Examining a Multicomponent Intervention to Improve HIV Health among Black Men in Southern Ending the HIV Epidemic in the U.S. Jurisdictions

检查改善南部黑人男性艾滋病毒健康的多成分干预措施，结束美国司法管辖区的艾滋病毒流行

• 批准号: 10744410
• 负责人: Devin English
• 金额: $ 70.09万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10744410
• 关键词: Address; Anxiety; Area; Behavioral; Caring; Collaborations; Communities; Economics; Effectiveness; Elements; Ensure; Epidemic; Evaluation; Evidence based intervention; Fostering; Funding; HIV; HIV diagnosis; HIV disparities; Health; Health Promotion and Education; Health Status; Health behavior; Health education; Healthcare; Housing; Hybrids; Individual; Inequity; Institution; Intervention; Leadership; Link; Maintenance; Mental Health; Mental health promotion; Methods; Modeling; Monitor; Motivation; National Institute of Mental Health; Outcome; Pathway interactions; Patient Self-Report; Population; Race; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Research Personnel; Resource-limited setting; Running; Service delivery model; Social Work; Social isolation; Social support; Testing; Time; Transportation; Unsafe Sex; Waiting Lists; antiretroviral therapy; anxiety symptoms; arm; behavioral health; behavioral outcome; black men; black men who have sex with men; combat; community based participatory research; community organizations; depressive symptoms; diaries; effective intervention; effectiveness testing; effectiveness/implementation trial; emotion dysregulation; emotion regulation; empowerment; evidence base; experience; implementation design; improved; improved outcome; innovation; member; multi-component intervention; multidisciplinary; pilot trial; primary outcome; psychologic; psychological outcomes; research study; secondary outcome; sexual minority; skills; social capital; social stigma; substance use; theories; therapy design; treatment adherence; trend; uptake

PROJECT SUMMARY/ABSTRACT Black men who have sex with men (BMSM) in the U.S. continue to experience a vastly inequitable HIV burden, particularly in Southern Ending the HIV Epidemic in the U.S. (EHE) jurisdictions. To combat this alarming trend, there is a need for innovative, accessible, and community-developed interventions to promote HIV health among BMSM in these areas. Given research that daily and multilevel intersectional stigma contributes to HIV inequities among BMSM, a multicomponent intervention that addresses multilevel barriers to HIV health and combats intersectional stigma is essential. In collaboration with THRIVE SS, a leading BMSM- led community-based organization serving BMSM living with HIV in the Atlanta area, we developed THRIVE365, an evidence-based multicomponent HIV intervention that provides individual-level health education and motivation, builds social support among BMSM, facilitates access to culturally-affirmative healthcare, and combats barriers to housing and economic empowerment in line with the Information- Motivation-Behavioral skills, social capital, and socioecological models of health. Pilot evidence indicates THRIVE365 is feasible, acceptable, and efficacious in promoting daily antiretroviral treatment (ART) adherence and reducing daily depressive symptoms, anxiety symptoms, and emotion regulation difficulties among BMSM living with HIV. THRIVE365 is ready for a full-scale evaluation guided by the RE-AIM framework that includes a robust examination of its effectiveness for HIV-related behavioral and psychological outcomes, its moderation effects on intersectional stigma, and its maintenance and reach over time. We will do so with a fully-powered hybrid type 2 implementation-effectiveness trial using daily diary methods, self-report follow-ups over 6 months, and paradata to examine daily and longer-term intervention engagement, effects, and adaptations. The overarching aims of this research are to: 1) Test the effectiveness of THRIVE365 in improving daily and longer-term HIV-related behavioral health (primary outcome: ART adherence) and psychological health (e.g., secondary outcomes: lower depressive and anxiety symptoms) in a 6-month waitlist randomized controlled trial with 350 BMSM living with HIV in the four Atlanta-area EHE jurisdictions; 2) Examine the moderating effect of THRIVE365 on associations between intersectional stigma and our primary and secondary HIV outcomes; 3) Evaluate THRIVE365 maintenance and reach at the user-level (e.g., within-user changes in engagement and daily effects) and setting-level (e.g., intervention adaptations, BMSM community uptake). Together, these results will establish the effectiveness of THRIVE365, a community-led, multicomponent intervention, for improving HIV-related behavioral and psychological health among BMSM living with HIV in four of the EHE jurisdictions with the greatest HIV burden. THRIVE365 was designed for implementation and is poised to offer a model for effective HIV care among BMSM in high-stigma, low-resource areas of the U.S. South and beyond.

项目摘要/摘要 与男人发生性关系（BMSM）的黑人继续感到艾滋病毒不平等的艾滋病毒 负担，特别是在南部结束美国艾滋病毒流行（EHE）司法管辖区的负担。对抗这一点 令人震惊的趋势，需要创新，可访问和社区发展的干预措施来促进 在这些领域，BMSM中的艾滋病毒健康。考虑到每日和多层交叉污名的研究 BMSM之间有助于艾滋病毒的不平等，这是一种多层干预措施，可解决多层次障碍 艾滋病毒的健康和战斗交叉污名至关重要。与领先的BMSM-与Thrive SS合作 LED社区组织服务于亚特兰大地区的艾滋病毒居住的BMSM，我们开发了 Thrive365，一种基于证据的多组分HIV干预措施，可提供个人水平的健康 教育和动力，在BMSM之间建立社会支持，促进获得文化的机会 医疗保健，并根据信息与住房和经济能力打击障碍 - 动机行为技能，社会资本和健康的社会生态模型。飞行员证据表明 Thrive365在促进每日抗逆转录病毒治疗（ART）依从性方面是可行的，可接受和有效的 减少BMSM的每日抑郁症状，焦虑症状和情绪调节困难 与艾滋病毒一起生活。 thrive365已准备好进行全面评估，这些评估由Re-Aim框架指导，其中包括 对与HIV相关的行为和心理结局的有效性的强有力检查，适度 对交叉污名的影响及其维护和随着时间的流逝。我们将使用完全动力 使用每日日记方法，自我报告的随访6型混合2型实施效应试验 几个月，并且天堂可以检查日常和长期干预，效果和适应。 这项研究的总体目的是：1）测试Thrive 365在改善每日和 长期与HIV相关的行为健康（主要结果：艺术依从性）和心理健康（例如， 次要结果：降低抑郁和焦虑症状）在6个月的候补列表随机对照试验中 在亚特兰大四个地区的司法管辖区中，有350 BMSM患有艾滋病毒； 2）检查 关于交叉污名与我们的原发性和继发性HIV结果之间的关联的壮成长365； 3） 评估Thrive365在用户级别的维护和覆盖 每日效果）和设置级别（例如，干预改编，BMSM社区吸收）。在一起，这些 结果将确定Thrive365的有效性，365，这是一种社区主导的多组分干预措施，用于 在四个EHE中改善HIV的BMSM中与HIV相关的行为和心理健康 艾滋病毒负担最大的管辖权。 Thrive365专为实施而设计，并准备提供 在美国南部及其他地区，BMSM中有效的HIV护理模型。