Jamaica CARES Project: Connecting HIV/AIDS Resources to Engage Jamaican Sexual and Gender Minorities

牙买加 CARES 项目：连接艾滋病毒/艾滋病资源以吸引牙买加性少数群体

• 批准号: 10480973
• 负责人: Orlando Omar Harris
• 金额: $ 20.12万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10480973
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Advocacy; Affect; Anti-Retroviral Agents; Anxiety; Appointment; Automobile Driving; Behavior Therapy; Caribbean region; Caring; Clinic; Clinical; Communities; Complex; Consult; Cross-Sectional Studies; Data; Development; Discrimination; Drops; Educational workshop; Epidemic; Evaluation; Feedback; Focus Groups; Foundations; Gender; General Population; Goals; Grant; HIV; HIV Infections; Health; Health Personnel; Health behavior change; High Prevalence; Homo; Human Rights; Immunologics; Individual; Intervention; Intervention Trial; Interview; Jamaica; Jamaican; K-Series Research Career Programs; Knowledge; Laws; Measurement; Measures; Medical; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Modeling; Nurses; Outcome; Participant; Pathway interactions; Patient Self-Report; Personal Satisfaction; Persons; Policies; Population; Positioning Attribute; Prevalence; Prevention; Property; Provider; Psychologist; Psychology; Psychometrics; Randomized; Reading; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Resource-limited setting; Resources; Risk; Same-sex; Scientist; Services; Sex Behavior; Sexual Health; Sexual and Gender Minorities; Sexuality; Social Workers; Surveys; Sustainable Development; Symptoms; System; Target Populations; Testing; Theory of Change; Time; Training; Training Activity; Trauma; Treatment outcome; United Nations; United States; Violence; Viral; Viral Load result; acceptability and feasibility; base; care outcomes; clinical research site; cognitive interview; design; experience; feasibility testing; formative assessment; global health; health disparity; implementation barriers; implementation facilitators; improved; indexing; innovation; insight; instrument; intersectionality; intervention mapping; longitudinal analysis; low and middle-income countries; male; meetings; men who have sex with men; patient health information; perceived discrimination; pilot test; prevention service; programs; public health relevance; racism; randomized trial; skills; social health determinants; social stigma; social structure; sodomy; success; theories; therapy design; therapy development; transgender women; transphobia; treatment services

PROJECT SUMMARY/ABSTRACT Jamaica’s HIV/AIDS epidemic among sexual and gender minorities is the most severe in the Caribbean in terms of its breadth and consequences. HIV prevalence among men who have sex with men is estimated at 33% and 51% among transgender women, which is significantly higher than the 1.8% observe in the general population. Intersectional stigma (often related to intersecting identities) and violence are key drivers of poor mental health and HIV care engagement, leading to higher rates of depression, anxiety, and low viral suppression (21%). The goals of the proposed research are to 1) gain and understanding of the influences and mechanisms by which intersectional stigma and violence impact mental health and engagement in HIV care; and 2) refine our conceptual framework to aid in intervention development that assists sexual and gender minorities to engage in HIV care. Candidate: I am a nurse-scientist with a background in health behavior change theory and social determinants of health in the context of HIV. I am applying for a K23 Career Development Award to obtain training, mentorship, and research experience to become an expert and independent investigator in theory-based, behavioral intervention design to improve the health of sexual and gender minorities in the Caribbean and in other low-resource settings. Mentoring: I have put together an exceptional mentoring team with extensive experience in intersectional stigma measurement research, mental health, and HIV treatment and prevention in resource-limited settings like Jamaica. Drs. Sheri Weiser and Carol Dawson-Rose will serve as co-Primary mentors and bring complementary expertise in HIV treatment and prevention, trauma, conceptual model framework refinement, and development and implementation of behavioral interventions in resource-limited settings. My co-mentors, scientific advisor, and collaborator round out my team to bring specific content and methods expertise and are based both in the United States and Jamaica, including: Dr. Mallory Johnson (clinical psychologist, intervention design and evaluation; feasibility implementation, ART adherence); Dr. Tor Neilands (psychology, quantitative methods, design and analysis of longitudinal data); Dr. Sharlene Jarrett (clinical psychologist, mental health and HIV treatment in the Jamaican context); Carmen Logie (clinical social worker, intersectionality and mixed methods research); Dr. Jae Sevelius (clinical psychologist, intersectional stigma measurements, cognitive interviewing, and gender affirmation); Dr. Anita Stewart (psychologist, measurement adaptation and testing expert); and Dr. Mark Padilla (medical anthropologist, Caribbean sexualities researcher). Training: I propose to obtain training in acquiring foundational knowledge in measures of intersectional stigma (adaptation and testing), advanced quantitative training to collect and analysis skills, and to attain expertise in developing, piloting, and evaluating HIV behavioral interventions. Training will be achieved through mentoring meetings, coursework, workshops, mentored direct readings and primary research in Jamaica. Research: The goals of the proposed research are to 1) identify the pathways between intersectional stigma, violence, mental health and HIV care engagement among Jamaican sexual and gender minorities living with HIV; 2) develop and manualize a multi-level intervention that addresses intersectional stigma, violence, and poor mental health in order to optimize HIV care engagement among Jamaican sexual and gender minorities living with HIV; and 3) pilot test the multi- level intervention for acceptability and feasibility among sexual and gender minorities living with HIV and their healthcare provider. We will plan for a full-scale testing of the intervention in a planned R01 submission in year 5. Summary: The recently announced Ending the HIV Epidemic (EtHE) by the DHHS and under Sustainable Development Goal 3 of the United Nations Program on HIV/AIDS highlight the pressing need for research to address disparities among SGM and other key populations in the quest to halt HIV infections globally by 2030. The proposed research and training activities will position me to conduct innovative, high-impact research to address intersectional stigma, violence and mental health among SGM living with HIV in low-resource settings to improve HIV treatment engagement.

项目总结/文摘