San Francisco-Rio de Janeiro collaborative research on HIV prevalence, risk, and biomedical prevention interventions among young men who have sex with men

旧金山-里约热内卢合作研究男男性行为青年中的艾滋病毒患病率、风险和生物医学预防干预措施

• 批准号: 10375409
• 负责人: BEATRIZ GRINSZTEJN
• 金额: $ 11.05万
• 依托单位: PUBLIC HEALTH FOUNDATION ENTERPRISES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-10 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10375409
• 关键词: AIDS prevention; Acute; Address; Adherence; Age; American; Biological Markers; Biomedical Research; Black race; Brazil; CD4 Lymphocyte Count; California; Caring; Cities; Clinical; Clinical Trials; Collaborations; Cross-Sectional Studies; Detection; Development; Diagnosis; Drops; Effectiveness; Epidemic; Ethics; Face; Foundations; Future; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; Health; Health Services; Incidence; Infection; Interruption; Intervention; Investigation; Investments; Joints; Knowledge; Link; Measures; Methods; Minor; Minority Men; Outcome; Parents; Participant; Patients; Persons; Phylogenetic Analysis; Policies; Population; Prevalence; Prevention Research; Prevention program; Provider; Public Health; RNA; Race; Reporting; Research; Research Personnel; Resources; Respondent; Risk; Risk Behaviors; Sampling; San Francisco; Scientist; Sexual Health; Sexually Transmitted Diseases; South America; Surveys; Technology; Testing; Translations; United States National Institutes of Health; Viral; Viral Load result; acute infection; base; black men who have sex with men; experience; improved; innovation; intervention program; low and middle-income countries; men who have sex with men; novel strategies; pilot test; population based; pre-exposure prophylaxis; prevent; preventive intervention; programs; racial disparity; rapid diagnosis; scale up; social media; success; transmission process; uptake; young man; young men who have sex with men

ABSTRACT As San Francisco’s HIV epidemic is set to reach zero infections, Rio de Janeiro is experiencing a resurgence in new reported HIV cases among MSM. San Francisco’s success can be attributed to effective biomedical interventions, namely: rapid diagnosis, immediate ART, sustained viral load suppression, wide uptake of PrEP, and interrupting new clusters of transmission. In Brazil, however, uptake of these biomedical interventions has so far been insufficient to reverse the epidemic, despite being the first low/middle income country to provide free ART to all persons with HIV, participation in clinical trials proving PrEP efficacy, and national policy to provide free PrEP. Meanwhile, young MSM, particularly Black/Afro-Brazilians, have high HIV incidence, low viral suppression, and poor PrEP adherence. We therefore propose collaborative research between the San Francisco Department of Public Health and the Oswaldo Cruz Foundation (Fiocruz) in Rio de Janeiro. We will focus on identifying the drivers of HIV infection, ways to address barriers to biomedical interventions, and identifying the hurdles to including young MSM in biomedical research. Methods include a cross-sectional survey of MSM age 18-24 using respondent-driven sampling adapted for social media-based sampling; development of a technology-based rapid ART and PrEP engagement and retention intervention; and a qualitative study of MSM age 15-17, their parents, and providers of sexual health services to better understand the onset of risk and the feasibility of increasing inclusion of minors in biomedical HIV research and intervention programs. San Francisco stands as an American test case for the elimination of HIV, yet remaining challenges exist in reaching young and minority MSM. Rio de Janeiro is an engine of HIV research in South America, yet faces challenges in reaping the benefit of proven biomedical interventions for MSM. The proposed US-Brazil research collaboration will provide mutual benefit in increasing the effectiveness of biomedical interventions to reverse the HIV epidemic among MSM in Brazil and address remaining disparities in the US.

抽象的 由于旧金山的艾滋病毒流行病将达到零感染，里约热内卢正在经历 MSM中新报告的HIV病例的复兴。旧金山的成功可能是 归因于有效的生物医学干预措施，即：快速诊断，直接技术， 持续的病毒负荷抑制，广泛吸收准备，并中断了新的簇 传播。然而，在巴西，到目前为止，这些生物医学干预措施已经 不足以扭转流行病，多皮是第一个提供的低/中等收入国家 给所有艾滋病毒的人免费艺术，参与临床试验证明准备效率以及 提供免费准备的国家政策。同时，年轻的MSM，尤其是黑人/非洲巴西人， 具有高HIV入射，病毒抑制较低和依从性差。因此，我们 旧金山公共卫生部与 里约热内卢的奥斯瓦尔多·克鲁兹基金会（Fiocruz）。我们将专注于确定 艾滋病毒感染，解决生物医学干预障碍的方法以及确定障碍 在生物医学研究中包括年轻的MSM。方法包括对 MSM年龄18-24使用响应驱动的抽样，适用于基于社交媒体的抽样； 开发基于技术的快速艺术和预备工作和保留 干涉;以及对15-17岁的MSM的定性研究，他们的父母和性提供者 卫生服务以更好地了解风险的发作和增加纳入的可行性 生物医学艾滋病毒研究和干预计划的未成年人。旧金山站在 消除艾滋病毒的美国测试案例，但仍存在挑战 和少数MSM。里约热内卢是南美的艾滋病毒研究引擎，但面对 在收获已验证的MSM生物医学干预措施的好处方面面临的挑战。提议 美国 - 巴西研究合作将为提高有效性提供共同利益 生物医学干预措施以扭转巴西MSM之间的HIV流行和地址 在美国剩余的分布。