Understanding Viral Suppression for Newly Diagnosed HIV+ Men to Inform Implementation of TasP and U=U

了解新诊断的 HIV 男性的病毒抑制，为 TasP 和 U=U 的实施提供信息

• 批准号: 10390620
• 负责人: H. Jonathon Rendina
• 金额: $ 79.46万
• 依托单位: WHITMAN-WALKER INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-24 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10390620
• 关键词: Address; Adherence; American; Back; Behavioral; Benefits and Risks; Biological; Bisexual; Blood; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Clinical Trials; Communities; Complement; Consensus; Continuity of Patient Care; Couples; Data Reporting; Development; Diagnosis; Drops; Early Intervention; Empirical Research; Enrollment; Ensure; Epidemic; Epidemiology; Event; Focus Groups; Funding; Future; Gays; General Population; Goals; Guidelines; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; Health; Home; Individual; Infection; Intervention; Interview; Language; Lead; Link; Location; Medical; Methods; Modeling; Monitor; Morbidity - disease rate; Movement; National Institute of Allergy and Infectious Disease; National Institute of Child Health and Human Development; National Institute of Mental Health; Nature; Newly Diagnosed; Outcome; Participant; Patient Self-Report; Patients; Pattern; Persons; Phase; Provider; Public Health; Research; Resistance; Resources; Risk; Role; Sampling; Series; Sex Behavior; Sexually Transmitted Diseases; Spottings; Structure; Study models; Surveys; Testing; Time; TimeLine; Translating; Treatment Efficacy; United States National Institutes of Health; Unsafe Sex; Viral; Viral Load result; antiretroviral therapy; base; care outcomes; cohort; critical period; design; efficacy validation; high risk; improved; improved outcome; indexing; insight; men; men who have sex with men; men' s group; mortality; phase 1 study; phase 2 study; provider-level barriers; psychosocial; recruit; resilience; routine practice; sexual HIV transmission; sexual minority; social; success; surveillance data; therapy adherence; therapy development; transmission process; treatment as prevention; treatment risk; virtual; working group

Project Summary Gay and bisexual men and other sexual minority men (SMM) in the U.S. are burdened by a high and disproportionate rate of HIV infection. Improving outcomes of the HIV Care Continuum through to maintaining viral load (VL) suppression is associated with a significant reduction in the sexual transmission of HIV and significantly better long-term health outcomes. However, little research provides insight into the preventable structural, psychosocial, and behavioral factors that influence VL suppression for the purposes of developing effective early intervention strategies. Moreover, the successful implementation of TasP and U=U messaging is a necessary component of the strategy to end the HIV epidemic, but rigorous research is needed to address the remaining concerns of providers and the general public to ensure their success. Specifically, Aim 1 of the study is to examine time to initial VL suppression and patterns in VL rebound to better understand the dynamic nature of VL suppression and use the Social Ecological Model to longitudinally investigate structural, psychosocial, and behavioral factors associated with VL suppression to better understand risk and resilience. Next, Aim 2 is to examine concordance between perceived and actual VL suppression status and their overlap with event-level sexual behaviors and STI infections to better understand any potential risks of TasP. Finally, Aim 3 will qualitatively examine provider barriers to implementing TasP and their insights into messaging U=U and will synthesize findings to develop resources for use by providers when discussing TasP and U=U. To do so, we will leverage the LITE cohorts to recruit 250 GBMSM diagnosed with HIV during the course of the studies—we will follow these men for two years after diagnosis, collecting home-based dried blood spot for VL on a monthly basis. In addition to self-reported data, the study will include objective indicators of adherence and care engagement and biological samples for viral load. The study will also include qualitative interviews with 50 randomly selected participants at baseline, 12-months and 24-months post-diagnosis to identify risk and resilience factors that can be used to guide future intervention development. Achieving the aims of the proposed study will provide key insights that will be critical for translating to or adapting interventions to enhance their potency and durability and improve the health of HIV-positive GBMSM.

项目摘要 在美国，同性恋和双性恋男性以及其他性少数男性（SMM）负担着高， 艾滋病毒感染率过高。通过维持艾滋病毒持续护理， 病毒载量（VL）抑制与HIV性传播的显著减少有关， 更好的长期健康结果。然而，很少有研究能够深入了解可预防的 结构，心理和行为因素，影响VL抑制的目的，发展 有效的早期干预策略。此外，TasP和U=U消息传递的成功实现是 这是结束艾滋病毒流行战略的必要组成部分，但需要进行严格的研究来解决 供应商和公众的其余关切，以确保其成功。具体而言， 本研究旨在检查初始VL抑制的时间和VL反弹的模式，以更好地了解动态 VL抑制的性质，并使用社会生态模型纵向调查结构， 与VL抑制相关的心理社会和行为因素，以更好地了解风险和弹性。 接下来，目标2是检查感知和实际VL抑制状态之间的一致性及其重叠 与事件层面的性行为和性传播感染进行比较，以更好地了解TasP的任何潜在风险。最后， 目标3将定性研究提供商实施TasP的障碍，以及他们对消息传递U=U的见解 并将综合研究结果，以开发资源，供供应商在讨论TasP和U=U时使用。做 因此，我们将利用LITE队列招募250名被诊断为HIV的GBMSM， 研究-我们将在诊断后随访这些人两年，收集家庭干血斑进行VL 按月除了自我报告的数据外，该研究还将包括依从性的客观指标 以及护理参与和病毒载量的生物样本。这项研究还将包括定性访谈 在基线、诊断后12个月和24个月随机选择50名参与者，以确定风险 和复原力因素，可用于指导未来的干预发展。实现联合国 拟议的研究将提供关键的见解，这些见解对于将干预措施转化为或调整为 增强其效力和持久性，并改善艾滋病毒阳性GBMSM的健康状况。