PrEP and substance use among sexual minority young adults

性少数年轻人的 PrEP 和药物使用

• 批准号: 10378071
• 负责人: Ryan J Watson
• 金额: $ 19.04万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10378071
• 关键词: AIDS prevention; Accounting; Address; Affect; African American; African American population; Alcohol consumption; Alcohols; Area; Attention; Bisexual; Caring; Characteristics; Civil Rights; Collaborations; Communities; Connecticut; Continuity of Patient Care; Data; Data Collection; Data Set; Disclosure; Drug usage; Enrollment; Epidemic; Ethnic Origin; Evidence based intervention; Fibrinogen; Foundations; Future; Geography; Goals; HIV; HIV Infections; HIV risk; Health; Heterosexuals; Hispanic; Human Rights; Incidence; Individual; Infection; Institution; Intervention; Interview; Investigation; Knowledge; Latino; Latino Population; Lesbian Gay Bisexual Transgender Queer; Maps; Marijuana; Measures; Mentorship; Minority; Modeling; New England; Outcome; Participant; Pattern; Persons; Pharmaceutical Preparations; Population; Prevention Research; Prevention program; Prevention strategy; Qualitative Methods; Race; Recording of previous events; Reporting; Request for Applications; Research; Research Personnel; Risk; Role; Sample Size; Sex Orientation; Sexuality; Societal Factors; Structure; Surveys; Time; Training; Universities; Victimization; Vulnerable Populations; Work; base; career; career development; cohort; community-level factor; contextual factors; disparity elimination; experience; follow-up; health disparity; high risk sexual behavior; male; member; men of color; minority stress; misuse of prescription only drugs; novel; novel strategies; pre-exposure prophylaxis; prescription opioid misuse; programs; sexual identity; sexual minority; sexual role; skill acquisition; social factors; substance use; substance use prevention; symposium; therapy development; tool; uptake; young adult; young men who have sex with men

This application requests support and training for a New/Early Stage Investigator in research independence to conduct HIV and substance use prevention research. The PI and mentorship team will explore sexual identity, sexual identity disclosure, and minority stress as it relates to pre-exposure prophylaxis (PrEP) linkage to care and substance use experiences among African American and Hispanic/Latino young men who have sex with men (AA/HL YMSM). Substance use compounds HIV risk and disrupts the PrEP care continuum. This proposal is focused on AA/HL YMSM because of the high incidence of HIV infection among these populations and disproportionately high rates of substance use. PrEP is a key approach to addressing the HIV epidemic, but uptake is unequal across populations at elevated risk for HIV. Furthermore, the PI has found that rates of substance use are increasing among sexual minority YMSM. Research has largely failed to consider the role of interpersonal, community, and societal factors that thwart PrEP uptake and exacerbate substance use among AA/HL YMSM. A robust training plan is proposed that includes three core areas for skill development: (1) HIV- related intervention development; (2) qualitative methods to gain in-depth understanding of perspectives and experiences of minorities with substance use; and (3) content expertise in HIV prevention, problem substance use, and minority stress. The plan involves a mentorship team of six HIV and substance use prevention scholars, individualized trainings, coursework, and professional conferences. Career goals include a subsequent R01 application and the creation of a sexuality-focused niche in HIV and substance use prevention. Career development will take place at the University of Connecticut in collaboration with leading institutions and centers in New England. Based on our preliminary work, we propose three studies that explore the role of sexual identity and disclosure in PrEP and substance use experiences across the PrEP care continuum. We will address three specific aims. Specific Aim 1: Informed by a minority stress model, evaluate PrEP uptake and substance use among YMSM in a national cohort. We will collect new national data (N = 3,000 18 to 29-year-old AA/HL YMSM) to evaluate how diverse interpersonal, community, and societal factors affect PrEP uptake and substance use. Specific Aim 2: Define the PrEP care continuum for YMSM with and without substance use (from Aim 1). We will do so via four biyearly follow-up surveys (N = 300) over 24 months from participants in areas of high HIV incidence. Specific Aim 3: Perform semi-structured interviews among YMSM for future sexuality-informed PrEP/SU interventions (N = 30). How multiple barriers are related to substance use and PrEP uptake will be explored. Additionally, using the ADAPT-ITT model and based on previous findings, the we will identify the modifiable characteristics among current interventions that can be applied to prevention programs targeting YMSM. This project has the potential to systematically address the lack of attention to sexuality in interventions that focus on high rates of HIV and substance use.

此应用程序要求支持和培训新/早期研究人员的研究独立性，以 开展艾滋病毒和药物使用预防研究。PI和导师团队将探索性身份， 性身份披露，以及与暴露前预防(PrEP)与护理联系有关的少数民族压力 非裔美国人和西班牙裔/拉丁裔年轻男性中与之发生性关系的药物使用经历 男性(AA/HL YMSM)。物质使用增加了艾滋病毒风险，并扰乱了PrEP护理的连续体。这 提案的重点是AA/HL YMSM，因为这些人群中艾滋病毒感染的发生率很高 以及不成比例的高药物使用率。准备工作是应对艾滋病毒流行的关键方法， 但在感染艾滋病毒风险较高的人群中，吸毒率并不平等。此外，PI还发现， 性少数YMSM的药物使用正在增加。研究在很大程度上没有考虑到 阻碍PrEP摄取和加剧物质使用的人际、社区和社会因素 AA/HL YMSM。提出了一个强有力的培训计划，其中包括技能发展的三个核心领域：(1)艾滋病毒-- 相关干预措施的发展；(2)定性方法，以深入了解观点和 少数民族在药物使用方面的经验；以及(3)艾滋病毒预防方面的内容专门知识，问题物质 使用，和少数族裔的压力。该计划包括一个由六人组成的艾滋病毒和药物使用预防指导小组 学者、个性化培训、课程作业和专业会议。职业目标包括 随后的R01申请和在艾滋病毒和药物使用中创建性取向的利基 预防。康涅狄格大学将与Leading合作进行职业发展 新英格兰的机构和中心。在前期工作的基础上，我们提出了三项研究，以探索 性认同和披露在PrEP和整个PrEP护理中的物质使用体验中的作用 连续体。我们将解决三个具体目标。具体目标1：受少数群体压力模型启发，评估 国家队列中青年男性接触者对PREP的摄取和物质使用。我们将收集新的国家数据 (n=3,000名18至29岁的AA/HL YMSM)，以评估人际、社区和社会的多样性 影响PrEP摄取和物质使用的因素。具体目标2：定义基督教青年会的PrEP护理连续体 以及不使用物质(来自目标1)。我们将通过在24个月内进行四次半年期跟踪调查(N=300)来实现这一目标 与艾滋病毒高发区的参与者相距数月。具体目标3：进行半结构化面谈 在男男性接触者中，对未来的性行为知晓PrEP/SU干预(N=30)。多个障碍如何相关 对物质使用和PrEP摄取进行探讨。此外，使用Adapt-ITT模型并基于 之前的发现，我们将确定当前干预措施中的可修改特征，这些特征可以 适用于针对YMSM的预防计划。该项目有可能系统地解决 在侧重于艾滋病毒高感染率和药物使用的干预措施中，缺乏对性的关注。