Increasing engagement and improving HIV care outcomes via stigma reduction in an online social networking intervention among racially diverse young men who have sex with men and transgender women

通过在线社交网络干预减少男男性行为和跨性别女性的种族不同的年轻男性的耻辱感，提高参与度并改善艾滋病毒护理结果

• 批准号: 10360761
• 负责人: Jose Arturo Bauermeister
• 金额: $ 10.09万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-16 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360761
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affect; Age; Anti-Retroviral Agents; Behavior; Behavior assessment; Behavioral; Biological Markers; Caring; Communities; Continuity of Patient Care; Data; Elements; Enrollment; Epidemic; Ethnic Origin; Face; Feedback; Gender; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; Human immunodeficiency virus test; Individual; Intervention; Latino; Length; Logistics; Measures; Mediating; Methods; Nature; Not Hispanic or Latino; Outcome; Outcome Measure; Participant; Patient Recruitments; Persons; Population; Race; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Sampling; Schedule; Sexual and Gender Minorities; Sexuality; Site; Social Environment; Social Network; Social support; Source; Structure; Technology; Testing; Time; United States; Viral; Viral Load result; Well in self; Work; Youth; arm; care outcomes; design; ethnic diversity; experience; improved; innovation; intersectionality; intervention effect; men who have sex with men; online intervention; online version; patient engagement; peer; primary outcome; racial diversity; randomized trial; recruit; research study; response; sexual minority; social; social networking website; social stigma; theories; transgender women; transgender women who have sex with men; transmission process; treatment arm; trial design; young men who have sex with men

ABSTRACT Multiple stigmas related to sexuality, race, and HIV infection negatively impact HIV testing, engagement in HIV care, and consistent viral suppression (VS) among young Black or Latino men who have sex with men and transgender women (YBLMT). At present, few interventions have addressed the effects of intersectional stigma among HIV-infected and uninfected populations. In response to RFA-MH-18-606, this study tests whether an online intervention tailored for intersectional stigma amelioration can elicit online social support, promote intervention engagement, and mitigate the impact of multiple stigmas on HIV-related outcomes. We will recruit and enroll 1,050 young (ages 15-29), racially and ethnically diverse men who have sex with men and transgender women affected by HIV across the United States. Using a HIV-status stratified randomized trial design, participants will be assigned into one of three conditions (information-only control, a researcher-driven social network intervention, or a peer-driven social network intervention). Behavioral assessments will occur at baseline, 3, 6, 9 and 12 months; biomarkers (viral load) are scheduled for baseline, 6 and 12 months. The primary outcome is stratified by HIV status and defined as successful engagement in care (consistent VS for HIV-positive participants and routine testing for HIV-negative participants). The specific aims are: 1) Test whether an online intervention that promotes user-generated content and engagement to address intersectional stigma is associated with improvements in the HIV prevention and care continuum (HIV testing, antiretroviral adherence, VS) as compared to an information-only control arm; 2) Explore whether user engagement, as measured by quantitative and qualitative paradata, mediates the intervention’s stigma- and HIV care-related outcomes; and, 3) Examine how changes in intersectional stigma and improvements across the HIV care continuum vary between the researcher-driven vs. peer-driven social network intervention conditions. Our research study is innovative given its focus on intersectional stigma as a key target of intervention, and its ability to assess how different kinds of online social network structures influence participants’ engagement over time, reduce experiences of intersectional stigma, and improve successful engagement in care. This research addresses a critical need to reduce the effects of multiple stigmas in a priority population using an intervention delivered through a highly appealing, widely-utilized technology. If effective, this form of stigma amelioration via online support can be broadly disseminated to reduce HIV transmission and improve care among YBLMT.

摘要 与性行为、种族和艾滋病毒感染有关的多重污名对艾滋病毒检测、艾滋病毒感染的参与产生了负面影响 与男性发生性关系的年轻黑人或拉丁裔男性的护理和持续的病毒抑制(VS) 变性人妇女(YBLMT)。目前，很少有干预措施解决跨部门污名的影响。 在感染和未感染艾滋病毒的人群中。作为对RFA-MH-18-606的响应，本研究测试了 为改善跨部门耻辱而量身定做的在线干预可以获得在线社会支持，促进 干预参与，并减轻多重污名对艾滋病毒相关结果的影响。我们将招募 招募1,050名年轻(15-29岁)、种族和民族多元化的男性与男性发生性关系，并 全美感染艾滋病毒的变性女性。使用HIV状态分层随机试验 设计，参与者将被分配到三种情况之一(仅限信息控制，研究人员驱动 社交网络干预，或同行驱动的社交网络干预)。行为评估将在 基线为3、6、9和12个月；生物标志物(病毒载量)计划为基线、6和12个月。这个 主要结果是根据艾滋病毒状况分层，并定义为成功参与护理(一致与 艾滋病毒阳性参与者和艾滋病毒阴性参与者的常规检测)。具体目标是：1)测试 促进用户生成内容和参与度的在线干预是否能够解决 跨部门的耻辱与艾滋病毒预防和护理连续体(艾滋病毒检测， 抗逆转录病毒依从性，VS)与仅提供信息的对照手臂进行比较；2)探索用户 通过定量和定性的ParaData衡量的参与度，调解了干预的耻辱--和 与艾滋病毒护理相关的结果；以及，3)检查跨部门污名的变化和改善 在研究人员驱动的和同伴驱动的社会网络干预之间，艾滋病毒护理连续体是不同的 条件。我们的研究是创新的，因为它的重点是交叉耻辱作为关键目标 干预，以及它评估不同类型的在线社交网络结构如何影响的能力 随着时间的推移，参与者的参与度，减少跨部门污名的经历，并提高成功 全身心投入到护理中。这项研究解决了减少多个柱头的影响的迫切需要 通过一种极具吸引力、被广泛使用的技术进行干预的优先人群。如果 通过在线支持，这种形式的耻辱改善可以有效地广泛传播，以减少艾滋病毒 在青壮年中传播和改善护理。