Just-in-time adaptive interventions for improving young Latino sexual minority's success in HIV therapy.

项目总结/摘要 候选人：我的长期职业目标是成为一名独立资助的科学家，致力于消除 拉丁美洲性少数群体之间的艾滋病毒/艾滋病和药物使用护理和治疗差异。立即 这一建议的首要目标是配备创新工具， 抗逆转录病毒治疗（ART）的瞬时物质使用和心理社会因素以及活动空间 与艾滋病毒感染者发生性关系的年轻拉丁裔男性（YLMSM）的依从性， 及时适应性干预（JITAI）的设计知识。职业发展计划：我需要 在4个领域的指导培训，以达到我的研究和职业目标：1）拉丁美洲性少数群体的健康和 研究问题; 2）艾滋病毒及其综合症的临床护理和治疗; 3）生态瞬时评估 (EMA)和全球定位系统（GPS）技术; 4）EMI和JITAI的设计。培训和 研究计划将由一个专家小组指导：Trepka博士（艾滋病毒护理和治疗;人类受试者 研究）、Muñoz-Laboy（性少数群体健康）、Devieux（干预发展）和邓肯（EMA; GPS）。环境：佛罗里达国际大学（FIU）在艾滋病毒和健康方面有着杰出的记录。 差距研究，从而为拟议的培训和研究提供了一个知识丰富的环境。 除了广泛的物质资源外，我还可以接触到 美国拉丁美洲人药物使用和艾滋病毒/艾滋病研究中心和金融情报室的健康差异倡议 （人类发展指数）。研究项目：拟议的研究有两个主要目标。首先，我们将确定 瞬时状态物质使用和心理社会因素以及ART发生的活动空间 艾滋病毒感染者中YLMSM的依从性。第二，我们将评估频繁和重复的效果。 ART依从性作为YLMSM的潜在干预措施，并探讨相关 吉泰。为了实现我们的目标，我们建议在75个YLMSM年龄组中实施EMA/GPS研究 佛罗里达的迈阿密18比34。这项拟议中的创新研究将是第一个评估 物质使用、心理社会因素和活动空间影响ART依从性。这些信息对于 设计JITAI，整合日常患者风险数据，以适应和提供真实的干预组件- 在患者的日常生活中。这项研究意义重大，因为它针对的是一个新指定的健康 美国国立卫生研究院研究的差异人口（MSM）生活在一个大都市地区，艾滋病毒诊断率最高， 国家艾滋病毒/艾滋病战略的目标，即减少艾滋病毒感染者之间的差距， 高危人群，包括拉丁美洲人、男男性接触者和居住在美国南部的人。此外，研究 将为我提供知识、专业知识和研究成果，以开展我的独立研究生涯 并成功提交R系列赠款，以设计，实施和检查高度创新的 和个性化的JITAI，将使用EMA/GPS技术来适应ART依从性的变化障碍。

Project Summary/ Abstract Candidate: My long-term career goal is to be an independently funded scientist committed to the elimination of HIV/AIDS and substance use care and treatment disparities among Latino sexual minorities. The immediate and overarching goal of this proposal is to become equipped with innovative tools to examine the role of momentary-state substance use and psychosocial factors, and activity spaces, on antiretroviral therapy (ART) adherence among young Latino men who have sex with men (YLMSM) with HIV and gain foundational knowledge in the design of Just-In-Time Adaptive Interventions (JITAI). Career development plan: I require mentored training in 4 areas to reach my research and career objectives: 1) Latino sexual minority health and research issues; 2) clinical care and treatment of HIV and its syndemics; 3) Ecological Momentary Assessment (EMA) and Global Positioning System (GPS) technology; and 4) design of EMI and JITAI. The training and research plan will be guided by a team of experts: Drs. Trepka (HIV care and treatment; human subject research), Muñoz-Laboy (sexual minority health), Devieux (intervention development), and Duncan (EMA; GPS). Environment: Florida International University (FIU) has a distinguished record of HIV and health disparity research and thus provides an intellectually rich environment for the proposed training and research. In addition to extensive physical resources, I will have access and exposure to expert researchers at the Center for Substance Use and HIV/AIDS Research on Latinos in the US and FIU’s Health Disparities Initiative (HDI). Research Project: The proposed study has two primary objectives. First, we will determine the role of momentary-state substance use and psychosocial factors and the activity spaces where ART occurs on ART adherence among YLMSM living with HIV. Second, we will assess the effect of frequent and repeated measures of ART adherence as a potential intervention for YLMSM and explore the acceptability of a related JITAI. To accomplish our objectives, we propose to implement an EMA/GPS study among 75 YLMSM ages 18-34 in Miami, Florida. The proposed innovative study will be the first to assess how daily changes in substance use, psychosocial factors, and activity spaces impact ART adherence. This information is critical to design JITAI that integrate daily patient-level risk data to adapt and deliver intervention components in real- time during patient’s everyday life. The study is significant because it targets a newly designated health disparity population for NIH research (MSM) living in a metropolitan area with the highest HIV diagnosis rate in the nation, thereby supporting the National HIV/AIDS Strategy objectives of reducing HIV disparities in populations at high risk, including Latinos, MSM, and persons living in the Southern US. In addition, the study will provide me with knowledge, expertise, and research findings to launch my independent research career and successfully submit an R-series grant to design, implement and examine the efficacy of a highly innovative and individualized JITAI that will use EMA/GPS technology to adapt to shifting barriers of ART adherence.