Assessing the Influence of State-Level Confidentiality-Relevant HIV Laws on U.S. Adolescents' HIV Testing Practices

评估州级保密相关艾滋病毒法律对美国青少年艾滋病毒检测实践的影响

• 批准号: 10323792
• 负责人: Christina Maria Aivadyan
• 金额: $ 4.19万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10323792
• 关键词: AIDS prevention; AIDS/HIV problem; Active Learning; Address; Adolescent; Adolescent HIV risk; Adolescent Risk Behavior; Adolescent and Young Adult; Affect; Age; Area; Awareness; Caring; Centers for Disease Control and Prevention (U.S.); Climate; Collection; Communication; Communities; Consent; Continuity of Patient Care; Criminal Law; Data; Data Analyses; Data Collection; Development; Disclosure; Drug usage; Early Diagnosis; Early treatment; Foundations; Future; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Health Benefit; Health Insurance; Health Personnel; Health Promotion; Health Services; Human immunodeficiency virus test; Incidence; Individual; Individual National Research Service Award; Infection; Injecting drug user; Intervention; Interview; Investigation; Laws; Legal; Link; Mentorship; Minor; National Institute of Mental Health; Needle Sharing; Outcome; Parents; Patient Self-Report; Perception; Policies; Population; Prevention Research; Prevention strategy; Preventive care; Provider; Public Health; Research; Research Personnel; Research Priority; Research Training; Risk; Sexual Health; Shapes; Statutes and Laws; Structure; System; Testing; Time; Training; United States; United States National Institutes of Health; Variant; Writing; Youth; adolescent HIV prevention; adolescent health outcomes; age group; aged; barrier to care; base; career; health care settings; improved; knowledge base; patient screening; population based; pre-doctoral; pre-exposure prophylaxis; prevent; public health priorities; secondary analysis; sex; skills; training opportunity; transgender; transmission process; uptake; young men who have sex with men

PROJECT SUMMARY/ABSTRACT The purpose of this Ruth L. Kirschstein Predoctoral Individual National Research Service Award (F31) is to provide essential research and training opportunities to lay the foundation for a successful career as an independent investigator who conducts community-engaged, policy-relevant HIV prevention research among youth. Compared to all other age groups, U.S. adolescents are the least likely to be aware of their HIV infection and linked to care in a timely manner. Increasing HIV testing is essential to improving adolescents’ health outcomes at every step of the HIV care continuum. For young key populations at disproportionate risk for HIV, including young men who have sex with men (YMSM), transgender youth (TGY), and young people who inject drugs (YPWID), regular HIV testing is especially critical. Prior research has largely focused on individual-level factors associated with HIV testing among adolescents, leaving a gap in the knowledge base about structural- level factors which may affect their access to and uptake of HIV testing. Confidentiality concerns are a major barrier to health care for adolescents, suggesting that laws related to confidentiality may have an influence on their testing practices. Confidentiality-relevant HIV laws vary on the state-level, with wide variation in legislation that allows minors to consent to HIV testing, requires minors to be a specific age to waive parental/guardian consent, allows providers to notify parents/guardians of minors’ HIV testing, protects the confidentiality of minors insured as dependents, and requires individuals who test positive for HIV to inform their sexual and/or needle- sharing partners. To achieve widespread access to testing and linkage to care – a key area of focus of the National HIV/AIDS Strategy – it is important to identify structural-level factors (e.g., state laws) that can be modified to mitigate HIV risk for adolescents on a population level. However, there is a paucity of research on the relationship between confidentiality-relevant HIV laws and adolescents’ HIV testing practices. The goal of the proposed research is to address this gap by examining the influence of state legal climate – confidentiality- relevant HIV laws in the aggregate – on U.S. adolescents’ HIV testing practices. This goal will be achieved through the following aims: (1) examine the influence of state legal climate on HIV testing for U.S. adolescents using state-level data from the 2019 Youth Risk Behavior Surveillance System, (2) evaluate whether state legal climate has a differential impact on HIV testing practices for YMSM, TGY, and YPWID, and (3) obtain rich qualitative data exploring adolescent perceptions of how confidentiality-relevant HIV laws affect their HIV testing practices. Through a combination of intensive mentorship, coursework, experiential learning through the proposed research, and professional development activities, this F31 will provide rigorous training in (1) advanced quantitative approaches to analyze and interpret population-based data, (2) the collection and analysis of qualitative data, and (3) empirical writing and academic communication skills and will facilitate transition to research independence.

项目概要/摘要 Ruth L. Kirschstein 博士前个人国家研究服务奖 (F31) 的目的是 提供必要的研究和培训机会，为成功的职业生涯奠定基础 独立调查员，在社区中开展与政策相关的艾滋病毒预防研究 与所有其他年龄组相比，美国青少年最不可能意识到自己感染艾滋病毒。 并与及时的护理联系起来，对于改善青少年的健康至关重要。 艾滋病毒护理连续过程中每一步的结果。 对于感染艾滋病毒风险较高的年轻重点人群， 包括男男性行为者 (YMSM)、变性青年 (TGY) 和注射青少年 (YPWID) 药物，定期艾滋病毒检测尤其重要，之前的研究主要集中在个人层面。 与青少年艾滋病毒检测相关的因素，在结构性知识库中留下了空白 可能影响他们获得和接受艾滋病毒检测的水平因素 保密问题是一个主要问题。 青少年医疗保健的障碍，表明与保密相关的法律可能会影响 各州与保密相关的艾滋病毒法律各不相同，立法差异很大。 允许未成年人同意接受艾滋病毒检测，要求未成年人达到特定年龄才能放弃父母/监护人的监护 同意，允许提供者通知父母/监护人未成年人的艾滋病毒检测，保护未成年人的机密 作为家属受保，并要求艾滋病毒检测呈阳性的个人告知其性行为和/或针头情况 共享合作伙伴。实现广泛的检测和护理联系——这是该组织关注的一个关键领域。 国家艾滋病毒/艾滋病战略——重要的是要确定结构层面的因素（例如州法律），这些因素可以 进行修改以降低人群水平上青少年的艾滋病毒风险。然而，这方面的研究很少。 与保密有关的艾滋病毒法律与青少年艾滋病毒检测实践之间的关系。 拟议的研究旨在通过审查国家法律环境（保密性）的影响来解决这一差距 关于美国青少年艾滋病毒检测实践的相关艾滋病毒法律总体而言将实现这一目标。 通过以下目标：（1）研究州法律环境对美国青少年艾滋病毒检测的影响 使用2019年青少年危险行为监测系统的州级数据，（2）评估州是否合法 气候对 YMSM、TGY 和 YPWID 的 HIV 检测实践有不同的影响，并且 (3) 获得丰富 定性数据探讨青少年对保密相关艾滋病毒法律如何影响其艾滋病毒检测的看法 通过密集指导、课程作业和体验式学习的结合。 拟议的研究和专业发展活动，这架 F31 将在 (1) 方面提供严格的培训 先进的定量方法来分析和解释基于人群的数据，（2）收集和分析 定性数据，以及（3）实证写作和学术沟通技巧，并将促进向 独立研究。