Using Longitudinal Research to Engage African American and Latinx Sexual- and Gender-Minority Youth in the HIV Prevention and Care Continua and Reduce HIV/AIDS-Related Disparities

利用纵向研究让非裔美国人和拉丁裔性少数群体青年参与艾滋病毒预防和护理工作并减少与艾滋病毒/艾滋病相关的差距

• 批准号: 10426196
• 负责人: Jeremy Thomas Goldbach
• 金额: $ 284.74万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10426196
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adherence; Administrative Supplement; African American; Age; Age-Years; Award; Awareness; Black American; Caring; Collaborations; Color; Data; Data Collection; Development; Disease Progression; Drug Screening; Drug usage; Epidemic; Fright; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; Health; Healthcare; Immigration; Infection; Interview; Latino; Latinx; Los Angeles; Major Depressive Disorder; Mental Health; Mental disorders; Methods; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Pediatric Hospitals; Pharmaceutical Preparations; Plasma; Policy Maker; Population; Populations at Risk; Process; Quality of life; Reporting; Research; Research Methodology; Research Personnel; Resources; Risk; Sexual and Gender Minority Youth; Sexually Transmitted Diseases; Surveys; Swab; Testing; Time; Work; Youth; anxious; barrier to care; care systems; cohort; community organizations; comorbidity; drug testing; early childhood; early-career faculty; experience; follow-up; food insecurity; gender minority youth; gender nonconforming; high risk; improved; infection risk; innovation; interest; marijuana use; men; men of color; multi-racial; pre-exposure prophylaxis; prevent; prevention service; psychiatric comorbidity; racial and ethnic; recruit; rectal; retention rate; sexual HIV transmission; social stigma; stem; transgender; translational pipeline; transmission process; uptake; young adult; young man; young men who have sex with men

The U.S. has set a goal to end the HIV epidemic by the year 2030, which can be achieved but only if targeted approaches are implemented with at-risk populations to address known barriers of engagement along the HIV prevention and care continua. Populations of greatest concern include young men who have sex with men (YMSM), especially YMSM of color, who now account for the vast majority of new HIV infections each year. Transgender and gender non-conforming/non-binary youth are also at high risk for HIV acquisition, accounting for an increasing proportion of new infections each year. In 2015, we were awarded a grant from NIDA to establish a new cohort of 448 African American/Black (AA/B) and Latino YMSM, called the Healthy Young Men’s (HYM) Cohort. We also received an administrative supplement to collect two waves of data from a smaller cohort of B/AA and Latinx 108 transgender and gender nonconforming/non-binary youth (TGMY), called the TRUTH Cohort. Both HYM and TRUTH participants were 16 to 24 years of age at the time of recruitment. The overarching aim was to conduct longitudinal research focused on these youths’ engagement in the HIV prevention and care continua in an effort to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities. Mixed methods research is conducted using qualitative interviews, a self- report survey, drug screening, and testing for sexually transmitted infections (STIs) and HIV. Biospecimens (plasma, buffy coat, rectal swabs) are also collected and banked. Analyses performed to date provide clear evidence that participants in both cohorts are at high risk for HIV, drug use, and mental health/psychiatric conditions. Intersectional stigma—i.e., experiences of stigma stemming from multiple, intersecting identities1- 5—also appears to discourage AA/B and Latinx YMSM and TGMY from engaging in care and perhaps may impact their developmental arcs of risk, transmission, and health. Building on this work, we are proposing to longitudinally: i) examine B/L-YMSM’s engagement in the HIV prevention and care continua, as well as their developmental transitions and trajectories in drug use, STI/HIV infection, health, and psychiatric/mental health comorbidities (Aim 1); ii) examine TGMY’s engagement in the HIV prevention and care continua and identify shared and unique transitions and trajectories with respect to TGMY’s use of drugs, infections with STI/HIV, health and psychiatric/mental health comorbidities (Aim 2); and iii) serve as a local and national resource for collaborations and dissemination. We will actively participate in and contribute to the Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO), the Coordinating Center for NIDA’s U01 cohorts. We will also partner with key stakeholders (e.g., community organizations, policy makers) and collaborate with trainees, early career faculty and investigators across the translational spectrum (Aim 3).

美国已经制定了到2030年结束艾滋病毒流行的目标，这是可以实现的，但前提是有针对性 在高危人群中实施方法，以解决艾滋病毒感染过程中已知的接触障碍 预防和护理连续不断。最令人担忧的人群包括与男性发生性关系的年轻男性 基督教青年会(YMSM)，特别是有色人种的YMSM，现在占每年新增艾滋病毒感染的绝大多数。 变性人和性别不符/非双性恋的年轻人感染艾滋病毒的风险也很高 每年新感染的比例都在增加。2015年，我们获得了NIDA的拨款，以 建立一个由448名非裔美国人/黑人(AA/B)和拉丁裔YMSM组成的新队列，称为Healthy Young 男子(Hym)队。我们还收到了一份行政补充资料，用于从 B/AA和Latinx 108变性人和性别不一致/非二元青年(TGMY)的较小队列， 被称为真相队列。HYM和TRUE参与者的年龄都在16岁到24岁之间 招聘。总体目标是对这些年轻人的参与度进行纵向研究 在艾滋病毒预防和护理方面，努力预防新的艾滋病毒感染，减少传播，以及 减少与艾滋病毒/艾滋病有关的差距。混合方法研究采用定性访谈进行，自我调查 报告调查、药物筛查和性传播感染(STI)和艾滋病毒检测。生物旋毛虫 (血浆、棕黄色大衣、直肠拭子)也被收集和储存。到目前为止执行的分析提供了明确的 有证据表明，两组参与者都有感染艾滋病毒、吸毒和精神健康/精神疾病的高风险 条件。柱头相交--即柱头起源于多个相交的鉴定1- 5-似乎还会阻止AA/B和Latinx YMSM和TGMY从事护理工作，可能还会 影响他们的风险、传播和健康的发展弧线。在这项工作的基础上，我们提议 纵向：i)审查B/L-基督教青年会参与艾滋病毒预防和护理的情况以及他们 药物使用、性传播感染/艾滋病毒感染、健康和精神/精神健康的发展转变和轨迹 合并症(目标1)；二)审查TGMY在艾滋病毒预防和护理方面的参与，并确定 TGMY的药物使用、性传播感染/艾滋病毒感染、 健康和精神/精神健康合并症(目标2)；和三)作为地方和国家资源 合作和传播。我们将积极参与并为合作联盟做出贡献 产生NIDA机会的队列(C3PNO)，NIDA的U01队列协调中心。我们会 还与关键利益攸关方(例如，社区组织、政策制定者)合作，并与 翻译领域的实习生、早期职业教师和研究人员(目标3)。