PrEP and substance use among sexual minority young adults

性少数年轻人的 PrEP 和药物使用

基本信息

批准号：
9902389
负责人：
Ryan J Watson
金额：
$ 19.04万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9902389
关键词：
AIDS prevention Accounting Address Affect African American Alcohol consumption Alcohol or Other Drugs use Alcohols Area Attention Bisexual Caring Characteristics Civil Rights Collaborations Color Communities Connecticut Continuity of Patient Care Data Data Collection Data Set Disclosure Drug usage Enrollment Epidemic Ethnic Origin Evidence based intervention Fibrinogen Foundations Future Geography Goals HIV HIV Infections HIV risk Health Heterosexuals Hispanics Human Rights Incidence Individual Infection Institution Intervention Interview Investigation Knowledge Latino Lesbian Gay Bisexual Transgender Queer Maps Marijuana Measures Mentorship Minority Modeling New England Outcome Participant Pattern Pharmaceutical Preparations Population Prevention Research Prevention program Prevention strategy Qualitative Methods Race Recording of previous events Reporting Request for Applications Research Research Personnel Risk Role Sample Size Sex Orientation Sexuality Societal Factors Stress Structure Surveys Time Training Universities Victimization Vulnerable Populations Work base career career development cohort contextual factors experience follow-up health disparity high risk sexual behavior male member misuse of prescription only drugs novel novel strategies pre-exposure prophylaxis prescription opioid misuse programs sexual identity sexual minority sexual role skill acquisition social factors substance use prevention symposium therapy development tool uptake young adult young men who have sex with men

项目摘要

This application requests support and training for a New/Early Stage Investigator in research independence to conduct HIV and substance use prevention research. The PI and mentorship team will explore sexual identity, sexual identity disclosure, and minority stress as it relates to pre-exposure prophylaxis (PrEP) linkage to care and substance use experiences among African American and Hispanic/Latino young men who have sex with men (AA/HL YMSM). Substance use compounds HIV risk and disrupts the PrEP care continuum. This proposal is focused on AA/HL YMSM because of the high incidence of HIV infection among these populations and disproportionately high rates of substance use. PrEP is a key approach to addressing the HIV epidemic, but uptake is unequal across populations at elevated risk for HIV. Furthermore, the PI has found that rates of substance use are increasing among sexual minority YMSM. Research has largely failed to consider the role of interpersonal, community, and societal factors that thwart PrEP uptake and exacerbate substance use among AA/HL YMSM. A robust training plan is proposed that includes three core areas for skill development: (1) HIV- related intervention development; (2) qualitative methods to gain in-depth understanding of perspectives and experiences of minorities with substance use; and (3) content expertise in HIV prevention, problem substance use, and minority stress. The plan involves a mentorship team of six HIV and substance use prevention scholars, individualized trainings, coursework, and professional conferences. Career goals include a subsequent R01 application and the creation of a sexuality-focused niche in HIV and substance use prevention. Career development will take place at the University of Connecticut in collaboration with leading institutions and centers in New England. Based on our preliminary work, we propose three studies that explore the role of sexual identity and disclosure in PrEP and substance use experiences across the PrEP care continuum. We will address three specific aims. Specific Aim 1: Informed by a minority stress model, evaluate PrEP uptake and substance use among YMSM in a national cohort. We will collect new national data (N = 3,000 18 to 29-year-old AA/HL YMSM) to evaluate how diverse interpersonal, community, and societal factors affect PrEP uptake and substance use. Specific Aim 2: Define the PrEP care continuum for YMSM with and without substance use (from Aim 1). We will do so via four biyearly follow-up surveys (N = 300) over 24 months from participants in areas of high HIV incidence. Specific Aim 3: Perform semi-structured interviews among YMSM for future sexuality-informed PrEP/SU interventions (N = 30). How multiple barriers are related to substance use and PrEP uptake will be explored. Additionally, using the ADAPT-ITT model and based on previous findings, the we will identify the modifiable characteristics among current interventions that can be applied to prevention programs targeting YMSM. This project has the potential to systematically address the lack of attention to sexuality in interventions that focus on high rates of HIV and substance use.

该申请要求为新/早期研究人员提供独立研究方面的支持和培训，以便开展艾滋病毒和药物滥用预防研究。 PI 和导师团队将探索性别认同、性别身份披露和少数群体压力，因为这与暴露前预防 (PrEP) 与护理的联系有关与性行为的非裔美国人和西班牙裔/拉丁裔年轻男性的物质使用经历男性（AA/HL YMSM）。药物使用会增加 HIV 风险并扰乱 PrEP 护理的连续性。这该提案的重点是 AA/HL YMSM，因为这些人群中 HIV 感染率很高以及不成比例的高物质使用率。 PrEP 是应对艾滋病毒流行的关键方法，但艾滋病毒高危人群的吸收情况并不相同。此外，PI 还发现，性少数 YMSM 中的物质使用正在增加。研究在很大程度上没有考虑到阻碍 PrEP 吸收并加剧药物滥用的人际、社区和社会因素 AA/HL YMSM。提出了一项强有力的培训计划，其中包括技能发展的三个核心领域：(1) HIV- 相关干预措施的发展； (2) 定性方法，深入了解观点和观点少数群体使用药物的经历； (3) 艾滋病毒预防、问题实质内容的专业知识使用和少数压力。该计划包括一个由六名艾滋病毒和药物使用预防组成的指导小组学者、个性化培训、课程作业和专业会议。职业目标包括随后的 R01 应用以及在艾滋病毒和药物滥用领域创建以性为中心的利基市场预防。职业发展将在康涅狄格大学与领先的机构合作进行新英格兰的机构和中心。基于我们的前期工作，我们提出了三项研究来探索性别认同和披露在 PrEP 中的作用以及整个 PrEP 护理中的物质使用经历连续体。我们将实现三个具体目标。具体目标 1：根据少数压力模型，评估全国队列中 YMSM 的 PrEP 摄取和物质使用情况。我们将收集新的国家数据（N = 3,000 名 18 至 29 岁 AA/HL YMSM）评估人际、社区和社会的多样性影响 PrEP 摄取和物质使用的因素。具体目标 2：定义 YMSM 的 PrEP 护理连续体并且不使用任何物质（来自目标 1）。我们将通过 24 年以上的四次两年期跟踪调查 (N = 300) 来做到这一点艾滋病毒高发地区参与者的月数。具体目标 3：进行半结构化访谈 YMSM 中未来性知情的 PrEP/SU 干预措施 (N = 30)。多个障碍如何相关将探讨物质使用和 PrEP 吸收的影响。此外，使用 ADAPT-ITT 模型并基于之前的发现，我们将确定当前干预措施中可修改的特征，这些特征可以应用于针对 YMSM 的预防计划。该项目有潜力系统地解决在针对艾滋病毒高发率和药物滥用的干预措施中缺乏对性的关注。