Identifying and Engaging Urban HIV infected and uninfected YSMSM in care

识别城市艾滋病毒感染者和未感染者 YSMSM 并让他们参与护理

• 批准号: 10214911
• 负责人: DAVID D. CELENTANO
• 金额: $ 15.94万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10214911
• 关键词: 2019-nCoV; AIDS prevention; Address; Adherence; Adolescent; Affect; Alcohol or Other Drugs use; Baltimore; Birth; COVID-19; COVID-19 pandemic; Caring; Cessation of life; Cities; Communities; Cross-Sectional Studies; Data; Data Collection; Diagnosis; Distress; Economics; Enrollment; Epidemic; Face; Female; Funding; Grant; HIV; HIV Infections; Health; Health Food; Housing; Inequality; Infection; Interview; Life; Lung; Marijuana; Medical; Mental Health; Methods; Minority Groups; Misinformation; National Institute of Drug Abuse; Occupations; Parents; Participant; Persons; Philadelphia; Population; Population Density; Prevention; Provider; Reporting; Risk; Risk Behaviors; Sampling; Schools; Sex Differences; Sexual and Gender Minorities; Structure; Time; Tobacco smoke; United States; Viral; Washington; Youth; aged; comorbidity; coping mechanism; design; ethnic minority population; experience; health seeking behavior; infection rate; infection risk; male; marijuana use; pandemic disease; pre-exposure prophylaxis; prevent; psychosocial; racial minority; racism; service providers; sex; social; social health determinants; treatment services; uptake

ABSTRACT Current data suggest a disproportionate burden of COVID-19 illness and death among racial and ethnic minority groups.1,2 In multiple urban cities across the United States (U.S.) Black and Latinx persons are disproportionately impacted by COVID-19 illness and death.1,3-5 Disproportionate rates are likely the result of concomitant comorbidities, and adverse social determinants of health, including high rates of substance use (SU), mental health, structural racism, high population density, inadequate housing, and poor access to healthy foods.6,7 The same social determinants of health that predispose communities to COVID-19 illness, contribute to high rates of HIV in Black and Latinx sexual and gender minority youth (aged 15-24 ) (SGMY). COVID-19 will likely worsen social and economic inequalities, which predispose Black and Latinx SGMY to SU and to HIV. Exacerbated inequalities will also like result in further disruption of the HIV prevention and treatment cascades.8 The national strategy, Ending the HIV Epidemic (EHE), seeks to diagnose, treat and prevent onward infection in communities hardest hit by HIV, particularly Black and Latinx SGMY. High rates of substance use12 in BLSGMY has been identified as a key factor in treatment and prevention non-engagement, 13-15 and increased substance use may occur during the COVID-19 pandemic as a coping mechanism. SARS-CoV-2, which causes COVID-19, preferentially attacks the lungs, making YBLSGMY who smoke tobacco or marijuana, particularly at-risk.16-19 We will use a sequential explanatory mixed methods design, inclusive of cross-sectional surveys among 200 PUSH participants (both assigned male and female participants) (aim 1) and qualitative data of 48 participants and their service providers (aims 2-3), to understand potential ways in which the COVID-19 epidemic has affected personal life circumstances, risk behaviors, and health seeking behaviors; community barriers to COVID-19 prevention and treatment; and coping mechanisms to address psychosocial distressed experienced during this time. Specific Aim 1: Using a cross-sectional survey among 200 Black and Latinx SGMY enrolled in PUSH to characterize the psychosocial (including school closures, job loss, mental health and SU) disruptions and access barriers to HIV prevention, treatment and substance treatment services due to COVID-19. Specific Aim 2: Qualitatively describe how psychosocial disruptions due to COVID-19 alters BLSGMY’s access to HIV prevention, treatment and substance treatment services and the coping mechanisms used to address disruptions. Specific Aim 3: Identify potential community barriers to COVID-19 treatment and prevention among BLSGMY and their service providers and how such experiences of medical mistrust and misinformation impact experiences of social disruption in BLSGMY. Potential barriers will be explored using paired depth interviews of BLSGMY and their providers. This supplement allows the team to better understand how the COVID-19 pandemic contributes to limited access for HIV prevention, treatment and substance treatment services, and how potential community barriers and assigned sex at birth modifies this relationship.

