Jamaica CARES Project: Connecting HIV/AIDS Resources to Engage Jamaican Sexual and Gender Minorities

牙买加 CARES 项目：连接艾滋病毒/艾滋病资源以吸引牙买加性少数群体

• 批准号: 10577883
• 负责人: Orlando Omar Harris
• 金额: $ 19.93万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10577883
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Advocacy; Affect; Anti-Retroviral Agents; Anxiety; Appointment; Automobile Driving; Behavior Therapy; Caribbean region; Caring; Clinic; Clinical; Communities; Complex; Consult; Cross-Sectional Studies; Data; Development; Discrimination; Disparate; Disparity; Drops; Educational workshop; Eligibility Determination; Epidemic; Evaluation; Feedback; Focus Groups; General Population; Goals; Grant; HIV; HIV Infections; HIV/AIDS; Health; Health Personnel; Health behavior change; High Prevalence; Homo; Human Rights; Immunologics; Individual; Intervention; Intervention Trial; Interview; Jamaica; Jamaican; K-Series Research Career Programs; Knowledge; Laws; Manuals; Measurement; Measures; Medical; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Modeling; Nurses; Outcome; Participant; Pathway interactions; Patient Self-Report; Personal Satisfaction; Persons; Policies; Policy Maker; Population; Positioning Attribute; Prevalence; Prevention; Property; Provider; Psychologist; Psychology; Psychometrics; Randomized; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Resource-limited setting; Resources; Risk; Same-sex; Scientist; Services; Sex Behavior; Sexual Health; Sexual and Gender Minorities; Sexuality; Social Workers; Surveys; Sustainable Development; Symptoms; System; Target Populations; Testing; Theory of Change; Time; Training; Training Activity; Trauma; Treatment outcome; United Nations; United States; Violence; Viral; Viral Load result; acceptability and feasibility; care outcomes; clinical research site; cognitive interview; design; experience; feasibility testing; gender affirmation; global health; health disparity; implementation barriers; implementation facilitators; improved; indexing; innovation; insight; instrument; intersectionality; intervention mapping; longitudinal analysis; low and middle-income countries; male; marginalization; meetings; men who have sex with men; patient health information; perceived discrimination; pilot test; prevention service; programs; public health relevance; racism; randomized trial; skills; social health determinants; social stigma; social structure; sodomy; success; theories; therapy design; therapy development; transgender women; transphobia; treatment services

PROJECT SUMMARY/ABSTRACT Jamaica’s HIV/AIDS epidemic among sexual and gender minorities is the most severe in the Caribbean in terms of its breadth and consequences. HIV prevalence among men who have sex with men is estimated at 33% and 51% among transgender women, which is significantly higher than the 1.8% observe in the general population. Intersectional stigma (often related to intersecting identities) and violence are key drivers of poor mental health and HIV care engagement, leading to higher rates of depression, anxiety, and low viral suppression (21%). The goals of the proposed research are to 1) gain and understanding of the influences and mechanisms by which intersectional stigma and violence impact mental health and engagement in HIV care; and 2) refine our conceptual framework to aid in intervention development that assists sexual and gender minorities to engage in HIV care. Candidate: I am a nurse-scientist with a background in health behavior change theory and social determinants of health in the context of HIV. I am applying for a K23 Career Development Award to obtain training, mentorship, and research experience to become an expert and independent investigator in theory-based, behavioral intervention design to improve the health of sexual and gender minorities in the Caribbean and in other low-resource settings. Mentoring: I have put together an exceptional mentoring team with extensive experience in intersectional stigma measurement research, mental health, and HIV treatment and prevention in resource-limited settings like Jamaica. Drs. Sheri Weiser and Carol Dawson-Rose will serve as co-Primary mentors and bring complementary expertise in HIV treatment and prevention, trauma, conceptual model framework refinement, and development and implementation of behavioral interventions in resource-limited settings. My co-mentors, scientific advisor, and collaborator round out my team to bring specific content and methods expertise and are based both in the United States and Jamaica, including: Dr. Mallory Johnson (clinical psychologist, intervention design and evaluation; feasibility implementation, ART adherence); Dr. Tor Neilands (psychology, quantitative methods, design and analysis of longitudinal data); Dr. Sharlene Jarrett (clinical psychologist, mental health and HIV treatment in the Jamaican context); Carmen Logie (clinical social worker, intersectionality and mixed methods research); Dr. Jae Sevelius (clinical psychologist, intersectional stigma measurements, cognitive interviewing, and gender affirmation); Dr. Anita Stewart (psychologist, measurement adaptation and testing expert); and Dr. Mark Padilla (medical anthropologist, Caribbean sexualities researcher). Training: I propose to obtain training in acquiring foundational knowledge in measures of intersectional stigma (adaptation and testing), advanced quantitative training to collect and analysis skills, and to attain expertise in developing, piloting, and evaluating HIV behavioral interventions. Training will be achieved through mentoring meetings, coursework, workshops, mentored direct readings and primary research in Jamaica. Research: The goals of the proposed research are to 1) identify the pathways between intersectional stigma, violence, mental health and HIV care engagement among Jamaican sexual and gender minorities living with HIV; 2) develop and manualize a multi-level intervention that addresses intersectional stigma, violence, and poor mental health in order to optimize HIV care engagement among Jamaican sexual and gender minorities living with HIV; and 3) pilot test the multi- level intervention for acceptability and feasibility among sexual and gender minorities living with HIV and their healthcare provider. We will plan for a full-scale testing of the intervention in a planned R01 submission in year 5. Summary: The recently announced Ending the HIV Epidemic (EtHE) by the DHHS and under Sustainable Development Goal 3 of the United Nations Program on HIV/AIDS highlight the pressing need for research to address disparities among SGM and other key populations in the quest to halt HIV infections globally by 2030. The proposed research and training activities will position me to conduct innovative, high-impact research to address intersectional stigma, violence and mental health among SGM living with HIV in low-resource settings to improve HIV treatment engagement.

