Examining Sleep Health and Adherence Outcomes Among Older HIV-Positive Men

检查老年艾滋病毒阳性男性的睡眠健康和依从性结果

• 批准号: 10170571
• 负责人: Brett M Millar
• 金额: $ 15.83万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10170571
• 关键词: AIDS/HIV problem; Address; Adherence; Affect; Affective; Aging; Alcohol or Other Drugs use; Alcohols; Anal Sex; Anti-Retroviral Agents; Behavior; Bisexual; Chronic Disease; Cognition; Cognitive; Comparative Study; Complex; Continuity of Patient Care; Data; Decision Making; Distress; Drug usage; Elderly; Emotions; Enrollment; Epidemic; Exercise; Feedback; Future; Gays; Gender; General Population; Glean; Goals; HIV; HIV Seropositivity; Health; Health behavior; Heterosexuals; Impairment; Individual; Influentials; Informal Social Control; Intervention; Link; Literature; Measures; Mental Health; Meta-Analysis; Nature; Outcome; Participant; Personal Satisfaction; Pharmaceutical Preparations; Phase; Population; Predictive Factor; Process; Public Health; Quality of life; Recommendation; Reporting; Research; Research Design; Risk; Risk Factors; Role; Sample Size; Sampling; Sampling Studies; Science; Self Efficacy; Self-control as a personality trait; Sex Behavior; Sex Orientation; Sexual Partners; Sleep; Sleep Deprivation; Sleep disturbances; Testing; Time; Viral; Woman; Work; actigraphy; age group; aged; base; behavioral outcome; comparative; condoms; design; diaries; experience; follow up assessment; improved; interdisciplinary approach; men; multidisciplinary; negative mood; novel; physical conditioning; positive mood; racial diversity; recruit; response; sexual minority; sexual risk behavior; sleep behavior; sleep health; sleep quality; transmission process

Project Summary Sleep deficiency, given its impairing effects on emotion, cognition, and decision-making, is likely a key risk factor contributing to non-adherence to antiretroviral (ART) medications in older HIV-positive gay and bisexual men (GBM). However, research on sleep deficiency’s effect on ART adherence and on self-efficacy regarding adherence is very limited, has been mostly cross-sectional in nature, and has not focused on older adults. We are submitting this application in response to PAR-17-320, with the aim of conducting novel, hypothesis-driven exploratory research into sleep deficiency among older HIV-positive GBM within a daily diary study design. We propose to recruit and enroll a racially-diverse sample of 100 HIV-positive GBM, aged 50 or older, who report suboptimal adherence at baseline. Gathering 21 days of twice-daily diary data and wristwatch actigraphy data for objective sleep indicators, we will work to achieve three primary aims: SPECIFIC AIM 1: To test the direct effect of day-level sleep quality ART adherence on a given day. SPECIFIC AIM 2: To examine whether a potential mechanism by which day-level sleep quality affects ART adherence is through its direct effect on day-level self-efficacy for adherence. SPECIFIC AIM 3: To gather qualitative feedback from participants about sleep, ART adherence, barriers to improving both, and recommendations for how sleep health interventions could be tailored to this population. By exploring the role of sleep deficiency in ART adherence among older GBM, as well as gleaning qualitative feedback from participants in the follow-up assessment regarding sleep health, perceived barriers, and intervention possibilities, the proposed project has high potential to improve adherence interventions aimed at achieving viral suppression and improved wellbeing among this population, with potential future applications to other groups.

项目概要 鉴于睡眠不足对情绪、认知和决策的影响，睡眠不足可能是一个主要风险 导致老年艾滋病毒阳性同性恋和双性恋者不坚持抗逆转录病毒（ART）药物的因素 男性（GBM）。然而，关于睡眠不足对 ART 依从性和自我效能影响的研究 依从性非常有限，基本上是跨部门的，并且不关注老年人。 我们提交此申请是为了响应 PAR-17-320，目的是开展新颖的、 在每日日记中对老年 HIV 阳性 GBM 睡眠不足进行假设驱动的探索性研究 研究设计。我们建议招募和登记 100 名 HIV 阳性 GBM 的不同种族样本，年龄在 50 岁或 年龄较大的人报告基线依从性不佳。收集 21 天每日两次的日记数据和手表 客观睡眠指标的体动记录数据，我们将努力实现三个主要目标： 具体目标 1：测试特定日期 ART 依从性的日间睡眠质量的直接影响。 具体目标 2：研究日间睡眠质量是否存在影响 ART 的潜在机制 坚持是通过其对日常坚持自我效能的直接影响来实现的。 具体目标 3：收集参与者关于睡眠、ART 依从性、睡眠障碍的定性反馈 改善两者，并就如何针对这一人群量身定制睡眠健康干预措施提出建议。 通过探索睡眠不足对老年 GBM 患者坚持 ART 的作用，以及收集 后续评估参与者对睡眠健康、感知障碍、 和干预的可能性，拟议的项目具有改善依从性干预的巨大潜力 旨在实现病毒抑制并改善该人群的福祉，未来可能 向其他团体的申请。