摘要 目前的数据表明，少数种族和族裔的COVID-19疾病和死亡负担不成比例 groups.1，2在美国的多个城市（美国）黑人和拉丁裔人不成比例 受COVID-19疾病和死亡的影响。1，3 -5不成比例的发病率可能是伴随的 共病和健康的不利社会决定因素，包括高物质使用率（SU），精神疾病， 健康、结构性种族主义、人口密度高、住房不足和难以获得健康食品。 同样的健康社会决定因素使社区容易患上COVID-19疾病， 艾滋病毒在黑人和拉丁性和性别少数青年（15-24岁）（SGMY）的比率。COVID-19将 这可能会加剧社会和经济不平等，使黑人和拉丁裔SGMY更容易感染SU和HIV。 不平等现象的加剧也会进一步破坏艾滋病毒的预防和治疗工作。 国家战略“结束艾滋病毒流行”旨在诊断、治疗和预防艾滋病毒的进一步感染， 受艾滋病毒影响最严重的社区，特别是黑人和拉丁裔SGMY。BLSGMY中物质使用率高12 已被确定为治疗和预防不参与的一个关键因素，13-15和增加实质性 在COVID-19大流行期间可能会使用，作为应对机制。引起COVID-19的SARS-CoV-2， 优先攻击肺部，使吸烟或吸食大麻的YBLSGMY特别危险。 将使用顺序解释混合方法设计，包括200个PUSH中的横断面调查 参与者（分配的男性和女性参与者）（目标1）和48名参与者的定性数据， 他们的服务提供商（目标2-3），以了解COVID-19疫情影响的潜在方式 个人生活环境、风险行为和寻求健康的行为;社区对COVID-19的障碍 预防和治疗;以及应对机制，以解决这一期间经历的心理社会痛苦。 时间具体目标1：在参加PUSH的200名黑人和拉丁裔SGMY中进行横断面调查， 描述社会心理（包括学校关闭，失业，心理健康和SU）中断和访问 由于COVID-19，艾滋病毒预防，治疗和物质治疗服务的障碍。具体目标二： Qualitative描述了COVID-19造成的心理社会破坏如何改变BLSGMY感染艾滋病毒的途径 预防、治疗和药物治疗服务以及用于应对干扰的应对机制。 具体目标3：确定BLSGMY中COVID-19治疗和预防的潜在社区障碍 以及这些医疗不信任和错误信息的经历如何影响 在BLSGMY的社会破坏的经验。潜在的障碍将通过成对的深度访谈进行探讨 和他们的供应商。这一补充使团队能够更好地了解COVID-19是如何 大流行导致艾滋病毒预防、治疗和药物治疗服务的获得受到限制， 潜在的社区障碍和出生时的性别分配如何改变这种关系。

项目成果

Dismantling Barriers and Transforming the Future of Pre-Exposure Prophylaxis Uptake in Young Black and Latinx Sexual Minority Men and Transgender Women.

消除障碍并改变年轻黑人和拉丁裔性少数男性和跨性别女性接受暴露前预防的未来。

• DOI: 10.1089/apc.2021.0222
• 发表时间: 2022
• 期刊: AIDS patient care and STDs
• 影响因子: 4.9
• 作者: Shorrock,Fiona;Alvarenga,Aubrey;Hailey-Fair,Kimberly;Vickroy,Wil;Cos,Travis;Kwait,Jennafer;Trexler,Constance;Wirtz,AndreaL;Galai,Noya;Beyrer,Chris;Celentano,David;Arrington-Sanders,Renata
• 通讯作者: Arrington-Sanders,Renata