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

项目摘要/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 艾滋病毒/艾滋病和物质使用、护理和治疗在拉丁裔性少数群体中的差异。最直接的 这项提案的首要目标是配备创新的工具来检查 关于抗逆转录病毒治疗的瞬时状态物质使用和心理社会因素，以及活动空间(ART) 感染艾滋病毒的年轻拉丁裔男男性行为者(YLMSM)的依从性并获得基础 掌握即时适应性干预(JITAI)的设计知识。职业发展计划：我要求 在4个领域进行指导培训，以实现我的研究和职业目标：1)拉美裔少数族裔性健康和 研究问题；2)艾滋病毒及其综合征的临床护理和治疗；3)生态瞬时评估 EMA和全球定位系统(GPS)技术；4)EMI和吉泰的设计。培训和 研究计划将由一个专家团队指导：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Duncan(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卓越的记录 因此，它为拟议的培训和研究提供了一个智力丰富的环境。 除了丰富的物质资源外，我还将有机会接触到 美国拉丁裔药物使用和艾滋病毒/艾滋病研究中心和FIU的健康差异倡议 (HDI)。研究项目：拟议的研究有两个主要目标。首先，我们将确定 瞬间状态的物质使用和心理社会因素以及艺术产生的活动空间 青年男性接触者HIV感染者的依从性。第二，我们将评估频繁和重复的影响 青壮年男男性接触者抗逆转录病毒治疗依从性评价及相关可接受性研究 吉太。为了实现我们的目标，我们建议在75名青年男女青年中进行一项EMA/GPS研究 佛罗里达州迈阿密，18胜34负。这项拟议的创新研究将是第一个评估日常变化如何 物质使用、心理社会因素和活动空间会影响艺术的坚持。这一信息对于 设计集成日常患者级别风险数据的JITAI，以适应并实时提供干预组件 患者日常生活中的时间。这项研究意义重大，因为它针对的是一种新指定的健康 美国国立卫生研究院研究(MSM)的不同人群生活在艾滋病毒诊断率最高的大都市地区 国家，从而支持在#年减少艾滋病毒差距的国家艾滋病毒/艾滋病战略目标 高危人群，包括拉丁裔、男男性接触者和生活在美国南部的人。此外，这项研究还 将为我提供知识、专业知识和研究成果，以启动我的独立研究生涯 并成功提交R系列拨款，以设计、实施和检查高度创新的 以及个性化的吉泰，将使用EMA/GPS技术来适应不断变化的艺术坚持障碍。

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.