Addressing Economic Marginalization to Improve HIV Prevention and Care Outcomes Among Gender Minorities in the United States

解决经济边缘化问题，改善美国性别少数群体的艾滋病毒预防和护理成果

• 批准号: 10619614
• 负责人: Emily Allen Paine
• 金额: $ 18.12万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619614
• 关键词: AIDS prevention; Address; Area; Behavior Therapy; Black race; COVID-19; Caring; Communities; Data; Data Analyses; Development; Disadvantaged; Economic Factors; Economics; Education; Educational workshop; Employment; Epidemic; Exposure to; Face; Gender; General Population; Generations; Goals; HIV; HIV Seronegativity; HIV risk; HIV/AIDS; Health; Health Priorities; Homelessness; Housing; Human immunodeficiency virus test; Income; Individual; Inequality; Inequity; Infrastructure; Intervention; Interview; K-Series Research Career Programs; Knowledge; Medical; Mentorship; Methods; Minority Groups; National Institute of Mental Health; New York; New York City; Outcome; Pathway interactions; Personal Satisfaction; Persons; Pilot Projects; Population; Poverty; Prevalence; Process; Protocols documentation; Race; Research; Research Design; Research Personnel; Research Priority; Resources; Risk; Risk Behaviors; San Francisco; Science; Scientific Advances and Accomplishments; Self Efficacy; Sexual and Gender Minorities; Shapes; Shoulder; Social Behavior; Stigmatization; Surveys; Target Populations; Testing; Training; Training Support; Unemployment; United States; United States National Institutes of Health; Universities; Viral; Vocation; Waiting Lists; Work; acceptability and feasibility; care outcomes; care systems; career; community based participatory research; community engagement; coronavirus disease; data integration; design; economic disparity; effective intervention; empowerment; experience; financial literacy; food insecurity; gender minority; gender minority group; hands on research; health disparity populations; high risk; high risk sexual behavior; improved; innovation; intervention refinement; marginalization; member; men; nonbinary; novel; pilot test; prevention service; secondary analysis; sex; sexual relationship; skills; social; social disparities; social factors; social structure; structural determinants; theories; transgender; transgender women; urban area

7. PROJECT ABSTRACT The purpose of this career development award is to provide the candidate with the training necessary to become an independent investigator 1) advancing scientific knowledge about how social and economic factors are shaping HIV risk and outcomes among marginalized, priority health disparity populations, and 2) designing effective interventions that reduce HIV prevalence and improve health and well-being within sexual and gender minority populations. Research Aims Transgender and nonbinary people experience significant economic hardships and disproportionately shoulder the burden of the HIV/AIDS epidemic in the United States. Guided by an integrated asset theory and social ecological framework, and using a multistage mixed methods approach, the candidate plans to conduct community-based paticipatory formative research necessary to inform the adaptation of an economic empowerment intervention to improve HIV prevention and care outcomes among transgender and nonbinary people who have sex with men (TGSM) in the U.S. First, the PI will establish a robust Community Collaborative Board (CCB) comprised of key members of the target populations. With the CCB and under the guidance of the mentorship team, the PI will finalize study design and protocol, informed by current pilot study findings. Next, the PI will undertake quantitative (surveys, N=390) and qualitative (interviews, n=36) research to achieve Aim 1: to estimate and qualitatively describe how co-occurring forms of economic hardship, defined as economic marginality, are associated with HIV outcomes among TGSM. Integrated Aim 1 findings and CCB guidance will inform study Aim 2: adaptation of an HIV economic empowerment intervention for economically marginalized TGSM in the U.S. After adapting the intervention, Aim 3 is: to assess acceptability and feasibility of the adapted intervention and generate preliminary data to inform an R01 application by pilot testing with 42 TGSM using a waitlist control design, then refining the intervention with the CCB. The proposed research builds from the infrastructure and community ties developed by Project AFFIRM (R01HD079603/ R01HL151559A1; PI: Bockting) in New York City, San Francisco, and Atlanta and furthers the NIH HIV strategic goal to “advance innovative research to identify and implement effective strategies to mitigate underlying HIV- associated medical and social inequalities that diminish the health and well-being of persons living with or at risk for HIV.”1,p.12 This research is designed to support the training goals of the PI. Training Goals To become an independent investigator, the candidate requires additional training in four core areas: community-based participatory research; asset theory; quantitative methods; and how to adapt, test, assess, and refine socio- behavioral interventions to improve HIV outcomes among key populations. Hosted by The HIV Center at Columbia University and New York State Psychiatric Institute, the candidate will engage in close mentorship, coursework, directed readings, workshops, workgroups, and hands-on research to achieve these training goals.

7。项目摘要 该职业发展奖的目的是为候选人提供必要的培训以成为 独立研究者1）促进有关社会和经济因素的科学知识 在边缘化，优先级健康差异人群中塑造艾滋病毒的风险和结果，2）设计 有效的干预措施可以减少艾滋病毒的患病率并改善性和性别的健康和福祉 少数群体。研究旨在跨性别者和非二元人经历重要的经济 在美国，苦难和不成比例地承受着艾滋病毒/艾滋病流行的负担。指导 综合资产理论和社会生态框架，并使用多阶段混合方法方法， 候选人计划进行基于社区的专利申请类型研究，以告知 适应经济授权干预措施，以改善预防艾滋病毒的预防和护理结果 在美国与男人发生性关系的跨性别者和非二进制人士首先，PI将建立一个强大的 社区合作委员会（CCB）完成了目标人群的主要成员。与CCB和 在Mentalship团队的指导下，PI将最终确定研究设计和协议，由当前告知 试点研究结果。接下来，PI将进行定量（调查，n = 390）和定性（访谈，n = 36） 实现目标1的研究：估计并定性地描述了如何共同出现的经济困难形式， 定义为经济边缘性，与TGSM之间的HIV结局有关。综合目标1调查结果 CCB指南将为研究目标2：适应艾滋病毒经济赋权干预措施 改编干预措施后，美国经济化的TGSM在美国，目标3是：评估可接受性 以及改编的干预措施的可行性，并生成初步数据，以告知飞行员的R01申请 使用候补列表控制设计使用42 TGSM测试，然后与CCB进行干预。提议 研究是根据项目确认（R01HD079603/ R01HL151559A1; PI：Bockting）在纽约市，旧金山和亚特兰大，以及NIH HIV策略 目标是“推进创新研究，以识别和实施有效的策略，以减轻基本的HIV- 相关的医疗和社会不平等，削弱了与或处于危险中的人的健康和福祉 第1页，第12页，本研究旨在支持PI。培训目标的训练目标，以成为一个 独立调查员，候选人需要在四个核心领域进行额外的培训：基于社区的 参与研究；资产理论；定量方法；以及如何适应，测试，评估和完善社会 行为干预措施以改善关键人群中的艾滋病毒结局。由艾滋病毒中心主持 哥伦比亚大学和纽约州精神病学院，候选人将进行仔细的心态， 课程工作，定向阅读，研讨会，工作组和动手研究，以实现这些培训目标。