Body Image and Self-care in HIV-infected MSM

HIV 感染 MSM 的身体形象和自我护理

基本信息

批准号：
9107916
负责人：
Aaron J Blashill
金额：
$ 17.1万
依托单位：
SAN DIEGO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9107916
关键词：
AIDS prevention AIDS/HIV problem Acute Address Adherence Affect Alcohol or Other Drugs use Anus Appearance Area Attention Award Behavior Behavior Therapy Behavioral Body Image Caring Chemoprophylaxis Child Sexual Abuse Cities Clinical Trials Control Groups Data Development Plans Face General Hospitals Goals Grant HIV HIV risk Health Health behavior Highly Active Antiretroviral Therapy Individual Intervention Interview Life Link Massachusetts Mental Depression Mental Health Mental disorders Mentors Mentorship Meta-Analysis Mid-Career Clinical Scientist Award (K24)Modeling Outcome Participant Peer Review Population Positioning Attribute Postdoctoral Fellow Preventive Intervention Process Prophylactic treatment Publications Quality of life Randomized Randomized Controlled Trials Research Research Personnel Research Project Grants Risk Risk Behaviors Risk Reduction Role Secondary Prevention Self Care Sexual Transmission Statistical Data Interpretation Substance abuse problem Testing Training Treatment Efficacy Virus active control antiretroviral therapy arm behavior change body dissatisfaction career career development condoms design efficacy testing experience high risk improved medical schools medication compliance men who have sex with men novel primary outcome prospective psychosocial public health intervention research and development secondary outcome sex risk sexual HIV transmission skills therapy development transmission process treatment as usual trial comparing uptake

项目摘要

DESCRIPTION (provided by applicant): This is an amended, previously well-received, K23 proposal addressing health risk behaviors in men who have sex with men (MSM) within the context of syndemics (co-occurring psychosocial problems), and a particular focus on body image disturbance and depression. MSM constitute, by far, the largest number (H60%) of individuals with HIV in the U.S. Modest effects of behavioral interventions for MSM may be because they generally do not address the unique and varied psychosocial context for this population. Study after study concludes that co-occurring syndemics contribute to poor self-care behaviors including, sexual risk and HAART non-adherence, and may interfere with uptake of interventions for MSM1-7. One example of an understudied psychosocial problem among HIV-infected MSM is dissatisfaction with one's appearance. It is estimated that 31% of HIV-infected MSM have elevated body dissatisfaction8, which is syndemic to depression, sexual transmission risk, and HAART non-adherence. CANDIDATE: I am a postdoctoral fellow at Massachusetts General Hospital/Harvard Medical School with 15 peer-reviewed publications (12 first-authored) on psychosocial problems such as body dissatisfaction and depression among MSM, HAART adherence, and HIV sexual transmission risk behaviors. The present proposal will allow me to acquire needed skills to achieve my goal of becoming an independent researcher studying co-occurring psychosocial and self-care problems among MSM living with and at risk for acquiring HIV. MENTORING: Dr. Steven Safren, the primary mentor, has expertise in addressing psychosocial problems in the context of interventions for self-care in HIV, including depression, HAART adherence, and HIV prevention. Drs. Kenneth Mayer and Sabine Wilhelm are secondary mentors and add considerable unique expertise to the mentoring team, with their respective research specializations in HIV prevention and body dissatisfaction interventions. RESEARCH: As an example of a way to integrate improving self-care behaviors while addressing an important psychosocial syndemic indicator, I will develop a novel intervention which addresses body dissatisfaction, syndemic to depression, secondary HIV prevention, and HAART adherence among HIV-infected MSM. With mentorship, this intervention will be developed through an initial iterative process, and then piloted in a randomized control trial. TRAINING: I will receive direct mentoring in addressing psychosocial problems in the context of self-care (HIV prevention and adherence), the iterative process of developing and testing interventions that focus on both psychosocial problems and self-care, as well as dissemination. This is directly tied to my primary mentor's K24 award (and his other grants), on which I can be part of, and observe the iterative intervention development related to syndemics. I will also receive training in advanced statistical analysis, take courses on clinical trials, longitudinal modeling, qualitative analysis, and missing data.

描述（由申请人提供）：这是一项经过修订、之前广受好评的 K23 提案，旨在解决同步流行病（同时发生的心理社会问题）背景下男男性行为者 (MSM) 的健康风险行为，并特别关注关于身体形象障碍和抑郁症。迄今为止，MSM 是美国 HIV 感染者人数最多的群体 (H60%)。对 MSM 的行为干预效果不大，可能是因为这些干预措施通常没有解决该人群独特且多样化的社会心理背景。一项又一项的研究得出结论，并发流行病会导致不良的自我保健行为，包括性风险和不遵守 HAART，并可能干扰 MSM1-7 干预措施的采用。感染艾滋病毒的男男性接触者中一个未被充分研究的心理社会问题的例子之一是对自己的外表不满意。据估计，31% 的 HIV 感染男男性行为者对身体不满意8，这是抑郁症、性传播风险和不遵守 HAART 的综合症状。候选人：我是马萨诸塞州总医院/哈佛医学院的博士后研究员，发表了 15 篇同行评审出版物（12 篇为第一作者），涉及心理社会问题，例如 MSM 中的身体不满意和抑郁、HAART 依从性和 HIV 性传播风险行为。目前的提案将使我能够获得所需的技能，以实现成为一名独立研究员的目标，研究感染艾滋病毒和有感染艾滋病毒风险的男男性接触者中同时发生的心理社会和自我护理问题。指导：主要导师 Steven Safren 博士在解决 HIV 自我保健干预措施中的心理社会问题方面拥有专业知识，包括抑郁症、HAART 依从性和 HIV 预防。博士。肯尼思·梅耶尔 (Kenneth Mayer) 和萨宾·威廉 (Sabine Wilhelm) 担任二级导师，为导师团队增添了大量独特的专业知识，他们各自的研究专长是艾滋病毒预防和身体不满干预。研究：作为将改善自我保健行为与解决重要的心理社会症状指标相结合的方法的一个例子，我将开发一种新颖的干预措施，解决身体不满意、抑郁症综合症、艾滋病毒二级预防以及感染艾滋病毒的男男性行为者中的 HAART 依从性。在指导下，这种干预措施将通过最初的迭代过程进行开发，然后在随机对照试验中进行试点。培训：我将接受直接指导，以解决自我护理（艾滋病毒预防和坚持）中的心理社会问题，这是开发和测试针对心理社会问题和自我护理以及传播的干预措施的迭代过程。这与我的主要导师的 K24 奖（以及他的其他资助）直接相关，我可以参与其中并观察与流行病相关的迭代干预发展。我还将接受高级统计分析方面的培训，参加临床试验、纵向建模、定性分析和缺失数据方面的课程。