项目概要/摘要 牙买加的艾滋病毒/艾滋病在性少数群体中的流行是加勒比地区最严重的 男男性行为者中的艾滋病毒感染率估计为 跨性别女性中这一比例为 33% 和 51%，显着高于一般人群的 1.8% 人口的交叉耻辱（通常与交叉身份有关）和暴力是贫困的关键驱动因素。 心理健康和艾滋病毒护理参与度，导致抑郁、焦虑和低病毒感染率升高 拟议研究的目标是 1) 获得并了解影响和影响。 交叉污名和暴力影响心理健康和艾滋病毒护理参与的机制； 2）完善我们的概念框架，以帮助制定有助于性和性别的干预措施 候选人：我是一名具有健康行为背景的护士科学家。 艾滋病毒背景下的健康变化理论和社会决定因素 我正在申请 K23 职业。 发展奖获得培训、指导和研究经验，成为专家和 独立研究者，从事基于理论的行为干预设计，以改善性和健康 加勒比地区和其他资源匮乏地区的性别少数群体辅导：我整理了一份报告。 杰出的指导团队，在交叉耻辱测量研究、心理 牙买加等资源有限地区的健康、艾滋病毒治疗和预防。 卡罗尔·道森-罗斯 (Carol Dawson-Rose) 将担任联合小学导师，并带来艾滋病毒治疗和治疗方面的补充专业知识。 预防、创伤、概念模型框架细化以及开发和实施 我的共同导师、科学顾问和合作者围绕资源有限的环境进行行为干预。 我的团队将提供特定的内容和方法专业知识，并且总部设在美国和 牙买加，包括：Mallory Johnson 博士（临床心理学家，干预设计和评估；可行性 Tor Neilands 博士（心理学、定量方法、设计和分析） Sharlene Jarrett 博士（牙买加临床心理学家，心理健康和艾滋病毒纵向治疗） Carmen Logie（临床社会工作者，交叉性和混合方法研究）； （临床心理学家、交叉耻辱测量、认知访谈和性别肯定）； Anita Stewart（心理学家、测量适应和测试专家）和 Mark Padilla 博士（医学）； 培训：我建议获得拟人化培训以获取 交叉耻辱测量的基础知识（适应和测试），高级定量 培训收集和分析技能，并获得开发、试点和评估艾滋病毒的专业知识 培训将通过指导会议、课程、研讨会来实现。 指导牙买加的直接阅读和初步研究：拟议研究的目标是。 1) 确定交叉污名、暴力、心理健康和艾滋病毒护理参与之间的途径 牙买加性少数群体和性别少数群体中艾滋病毒感染者；2) 制定并管理多层次的 解决交叉污名、暴力和心理健康状况不佳的干预措施，以优化艾滋病毒 牙买加性少数群体和性别少数群体艾滋病毒感染者的护理参与度；3) 试点测试多方参与； 性少数群体和性别少数群体艾滋病毒感染者及其群体的可接受性和可行性水平干预 我们将计划在今年提交的 R01 报告中对干预措施进行全面测试。 5. 摘要：最近由 DHHS 和可持续发展项目宣布的结束艾滋病毒流行 (EtHE) 联合国艾滋病毒/艾滋病规划署的发展目标 3 强调迫切需要开展研究，以 解决 SGM 和其他关键人群之间的差异，力求到 2030 年在全球范围内遏制艾滋病毒感染。 拟议的研究和培训活动将使我能够进行创新的、高影响力的研究 解决资源匮乏地区 SGM 艾滋病毒感染者之间的交叉耻辱、暴力和心理健康问题 提高艾滋病毒治疗参与度。