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

项目摘要 睡眠不足，鉴于其对情绪、认知和决策的损害作用，很可能是一个关键风险 导致老年HIV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，睡眠不足对ART依从性和自我效能感的影响研究 依从性非常有限，基本上是跨部门的，而且没有把重点放在老年人身上。 我们响应PAR-17-320提交这份申请，目的是进行小说， 在日常日记中对老年HIV阳性GBM患者睡眠不足的假设驱动的探索性研究 研究设计。我们建议招募和登记一个不同种族的样本，100名艾滋病毒阳性的GBM，年龄在50岁或 年龄较大的人，他们报告的遵从性在基线时不是最好的。收集21天每天两次的日记数据和手表 对于客观睡眠指标的活动数据，我们将努力实现三个主要目标： 具体目标1：测试在特定一天坚持每日睡眠质量的直接效果。 特定目标2：检查日间睡眠质量是否影响ART的潜在机制 坚持是通过其对坚持的日水平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、艺术坚持、障碍的定性反馈 改善这两个方面，并就如何针对这一人群量身定做睡眠健康干预措施提出建议。 通过探索睡眠不足在老年GBM患者坚持ART中的作用，以及收集 来自后续评估参与者的关于睡眠健康、感知障碍、 和干预的可能性，拟议的项目具有提高干预依从性的高潜力 旨在实现病毒抑制和改善这一人群的福祉，具有潜在的未来 向其他团体提出申请。

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.