A community-based intervention to increase PrEP initiation among Black sexual minority men in Prince George's County, Maryland: Reducing internalized stigma and increasing social support

以社区为基础的干预措施，以提高马里兰州乔治王子县黑人性少数男性的 PrEP 启动率：减少内在耻辱并增加社会支持

• 批准号: 10400394
• 负责人: Rodman Emory Turpin
• 金额: $ 8.63万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-08 至 2022-08-23
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10400394
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Area; Behavior; Bisexual; Black Populations; Black race; Centers for Disease Control and Prevention (U.S.); Church; Collaborations; Collection; Communication; Communities; County; Data; Data Analyses; Development; Drops; Economics; Epidemic; Ethnography; Evaluation; Event; Evidence based intervention; Funding; Future; Gays; Geography; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; HIV/STD; Homophobia; Improve Access; Incidence; Income; Interdisciplinary Study; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Lead; Literature; Maryland; Mentors; Methods; Modeling; Observational Study; Outcome; Participant; Pathway Analysis; Population; Prevalence; Prevention; Research; Research Ethics; Research Personnel; Research Project Grants; Resources; Respondent; Risk; Risk Behaviors; Sampling; Science; Site; Social support; Testing; Time; Training; Training and Education; United States; Ursidae Family; Washington; base; black men who have sex with men; career; career development; community intervention; design; ethnographic method; experience; falls; improved; innovation; internalized stigma; metropolitan; peer; peer support; pilot test; pre-exposure prophylaxis; programs; racism; recruit; research and development; resilience; rural setting; sexual minority men; skill acquisition; skills; social; social determinants; social stigma; social structure; suburb; therapy design; uptake

ABSTRACT My goal in pursuing a Mentored Research Career Development Award is to gain the necessary training, knowledge, and practical experience needed to become an independent investigator focused on improving access to and utilization of PrEP among Black men who have sex with men (BSMM) through social, peer- based intervention research. To continue my progress towards my career goals, I propose to conduct an intervention focused on increasing PrEP acceptability through developing and maintaining peer support and resilience to intersectional racism and homophobia among BSMM in Prince George’s County, MD. Despite a clear, well-documented need for greater uptake of PrEP among BSMM in this county, PrEP uptake among BSMM in this setting remains low, and extant literature specific to PrEP use in this setting and population is extremely limited. To address this need, I propose the following: Specific Aims: 1) Understand peer-peer interactions/exchanges and HIV prevention communications among BSMM through ethnographic qualitative observations (participant and direct) of two ongoing MPowerment models, 2) conduct qualitative in depth interviews to inform designing an intervention to reduce internalized racism, internalized homophobia and increase PrEP initiation among BSMM in PG County, and 3) pilot test a community-based intervention (130 participants) to reduce internalized racism, internalized homophobia, and HIV stigma and increase social support and PrEP initiation among BSMM in PG County, based on the MPowerment model. In addition to my specific aims, my Specific Career Development Aims are the following: 1) To develop expertise in the analysis of qualitative data, particularly related to social and structural factors, 2) to develop expertise in the collection and analysis of network data collected via respondent driven sampling, 3) to gain experience in the design, conduct, and evaluation of interventions and 4) to develop research management and professional development skills needed to lead future independent research projects. The knowledge and experience gained from the proposed research will provide me the skillset necessary to successfully compete for R01 funding to conduct a larger scale peer-focused intervention to promote PrEP acceptability and adherence among BSMM. The proposal makes significant contributions to the field in several ways, including 1) identifying barriers to PrEP acceptability among BSMM in Prince George’s County, 2) Qualitatively understand factors that may impact observed quantitative associations between barriers and PrEP use and acceptability, and 3) developing and evaluating an MPowerment intervention to improve PrEP use and acceptability in this population. My rigorous education, training, and research experience in social determinants of HIV/STI risk, collaborations with BSMM populations and organizations, proficiency with quantitative data analysis, and the expertise of my multidisciplinary research team, uniquely prepares me to conduct the proposed research and significantly contribute to HIV prevention science.

摘要 我追求导师研究职业发展奖的目标是获得必要的培训， 知识和实践经验，成为一名专注于提高 获得和利用PrEP的黑人男子谁与男子发生性关系（BSMM）通过社会，同伴， 基于干预研究。为了继续实现我的职业目标，我建议进行一次 干预措施的重点是通过发展和维持同伴支持来提高PrEP的可接受性， 在马里兰州乔治王子县的BSMM中，对交叉种族主义和同性恋恐惧症的恢复力。尽管 明确的，有据可查的需要更大的吸收PrEP之间的BSMM在这个县，PrEP吸收之间 在这种情况下，BSMM仍然很低，并且在这种情况下和人群中使用PrEP的现有文献 极其有限。为了满足这一需求，我提出以下建议：具体目标：1）理解对等 通过人种学定性研究，在BSMM之间进行互动/交流和艾滋病毒预防交流 两个正在进行的MPowerment模型的观察（参与者和直接），2）深入进行定性 访谈，为设计干预措施提供信息，以减少内化的种族主义、内化的同性恋恐惧症和 在PG县BSMM中增加PrEP启动，和3）试点测试基于社区的干预（130 减少内化的种族主义、内化的同性恋恐惧症和艾滋病毒污名， 在PG县BSMM之间的支持和PrEP启动，基于MPowerment模型。 除了我的具体目标外，我的具体职业发展目标如下： 发展分析定性数据的专门知识，特别是与社会和结构因素有关的数据，2） 发展收集和分析通过受访者驱动的抽样收集的网络数据的专业知识，3） 在干预措施的设计、实施和评估方面获得经验; 4）开展研究 领导未来独立研究项目所需的管理和专业发展技能。的 从拟议的研究中获得的知识和经验将为我提供必要的技能， 成功竞争R 01资金，以进行更大规模的以同伴为中心的干预，以促进PrEP BSMM的可接受性和遵守性。该提案在几个方面对该领域做出了重大贡献 方法，包括1）确定乔治王子县BSMM中PrEP可接受性的障碍，2） 质量管理人员了解可能影响障碍之间观察到的定量关联的因素， PrEP的使用和可接受性，以及3）开发和评估MPowerment干预措施以改善PrEP 在这一人群中的使用和可接受性。我严格的教育，培训和研究经验，在社会 艾滋病毒/性传播感染风险的决定因素，与BSMM人群和组织的合作， 定量数据分析和我的多学科研究团队的专业知识，使我做好了独特的准备， 开展拟议的研究，并为艾滋病毒预防科学做出重大贡献。