Neighborhoods, Networks, and the HIV Care Continuum among HIV-infected MSM in NYC

纽约市感染 HIV 的 MSM 的社区、网络和 HIV 护理连续体

• 批准号: 10534034
• 负责人: Hong Van Nhu Tieu
• 金额: $ 21.29万
• 依托单位: NEW YORK BLOOD CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534034
• 关键词: Americas; Anti-Retroviral Agents; Black race; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 testing; COVID-19 treatment; Caring; Continuity of Patient Care; Data; Enrollment; Epidemic; Funding; HIV; Health; Healthcare; Interview; Longitudinal Studies; Medical; Methods; Minority Groups; Morbidity - disease rate; National Institute of Mental Health; Neighborhoods; New York City; Outcome; Participant; Patients; Population; Provider; Research; Sampling; United States Dept. of Health and Human Services; Viral; Viral Load result; Work; base; black men who have sex with men; cohort; experience; follow-up; improved; medical appointment; medication compliance; men; men who have sex with men; mortality; pandemic disease; psychosocial; racism; social stigma; therapy adherence

Abstract Rapid HIV treatment and sustained viral suppression is one of the 4 strategies in the U.S. Department of Health and Human Services (HHS) plan to end the HIV epidemic in America. HIV disparities among Black men who have sex with men (BMSM) have been documented along all stages of the HIV care continuum, with BMSM having higher morbidity and mortality rate, less likely to engaged in HIV care and achieve viral suppression. While many factors influence engagement in HIV care, it is particularly important to understand psychosocial deterrents such as stigma and medical mistrust among BMSM, as this population often experience overlapping stigmas. Intersectional stigma, medical mistrust, and decreased likelihood of referral for HIV or COVID-19 testing and treatment have been shown to be associated with reduced engagement in care among minority populations and individuals living with HIV. Patient-provider relationship has been shown to negatively influence engagement in HIV care; however, this association is not well document among BMSM who are living with HIV especially in the context of a pandemic. The specific aims of the proposed research in this 1-year Diversity Supplement are to: Aim 1. Using the baseline and follow-up data from the CASI, determine the association between patient- provider interaction and perceived racism in healthcare and engagement in HIV care (medical appointment attendance, antiretroviral medical therapy adherence, and viral suppression) among BMSM; and examine the effect of the COVID-19 pandemic on BMSM’s ability to navigate the HIV care continuum. Aim 2. Conduct a qualitative sub-study involving in-depth interviews among 50 NNHIV participants who self-identify as Black using stratified random sampling based on viral load suppression to: (a) Characterize experiences of provider interaction and perceived racism in healthcare among BMSM; (b) Examine the ways in which patient-provider relationship influences navigation of the HIV care continuum, and how it has been impacted by the COVID-19 pandemic; (c) Characterize intersectional stigma associated with COVID-19 and HIV and how it impacts navigation of the HIV care continuum and overall health outcomes among Black MSM; (d) Identify strategies that participants believe should be implemented to improve patient- provider interaction, reduce racism in health care and help BMSM navigate the HIV care continuum. This work is a sub-study of the ongoing NIMH R01-funded longitudinal study called Neighborhoods, Networks and HIV Care (NNHIV) among BMSM living with HIV who reside in New York City. The findings of this study will help us elucidate the NNHIV quantitative data and advance our understanding of the ways in which the COVID-19 pandemic, patient-provider interaction and HIV and COVID-19 stigmas influence engagement in care and viral suppression among BMSM.

抽象的 快速艾滋病毒治疗和持续病毒抑制是美国卫生部的 4 项策略之一 卫生与公众服务部 (HHS) 计划结束美国黑人之间的艾滋病毒流行情况。 与男性发生性关系 (BMSM) 已在艾滋病毒护理连续体的各个阶段得到记录，其中 BMSM 的发病率和死亡率较高，不太可能参与艾滋病毒护理并实现病毒传播 虽然许多因素影响艾滋病毒护理的参与，但了解这一点尤为重要。 BMSM 中存在诸如耻辱和医疗不信任等心理社会威慑因素，因为该人群经常 经历重叠的耻辱、医疗不信任以及转诊的可能性降低。 HIV 或 COVID-19 检测和治疗已被证明与参与度降低有关 少数群体和艾滋病毒感染者之间的护理已得到证实。 然而，这种关联在 BMSM 中并没有得到充分记录。 艾滋病毒感染者，特别是在大流行背景下。拟议研究的具体目标是。 该为期 1 年的多样性补充旨在： 目标 1. 使用 CASI 的基线和后续数据， 确定患者与提供者的互动与医疗保健中感知到的种族主义之间的关联 参与艾滋病毒护理（就诊、抗逆转录病毒药物治疗依从性和病毒感染情况） BMSM 中的抑制）；并检查 COVID-19 大流行对 BMSM 导航能力的影响 目标 2. 对 50 名患者进行深入访谈的定性子研究。 使用基于病毒载量抑制的分层随机抽样自我认定为黑人的 NNHIV 参与者 (a) 描述 BMSM 中医疗保健提供者互动的经历和感知的种族主义； 检查患者与提供者关系如何影响艾滋病毒护理连续体的导航，以及 它如何受到 COVID-19 大流行的影响； (c) 描述与此相关的交叉耻辱特征； COVID-19 和 HIV 及其如何影响 HIV 护理连续体的导航和整体健康结果 (d) 确定参与者认为应该实施的策略，以改善患者的健康状况； 提供者互动，减少医疗保健中的种族主义，并帮助 BMSM 应对艾滋病毒护理连续性。 是正在进行的 NIMH R01 资助的名为“社区、网络和艾滋病毒”的纵向研究的子研究 居住在纽约市的艾滋病毒感染者 BMSM 的护理 (NNHIV) 这项研究的结果将为我们提供帮助。 阐明 NNHIV 定量数据并加深我们对 COVID-19 传播方式的理解 流行病、患者与提供者的互动以及 HIV 和 COVID-19 的耻辱影响了护理和病毒治疗的参与 BMSM 之间的抑制。

项目成果

Correlates of concordance between self-reported and lab-confirmed viral load among Black and Latine men who have sex with men (BLMSM) living with HIV in New York City.

纽约市感染艾滋病毒的黑人和拉丁裔男男性行为者 (BLMSM) 自我报告的病毒载量与实验室确认的病毒载量之间的一致性的相关性。

• 发表时间: 2024-05
• 影响因子: 1.7
• 作者: Greene, Emily;Walcott, Melonie;Guerra, Lauren;Tieu, Hong;Nandi, Vijay;Soler, Jorge;Diaz, Jose;Curriero, Frank;Latkin, Carl;Bosompem, Abena;Frye, Victoria;NNHIV Study Team
• 通讯作者: NNHIV Study Team