Young Men of Color Who Have Sex with Men Cohort Study

与男性发生性关系的年轻有色人种男性队列研究

• 批准号: 9126516
• 负责人: Michele D. Kipke
• 金额: $ 187.12万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9126516
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adherence; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Assessment tool; Behavior Therapy; Biological; Caring; Clinic; Cohort Studies; Color; Continuity of Patient Care; Data; Development; Diagnosis; Diffusion; Disease; Disease Progression; Disease-Free Survival; Drug usage; Ensure; Epidemic; Funding; Future; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Human immunodeficiency virus test; Illicit Drugs; Incidence; Infection; Insurance Coverage; Intervention; Intervention Studies; Latino; Los Angeles; Measures; Medical; Methods; Modeling; Monitor; Participant; Patients; Population; Predisposition; Prevention; Prevention approach; Prevention strategy; Primary Health Care; Probability; Prophylactic treatment; Quality of life; Randomized; Recruitment Activity; Research; Research Design; Research Priority; Risk; Sampling; Services; Sexually Transmitted Diseases; Site; Specimen; Substance abuse problem; Testing; Time; United States National Institutes of Health; Viral; Viral Load result; Virus; Youth; antiretroviral therapy; care seeking; clinical practice; cohort; design; experience; health care availability; health care service; health care service utilization; high risk; human leukocyte antigen testing; improved; member; men; men who have sex with men; microbicide; mobile computing; motivational enhancement therapy; prevent; prevention service; response; retention rate; seropositive; sex; social media; theories; therapy design; transmission process; treatment adherence; uptake; young man; young men who have sex with men

 DESCRIPTION: U01 - Cohort Study with Young Men of Color who have Sex with Men In this fourth decade of the HIV epidemic, we continue to see 50,000 new infections annually in the U.S., particularly among Black/African American and Latino young men who have sex with men (YMSM of color), who now account for 60% of new infections among Black/African American MSM and 45% of new infections among Latino MSM. Black/African American YMSM remain five times more likely to be HIV seropositive, seven times more likely to have an undiagnosed HIV infection, and 45% more likely to be diagnosed with an STI than other YMSM. YMSM of color are also the least likely to seek and remain in HIV/AIDS care, and when they do seek care, they typically already have advanced HIV disease. Among youth who initiate antiretroviral therapy (ART), 54% will achieve viral suppression; unfortunately 57% will not be retained in care and less than 6% will remain virally suppressed. Changing the course of this epidemic is going to require a dramatically different approach to prevention. We are therefore proposing to conduct longitudinal research with a large and diverse cohort of 450 YMSM of color in order to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Building on the HIV Continuum of Care and Prevention paradigm (i.e., seek, test, treat, and retain in care) and the Syndemic Theory of Risk, we will use a mixed-methods study design to collect and analytically triangulate quantitative, qualitative, and biological measures at baseline and every six months. Participants will be recruited from public venues, HIV test sites, and HIV/AIDS clinics using randomized probability and purposeful sampling designs. All participants will be tracked to ensure a retention rate of 90% or better, which is a feasible target given our retention rates of 94% in the Healthy Young Men's (HYM) Study. The specific aims are to 1) better understand and operationally define what linkage, engagement, retention to care (both primary health and HIV/AIDS treatment) and adherence means to HIV- and HIV+ YMSM of color; 2) characterize and monitor over time YMSM of color's use of alcohol and illicit drugs; utilization of HIV testing and prevention services; incidence of HIV and STIs; insurance status and access to health care services, including primary care and HIV/AIDS treatment services; engagement in and utilization of health care and HIV/AIDS treatment services; retention in HIV/AIDS care and adherence to ART; and utilization of biomedical interventions, such as PrEP and PEP; and 3) identify barriers/facilitator of engagement along the HIV Continuum of Care and Prevention. The proposed research builds on close to two decades of NIH-funded research by our team focused on this and other high-risk youth populations.

 描述：U01-与有色人种的年轻人进行研究，他们在艾滋病毒流行的第四个十年中与男人发生性关系，我们每年在美国继续看到50,000种新感染，尤其是在黑人/非裔美国人和拉丁裔年轻人中与男性发生性关系（YMSM）（YMSM）（YMSM的YMM）（现在是黑人/非洲人在非洲/非洲人中占46％的新感染），其中包括新的感染inino和45％。黑人/非洲裔美国YMSM的艾滋病毒血清阳性可能性的含量高五倍，患有单人hiv感染的可能性高七倍，而被诊断为STI的可能性高45％。 YMSM的颜色也是最不可能寻求并留在艾滋病毒/艾滋病护理中的YMS，当他们寻求护理时，它们通常已经患有晚期艾滋病毒疾病。在启动抗逆转录病毒疗法（ART）的年轻人中，有54％的人将获得病毒抑制；不幸的是，有57％的人不会保留在护理中，少于6％的人将继续受到病毒抑制。改变这种流行病的过程将需要动态不同的预防方法。因此，我们提议通过大量和多样化的450 YMSM颜色进行纵向研究，以防止新的HIV感染，减少传播并减少与HIV/AIDS相关的分布，通过关注成功参与护理。我们将在基于护理和预防范式的HIV连续体（即寻求，测试，治疗和保留护理中）和辛迪科风险理论，我们将使用混合方法研究设计在基线和每六个月内收集和分析三角测量定量，定性和生物学测量。参与者将使用随机概率和有目的的抽样设计从公共场所，HIV测试站点和HIV/AIDS诊所招募。将跟踪所有参与者以确保保留率为90％或更高，这是一个可行的目标，因为我们在健康的年轻男子（HYM）研究中的保留率为94％。具体目的是1）更好地理解并在操作上定义哪些联系，参与度，保留对护理（初级健康和艾滋病毒/艾滋病治疗）和依从性意味着对HIV-和HIV+ YMSM的颜色； 2）随着时间的推移，YMSM的颜色使用酒精和非法药物的特征和监测；利用艾滋病毒测试和预防服务；艾滋病毒和性传播感染的发病率；保险状况并获得医疗服务，包括初级保健和艾滋病毒/艾滋病治疗服务；从事医疗保健和艾滋病毒/艾滋病治疗服务的参与和利用；保留艾滋病毒/艾滋病护理和遵守艺术；并利用生物医学干预措施，例如PREP和PEP； 3）确定沿艾滋病毒的护理和预防连续体的障碍/促进者。拟议的研究基于将近二十年的NIH资助研究，我们的团队专注于这个和其他高风险的青年人口。