标。 (HYM) 研究的具体目标是 1) 更好地理解和操作性地定义 HIV-和 HIV+ YMSM 的特征是什么；长期监测有色人种使用酒精和非法药物的情况；艾滋病毒检测和预防服务的利用情况；艾滋病毒和性传播感染的保险状况和获得医疗保健服务的情况，包括初级保健和艾滋病毒/艾滋病治疗服务的参与；利用卫生保健和艾滋病毒/艾滋病治疗服务；保留艾滋病毒/艾滋病护理和坚持抗逆转录病毒治疗；以及利用生物医学干预措施，如 PrEP 和 PEP；以及 3) 确定艾滋病毒连续护理和预防过程中的障碍/促进因素。拟议的研究建立在美国国立卫生研究院资助的近二十年研究的基础上，该研究由我们的团队专注于这一群体和其他高危青年群体。