Examining Modifiable Psychosocial Predictors of HIV Seroconversion in a Large Nationwide Cohort of High Risk Men

检查全国范围内大量高危男性中 HIV 血清转化的可修改心理社会预测因素

• 批准号: 9393474
• 负责人: JEFFREY T PARSONS
• 金额: $ 137.53万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-19 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9393474
• 关键词: AIDS prevention; Age; Alcohol or Other Drugs use; Anal Sex; Behavior; Biological; Bisexual; Child Sexual Abuse; Chlamydia; Chlamydia Infections; Cohort Studies; Color; Development; Discrimination; Distal; Enrollment; Environment; Epidemic; Epidemiology; Ethnic Origin; Future; Gays; Geographic Locations; Goals; Gonorrhea; HIV; HIV Infections; HIV Seropositivity; HIV risk; HIV/STD; Incidence; Income; Individual; Infection; Intervention; Lead; Link; Measures; Mental Depression; Minority; Modeling; Outcome; Patient Self-Report; Population; Predisposition; Prevalence; Prevention Research; Prevention program; Preventive Intervention; Procedures; Psyche structure; Puerto Rico; Race; Recruitment Activity; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Stress; Subgroup; Testing; Time; Validity and Reliability; Work; aged; base; behavior change; cohort; design; disparity reduction; experience; high risk; high risk men; high risk population; improved; interest; intimate partner violence; men; men who have sex with men; mobile application; next generation; predictive modeling; prospective; psychosocial; rectal; response; seroconversion; sexual minority; stressor; willingness

Project Summary Gay, bisexual and other men who have sex with men (GBMSM) remain a population in the U.S. for whom the burden of HIV is high and disproportionate, particularly among younger GBMSM and GBMSM of color, for whom HIV incidence continues to rise despite decades of HIV prevention research to curb the epidemic. However, even among these highest risk groups, risk for infection is not equivalent and the goal of this study is to better understand what factors differentiate levels of risk for HIV infection. Research to date suggests that this disproportionate burden is likely to be exacerbated by psychosocial disparities faced by this population in the form of syndemics and sexual minority stress. However, research on these factors has been limited by a focus on risk for HIV infection operationalized as risk behavior or cross-sectional prevalence of HIV, making actual vulnerability to infection and temporal associations difficult, if not impossible, to determine. We are submitting this application in response to RFA-AI-16-031 Limited Interaction Targeted Epidemiology (LITE) to Advance HIV Prevention (UG3/UH3). We propose to recruit and enroll a large and diverse cohort of approximately 8,000 GBMSM ages 16 and older in the U.S. and Puerto Rico who are at high risk for infection. We will utilize mobile sexual networking applications (“mobile apps”) to identify and enroll these men both to allow for rapid and efficient recruitment and because these apps rapidly increasing in popularity, with research demonstrating that men who use mobile apps are at higher levels of risk for HIV infection than GBMSM recruited through other means. Using this cohort, we will work to achieve three primary aims: (1) we will establish HIV prevalence as well as prevalence of rectal sexually transmitted infections (STIs; gonorrhea and chlamydia) at baseline and subsequently establish rates of HIV and rectal STI incidence among these men 12 months thereafter; (2) we will utilize baseline levels of syndemic, minority stress, and other relevant psychosocial risk factors to develop a model of those modifiable factors that contribute to increased risk for HIV seroconversion (i.e., incidence) as well as rectal STI infection; (3) we will utilize the model to target men in the highest quartile of risk for HIV seroconversion in the cohort and follow them every 6 months thereafter for an additional two years to examine the predictive utility in prospectively predicting HIV seroconversion as well as time to seroconversion. Developing a model of modifiable psychosocial risk factors for actual HIV seroconversion and subsequently testing its reliability and validity in a prospective design has high potential to improve the next generation of HIV prevention interventions aimed at reducing disparities for this population.

项目概要 同性恋、双性恋和其他男男性行为者 (GBMSM) 仍然是美国的一个群体。 艾滋病毒负担很高且不成比例，特别是在年轻的 GBMSM 和有色人种的 GBMSM 中， 尽管进行了数十年的艾滋病毒预防研究以遏制这种流行病，但艾滋病毒发病率仍在持续上升。 然而，即使在这些最高风险人群中，感染风险也并不相同，本研究的目标是 迄今为止的研究表明，哪些因素可以区分艾滋病毒感染的风险水平。 这一不成比例的负担可能会因该人群面临的社会心理差异而加剧。 然而，对这些因素的研究受到了限制。 重点关注艾滋病毒感染风险，并将其作为风险行为或艾滋病毒横断面流行率进行操作， 实际的感染脆弱性和时间关联很难（如果不是不可能的话）确定。 将此申请提交给 RFA-AI-16-031 有限互动目标流行病学 (LITE) 我们建议招募和招募大量多样化的人群。 美国和波多黎各大约有 8,000 名 16 岁及以上的 GBMSM，他们是感染的高风险。 我们将利用移动性网络应用程序（“移动应用程序”）来识别这些男人并将其注册到 允许快速有效的招聘，并且因为这些应用程序迅速流行，研究 证明使用移动应用程序的男性比 GBMSM 感染艾滋病毒的风险更高 通过其他方式招募，我们将努力实现三个主要目标：（1）我们将 确定艾滋病毒流行率以及直肠性传播感染（性传播感染、淋病和 衣原体）在基线，并随后确定这些男性的艾滋病毒和直肠性传播感染发病率12 几个月后；（2）我们将利用综合症、少数群体压力和其他相关的基线水平 社会心理风险因素，用于开发导致艾滋病毒风险增加的可改变因素模型 血清转化（即发病率）以及直肠性传播感染；（3）我们将利用该模型来针对男性 队列中 HIV 血清转化风险最高的四分之一，此后每 6 个月进行一次随访 另外两年的时间来检验前瞻性预测 HIV 血清转化的预测效用以及 开发实际艾滋病毒可改变的社会心理危险因素模型。 血清转化和后续测试其在前瞻性设计中的可靠性和有效性具有很大的潜力 改善下一代艾滋病毒预防干预措施，旨在减少这一人群的差异。