Mobilizing Social Network Resources for HIV Care Support: Development and Testing of an Intervention for HIV-Positive MSM in St. Petersburg, Russia

动员社交网络资源支持艾滋病毒护理：俄罗斯圣彼得堡艾滋病毒阳性男男性接触者干预措施的开发和测试

• 批准号: 10160227
• 负责人: Yuri A Amirkhanian
• 金额: $ 21.23万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-17 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160227
• 关键词: Acquired Immunodeficiency Syndrome; Adherence; Advocacy; Affect; Age; Alcohol abuse; Appointment; Caregivers; Caring; Characteristics; Communities; Counseling; Country; Development; Epidemic; Ethics; Face; Family member; Feedback; Feeling; Friends; HIV; HIV Infections; HIV Seropositivity; Health; Health Benefit; Individual; Infection; Injections; Intervention; Intervention Studies; Interview; Lesbian Gay Bisexual Transgender; Life; Link; Mediating; Medical; Outcome; Participant; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Preparation; Prevalence; Procedures; Public Health; Qualitative Research; Randomized; Recommendation; Reporting; Research; Research Methodology; Resources; Risk Behaviors; Russia; Same-sex; Services; Sex Orientation; Sexual Transmission; Social Development; Social Network; Social support; Speed; Stigmatization; Supportive care; Testing; Treatment Efficacy; Viral; Viral Load result; Visit; Work; antiretroviral therapy; base; community setting; comparison group; coping; data format; disease transmission; effectiveness evaluation; experience; follow-up; group intervention; implementation evaluation; implementation intervention; improved; injection drug use; member; men who have sex with men; post intervention; prevent; primary outcome; psychosocial; psychosocial adjustment; recruit; referral services; resilience; same sex behavior; secondary outcome; self esteem; social; social exclusion; social group; social stigma; sociodemographics; substance use; therapy design; therapy development; treatment adherence; treatment as prevention; uptake

ABSTRACT Russia is one of five countries that account for the greatest number of infections in the world. Although historically associated with drug injection, Russia’s HIV epidemic is now primarily sexual, with a large number of infections among MSM. With few supports for medical care engagement, most HIV-positive MSM in Russia have unsuppressed viral load, fueling high continued disease transmission and poor health outcomes. HIV care engagement, adherence, and psychosocial coping are better among persons with supportive social resources. Given the hostile social circumstances they face, improved social supports are critical for the medical care engagement and psychosocial adjustment of HIV-positive MSM in Russia. This study will test an approach to help out-of-care, HIV-positive MSM identify, access, and mobilize social resources to support HIV care engagement. The mixed-methods research will begin with a formative phase of in-depth interviews with 25 PLH MSM in St. Petersburg as well as one supportive resource network member in the life of each participant to characterize the kinds of social resources that can be harnessed to support HIV care. Formative data and input from the study’s Community Advisory Panel will inform the tailoring of an intervention that has already been successfully pilot tested. The intervention study will recruit 100 out-of-care HIV+ MSM in community settings and online. After completing baseline assessments, participants will be randomized to either an individual care counseling (ICC) comparison condition or ICC plus a social support mobilization (SSM) intervention. In it, PLH MSM will attend five main and two booster sessions that underscore the benefits of medical care engagement, counter the effects of internalized intersectional stigma and promote resilience, and help participants develop and mobilize social resources supportive of HIV care. Support mobilization will begin by assisting participants develop care-supportive bonds with other group members, PLH friends, and connections made with LGBT and PLH NGOs. They will also be guided in developing and expanding supportive links with affirmative friends, family members, and other resources. In this way, the intervention will bolster care-related social support resources, resilience, and feelings of self-worth. Assessments administered at baseline will be repeated 6 and 12 months post-intervention, and in-depth followup interviews will be conducted with a subset of 20 participants to elicit feedback about the intervention experience. We hypothesize that the SSM intervention will produce greater preliminary evidence of benefit on the primary outcome of medical care attendance in the past 6 months and on secondary outcomes of having undetectable viral load, ART adherence, and psychosocial well-being. We will explore whether care-related outcomes are mediated by increases in social resources and other factors. If there is evidence of benefit, the intervention will be offered to the former comparison group as an ethical service after the final followup. If project findings are successful, we will plan a later evaluated full-scale implementation of the intervention.

摘要 俄罗斯是世界上感染人数最多的五个国家之一。虽然 历史上与毒品注射有关，俄罗斯的艾滋病毒流行现在主要是性传播， 在MSM人群中感染。由于对医疗保健参与的支持很少，俄罗斯大多数艾滋病毒阳性的男男性行为者 未受抑制的病毒载量，助长了高持续的疾病传播和不良的健康结果。艾滋病毒 护理参与，坚持，和心理社会应对的人更好的支持性社会 资源考虑到他们所面临的敌对社会环境，改善社会支持对他们来说至关重要。 俄罗斯艾滋病阳性男男性行为者的医疗服务参与和心理社会调整。这项研究将测试一个 一种方法来帮助护理外，艾滋病毒阳性男男性行为者识别，获取和动员社会资源，以支持艾滋病毒 关怀参与混合方法的研究将开始与形成阶段的深入访谈， 彼得堡的25名PLH男男性接触者以及每个人生活中的一名支持性资源网络成员 与会者对可用于支持艾滋病毒护理的社会资源类型进行了描述。形成性 研究的社区咨询小组的数据和投入将为定制干预措施提供信息， 已经成功地进行了试点测试。这项干预研究将招募100名艾滋病毒+男男性行为者， 社区设置和在线。完成基线评估后，受试者将被随机分配至 个人护理咨询（ICC）比较条件或ICC加社会支持动员 (SSM)干预在它，PLH男男性接触者将参加五个主要和两个助推器会议，强调的好处 医疗保健参与，对抗内化的交叉污名化的影响，促进复原力， 并帮助参与者开发和动员支持艾滋病毒护理的社会资源。支持动员将 开始，协助参与者与其他小组成员、PLH朋友建立护理支持联系， 与LGBT和PLH非政府组织建立联系。他们还将被引导发展和扩大 与持肯定态度的朋友、家庭成员和其他资源建立支持性联系。这样，干预将 支持与护理相关的社会支持资源、复原力和自我价值感。进行的评估 干预后6个月和12个月将重复基线调查， 与20名参与者的子集进行，以获得有关干预经验的反馈。我们 假设SSM干预将产生更多的初步证据，证明主要 过去6个月内的医疗护理结果以及无法检测的次要结果 病毒载量、ART依从性和心理健康。我们将探讨与护理相关的结果是否 通过社会资源的增加和其他因素来调节。如果有证据表明干预有益， 在最后一次随访后，作为伦理服务提供给前一个对照组。如果项目结果 如果成功，我们将计划在以后评估全面实施干预措施的情况。