Making space for HIV prevention: substance use among Latinx MSM in LA hotspots

摘要 与男性发生性关系的拉丁裔男子（MSM）构成了一个面临高风险的社区， 严重的负面个人和公共卫生后果，包括物质使用，艾滋病毒和COVID-19 疫情和社区服务严重不足我们建议深入研究， 定性访谈，心理因素和社会空间，可能有助于物质的使用， 拉丁裔男男性行为者中艾滋病毒感染率较高。这项工作将补充我们的父母赠款，旨在确定和 优先考虑城市、拉丁裔和黑人男性中艾滋病毒风险和药物使用的地理热点， 与男子我们的工作直接涉及种族和性别少数男性的健康公平问题， 重要的原因是：a）瞄准风险热点是“结束艾滋病毒流行”倡议的一个关键优先事项，以及B） 个性化的公共卫生，通常发生在不同的地点，而不是传统的卫生设施内， 社区，是提供适当的艾滋病毒预防，护理和治疗的有效途径。本补充 建议，我们解决了一个潜在的限制，有效的差异化服务提供，如同行驱动 减少危害干预措施，在我们的艾滋病毒风险热点，特别是拉丁美洲男男性行为者;也就是说，这些将 干预措施对那些与社会隔离的吸毒者有效吗？ 为了实现我们的目标，我们将对40名年龄在18-40岁之间的拉丁裔男男性接触者进行抽样调查， 活动空间研究，一项利用NIDA资助的mSTUDY的研究。我们的具体目标是：1） 识别和了解COVID-19期间的心理健康因素（例如，孤独，心理的 苦恼）和社会网络因素（例如，社会隔离、稀疏社交网络）激活或放大 艾滋病毒风险热点地区的药物使用;以及2）评估区分风险的可接受性和可行性- 在2019冠状病毒病大流行的背景下，对使用药物的拉丁裔男男性行为者采取减少干预措施。的 这项工作的目标导向成果将是关于如何最好地优先考虑降低风险的额外知识 在医疗机构以外的拉丁裔社区进行干预。数据将告知发展 以社区为基础的预防和临床干预措施，其中包括关键的心理问题， 与COVID-19大流行相关的独特挑战，因此将对 拉丁裔男男性接触者

Abstract Latino men who have sex with men (MSM) comprise a community that faces elevated risk for disparately negative personal and public health outcomes, including substance use, HIV, and COVID-19 syndemics, and a commuity that remains severely underserved. We propose to examine, in-depth using qualitative interviews, the psychological factors and social spaces that may contribute to substance use and higher rates of HIV among Latinx MSM. This work will supplement our parent grant, which aims to identify and prioritize geographic HIV risk and substance use hotspots among urban, Latinx and Black men who have sex with men. Our work directly engages with issues of health equity among racial and sexual minority men, and is significant because a) targeting risk hotspots is a key priority in the “Ending the HIV Epidemic” initiative, and b) personalized public health, often occurring in different venues other than traditional health facilities within the community, is an effective way to deliver appropriate HIV prevention, care, and treatment. In this supplemental proposal, we address a potential limitation to effective differentiated service delivery, such as peer-driven harm-reduction interventions, in our HIV risk hotspots specifically among Latinx MSM; namely, would these interventions work with socially-isolated individuals who engage in substance use? To achieve our goals, we will sample 40 Latino MSM aged 18-40 who previously participated in our Activity Space research, a study that leverages the NIDA-funded mSTUDY. Our specific aims are: 1) To identify and understand how psychological health factors during COVID-19 (e.g., loneliness, psychological distress) and social network factors (e.g., social isolation, sparse social networks) activate or amplify substance use in HIV risk hotspots; and 2) To assess the acceptability and feasibility of differentiated risk- reduction interventions among Latinx MSM who use substances in the context of the COVID-19 pandemic. The goal-oriented outcome of this work will be additional knowledge on how to best prioritize risk-reduction interventions in Latinx communities outside of healthcare settings. Data will inform the development of community-based prevention and clinical interventions that incorporate key psychological issues, including unique challenges associated with the COVID-19 pandemic, and will therefore have a stronger impact among Latino MSM.