Modeling perceptions of social location and decision-making to develop targeted messaging promoting HIV care engagement and ART adherence among women living with HIV in the South

对社会位置和决策的认知进行建模，以制定有针对性的信息，促进南方艾滋病毒感染妇女的艾滋病毒护理参与和抗逆转录病毒治疗依从性

• 批准号: 10325299
• 负责人: Courtney Ellis Caiola
• 金额: $ 21.8万
• 依托单位: EAST CAROLINA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10325299
• 关键词: Address; Adherence; Affect; Anti-Retroviral Agents; Bass; Caring; Chronic Disease; Collaborations; Communities; Computer software; Data; Decision Making; Development; Disease Progression; Epidemic; Face; Focus Groups; Funding; Future; Gender; Geographic Locations; Goals; HIV; Health; Individual; Intervention; Interview; Link; Location; Maps; Marketing; Meta-Analysis; Methodology; Methods; Modeling; North Carolina; Outcome; Patients; Population; Positioning Attribute; Prevention; Process; Public Health; Race; Reporting; Research; Research Priority; Risk; Rural; Self Management; Sexual Partners; Social Hierarchy; Social Perception; Subgroup; Survey Methodology; Surveys; United States; Variant; Viral; Voice; Woman; Women' s Health; Work; antiretroviral therapy; base; cis-female; contextual factors; efficacy testing; health management; improved; innovation; mathematical model; novel; preservation; prevent; resilience; social; social determinants; social health determinants; social stigma; sociodemographic group; three-dimensional modeling; transgender women; urban area; vector; viral transmission

PROJECT ABSTRACT/SUMMARY Women living with HIV (WLWH) in the South have the lowest rates of viral suppression among women in all regions in the United States (US). To date, HIV care engagement and antiretroviral (ART) adherence interventions aimed at decreasing viral suppression disparities for WLWH in the South are few in number and have failed to consider the women's diverse social locations. Social location, a key concept in intersectional frameworks, refers broadly to contextual factors and the position people occupy in a social hierarchy based on their intersecting identities and social determinants of health like gender-, race/ethnic-, and class inequities; geographic location; and HIV-related stigma. Guided by an intersectional framework, the overall objective of this application is to develop targeted HIV care engagement and ART adherence messaging for WLWH from diverse social locations in the South. Specifically, this project is to be implemented in rural and non-rural regions of North Carolina, one of the nine southern states that continues to drive the US epidemic and has a substantial percentage (46%) of people most impacted by HIV living outside large urban areas. The specific aims are to: 1) determine the social locations and decision-making processes for HIV care engagement and ART adherence as reported by WLWH in the South; 2) develop highly targeted messages to enhance engagement in HIV care and ART adherence for WLWH in the South; and 3) assess the comprehensibility, acceptability and personal relevance of the targeted HIV care engagement and ART adherence messaging. For the first aim, in-depth interviews (n=36) will be conducted with cis and transgender WLWH from diverse social locations in the South to inform the development of perceptual mapping surveys. For the second aim, perceptual mapping surveys will be administered to cis and transgender WLWH (n=108), analyzed, and used to create perceptual maps generated from multidimensional scaling software. Perceptual mapping and vector message modeling is a novel method that produces mathematical, three-dimensional models, resulting in the development of highly targeted messages. For the third aim, focus groups (n=30) will be conducted to assess the comprehensibility, acceptability, and personal relevance of the targeted messaging. The proposed research is innovative in its conceptual orientation to addressing the intersecting identities and social determinants of health for WLWH in the South and novel application of perceptual mapping and vector modeling method. The proposed research is significant because it is expected to provide highly targeted HIV care engagement and ART adherence messages aimed at decreasing viral suppression disparities for WLWH in the South.

项目摘要/总结 南方女性艾滋病毒感染者 (WLWH) 的病毒抑制率是所有女性中最低的 美国 (US) 的地区。迄今为止，艾滋病毒护理参与度和抗逆转录病毒 (ART) 依从性 旨在减少南方 WLWH 病毒抑制差异的干预措施数量很少，而且 没有考虑到妇女的不同社会地位。社会位置，交叉领域的一个关键概念 框架，广泛指的是背景因素和人们在基于社会等级的社会等级中所占据的位置 他们的交叉身份和健康的社会决定因素，如性别、种族/民族和阶级不平等； 地理位置；以及与艾滋病毒相关的耻辱。在交叉框架的指导下，总体目标 该应用程序旨在为 WLWH 制定有针对性的 HIV 护理参与和 ART 依从性信息 南方的不同社会地位。具体来说，该项目将在农村和非农村地区实施。 北卡罗来纳州地区是继续推动美国疫情蔓延的南方九个州之一， 受艾滋病毒影响最严重的人中有相当大比例（46%）生活在大城市地区以外。具体的 目标是： 1) 确定艾滋病毒护理参与的社会地点和决策过程，以及 南方 WLWH 报告的 ART 坚持情况； 2) 制定高度针对性的信息以增强 南方 WLWH 参与艾滋病毒护理和抗逆转录病毒治疗的依从性； 3）评估可理解性， 有针对性的艾滋病毒护理参与和抗逆转录病毒治疗依从性信息的可接受性和个人相关性。 对于第一个目标，将对来自不同群体的顺性别和跨性别 WLWH 进行深入访谈（n=36） 南方的社会地点，为感知测绘调查的发展提供信息。为了第二个目标， 感知映射调查将针对顺性别和跨性别 WLWH (n=108) 进行、分析和使用 创建由多维缩放软件生成的感知图。感知映射和矢量 消息建模是一种产生数学三维模型的新颖方法，从而产生 制定高度针对性的信息。对于第三个目标，将进行焦点小组（n = 30）来评估 目标信息的可理解性、可接受性和个人相关性。拟议的 研究在概念方向上具有创新性，旨在解决交叉的身份和社会问题 南方 WLWH 健康的决定因素以及感知映射和矢量的新颖应用 建模方法。拟议的研究意义重大，因为它有望提供高度针对性的艾滋病毒 旨在减少 WLWH 病毒抑制差异的护理参与和 ART 依从性信息 在南方。