LEVERAGING FAMILY-BASED ASSETS FOR BLACK MSM IN HOUSE BALL COMMUNITIES

在家庭舞会社区中利用家庭资产支持黑人男男性接触者

• 批准号: 10152677
• 负责人: Jeffrey M Birnbaum
• 金额: $ 31.97万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10152677
• 关键词: AIDS prevention; Address; Affect; Area; Behavior; Behavior Therapy; Biological; Buffers; Caring; Clinical Trials; Collaborations; Communication; Communities; Complement; Data; Elderly; Epidemic; Evidence based intervention; Face; Family; Feedback; Focus Groups; Future; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; Homophobia; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Lesbian Gay Bisexual Transgender; Manuals; Modeling; Modification; Outcome; Parents; Prevention; Protocols documentation; Randomized; Randomized Controlled Trials; Research; Risk; Sexual Partners; Siblings; Social Network; Social support; Testing; Training; Viral; Voice; Waiting Lists; Work; acceptability and feasibility; antiretroviral therapy; authority; base; black men; black men who have sex with men; care outcomes; caregiving; condomless anal sex; design; effectiveness testing; effectiveness trial; empowerment; expectation; experience; implementation protocol; improved; informal caregiving; intervention effect; member; men; post intervention; pre-exposure prophylaxis; primary outcome; racism; recruit; secondary outcome; sex; skills; social norm; social relationships; social stigma; social structure; standard of care; time use; tool; transmission process; trial design; underserved community; willingness

1 Despite the advent of highly effective prevention tools such as HIV pre-exposure prophylaxis (PrEP), Black men 2 who have sex with men (MSM) continue to have the highest incidence of new HIV diagnoses in the US. The risk 3 of onward HIV transmission is reduced to zero in HIV-positive individuals who are virally suppressed; however, 4 Black MSM are least likely to be engaged in care or to be suppressed. Many Black MSM face multiple stigmas 5 (e.g., racism, homophobia) and rejection from their biological families, but some have found refuge in the House 6 Ball Community (HBC)—a national network of Black LGBT kinship commitments (families) that provide (informal) 7 care giving, affirmation and survival skills-building for its members. Regarding skills-building and HIV prevention, 8 Many Men Many Voices (3MV) is a six-session, group-level behavioral intervention and is the only “best- 9 evidence” intervention for Black MSM. Family-based interventions have shown HIV prevention efficacy; however, 10 3MV is not a family-based intervention. In 3MV, HIV-negative Black MSM are recruited into artificial group 11 settings with individuals with whom they may have little social relationship. 3MV neither leverages the 12 connections and commitments nor addresses the variability in HIV-status that exists in house ball families. 13 Because Black MSM in the HBC have closer social relationships, 3MV requires adaptation to be more responsive 14 to this social structure and dynamic. Our goal in this clinical trial planning grant is to prepare for a cluster 15 randomized controlled trial (CRCT) to test the effectiveness of the modified 3MV vs. standard of care in reducing 16 new HIV infections and increasing rates of viral suppression among Black MSM in HBC families. Based on our 17 formative work, that MSM social networks predict HIV prevention behaviors and that HBC family cultural norms 18 are primed for communication about HIV prevention and treatment, our central hypothesis is that a modified 3MV 19 intervention incorporating family asset-building will have an amplifying effect on HIV prevention and treatment 20 outcomes. We will investigate this hypothesis with the specific aims: Aim 1: Conduct formative research to 21 identify key modifications to the 3MV intervention manual and implementation protocol. The eight-step ADAPT- 22 ITT model will guide our approach to modifying 3MV into Our Family Our Voices (OFOV), which accommodates 23 the lived experience of HBC families. Aim 2: Conduct a pilot CRCT to determine the feasibility and acceptability 24 of the modified 3MV trial protocol (OFOV) vs. waitlisted standard of care control. We will determine the feasibility/ 25 acceptability of OFOV as well as the CRCT design (n=6 families; 100 individuals) with NYC HBC families. This 26 study will provide necessary data to design and conduct a full-scale CRCT effectiveness trial of OFOV on HIV 27 prevention and care outcomes in Black MSM. The HBC is a large, yet underserved, community within the LGBT 28 community. By precision-tailoring an evidence-based intervention for the HBC, our research to improve HIV 29 testing and care engagement will complement national efforts to End the Epidemic by 2030, especially among 30 Black MSM—the highest priority group for domestic HIV prevention.

1尽管出现了非常有效的预防工具，如艾滋病毒暴露前预防（PrEP）， 在美国，男男性行为者（MSM）仍然是艾滋病毒新诊断的发病率最高的人群。风险 在病毒受到抑制的艾滋病毒阳性个体中，艾滋病毒的进一步传播减少到零;然而， 4黑人男男性行为者最不可能参与护理或受到压制。许多黑人男男性接触者面临多重污名 5（例如，种族主义，同性恋恐惧症）和来自亲生家庭的排斥，但有些人在众议院找到了避难所 6球社区（HBC）-一个全国性的黑人LGBT亲属关系承诺（家庭）网络，提供（非正式） 7给予关怀、肯定和培养其成员的生存技能。关于技能建设和艾滋病毒预防， 8许多男人许多声音（3 MV）是一个六届会议，小组级的行为干预，是唯一的“最好的- 9证据”干预黑人男男性接触者。以家庭为基础的干预措施已显示出预防艾滋病毒的效力;然而， 10 3 MV不是以家庭为基础的干预措施。在3 MV中，HIV阴性的黑人MSM被招募到人工组 11个与他们可能没有什么社会关系的人的设置。3 MV既不利用 12连接和承诺，也没有解决艾滋病毒状况的变化，存在于家庭球。 13由于HBC中的黑人男男性行为者有更密切的社会关系，3 MV需要适应才能更好地响应 14、这种社会结构和动态。我们在这个临床试验计划补助金的目标是准备集群 15项随机对照试验（CRCT），旨在测试改良3 MV与标准治疗相比在降低 16个新的艾滋病毒感染和HBC家庭中黑人男男性行为者的病毒抑制率增加。基于我们 17形成性工作，男男性接触者社交网络预测艾滋病毒预防行为和HBC家庭文化规范 18人准备好了关于艾滋病毒预防和治疗的交流，我们的中心假设是，修改后的3 MV 纳入家庭资产建设的干预措施将对艾滋病毒预防和治疗产生放大效应 20个结果我们将调查这一假设的具体目标：目标1：进行形成性研究， 21确定3 MV介入手册和实施方案的关键修改。八步适应- 22 ITT模型将指导我们将3 MV修改为Our Family Our Voices（OFOV）的方法， 23 HBC家庭的生活经历。目标2：开展试点CRCT，以确定可行性和可接受性 24例改良3 MV试验方案（OFOV）与等待标准治疗对照。我们将确定可行性/ OFOV以及CRCT设计（n=6个家庭; 100名个体）与NYC HBC家庭的可接受性。这 26项研究将提供必要的数据，以设计和实施一项全面的CRCT有效性试验， 27预防和护理结果在黑色男男性接触者。HBC是LGBT群体中的一个大型但服务不足的社区 28社区通过为HBC精确定制基于证据的干预措施，我们的研究可以改善艾滋病毒 29检测和护理参与将补充到2030年结束疫情的国家努力，特别是在 30黑人男男性行为者-国内艾滋病毒预防的最优先群体。