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/摘要 牙买加的艾滋病毒/艾滋病在性少数群体和性别少数群体中的流行是2005年加勒比地区最严重的。 它的广度和后果。据估计，男男性行为者的艾滋病毒感染率为 33%和51%的跨性别妇女，这是显着高于1.8%观察到的一般 人口交叉污名化（往往与交叉身份有关）和暴力是贫穷的主要驱动因素 心理健康和艾滋病毒护理参与，导致抑郁，焦虑和低病毒感染率的更高比率， 抑制（21%）。拟议研究的目标是1）获得和理解的影响， 交叉羞辱和暴力影响心理健康和参与艾滋病毒护理的机制; 和2）完善我们的概念框架，以帮助制定有助于性和性别的干预措施 少数群体参与艾滋病毒护理。应聘者：我是一名护士科学家，有健康行为学的背景 艾滋病毒背景下的健康变化理论和社会决定因素。我正在申请K23职业 发展奖，以获得培训，指导和研究经验，成为专家， 独立调查员在理论为基础的，行为干预设计，以改善健康的性和 在加勒比和其他资源匮乏的环境中，性别少数群体。导师：我已经把一个 杰出的指导团队，在跨部门的耻辱测量研究，心理 在牙买加这样资源有限的环境中，艾滋病毒的治疗和预防。Sheri Weiser博士和 卡罗尔·道森·罗斯将担任共同初级导师，并带来艾滋病毒治疗方面的补充专业知识， 预防，创伤，概念模型框架的完善，以及 在资源有限的环境中进行行为干预。我的共同导师，科学顾问和合作者 我的团队带来了具体的内容和方法的专业知识，并总部设在美国， 牙买加，包括：马洛里约翰逊博士（临床心理学家，干预设计和评价;可行性 Tor Neilands博士（心理学、定量方法、 Sharlene Jarrett博士（牙买加临床心理学家、心理健康和艾滋病毒治疗） 背景）; Carmen Logie（临床社会工作者，交叉性和混合方法研究）; Jae Sevelius博士 （临床心理学家，交叉污名测量，认知访谈和性别肯定）; Anita Stewart（心理学家、测量适应和测试专家）和Mark帕迪利亚博士（医学博士） 人类学家，加勒比性征研究员）。培训：我建议接受培训， 交叉污名措施的基础知识（适应和测试），高级定量 培训收集和分析技能，并获得开发、试点和评估艾滋病毒的专业知识 行为干预。培训将通过辅导会议、课程、讲习班， 在牙买加指导直接阅读和初步研究。研究：拟议研究的目标是 1）确定交叉污名，暴力，心理健康和艾滋病毒护理参与之间的途径 在牙买加感染艾滋病毒的性和性别少数群体中; 2）制定和手册化多层次的 干预，解决交叉污名，暴力和心理健康状况差，以优化艾滋病毒 牙买加感染艾滋病毒的性和性别少数群体的护理参与;以及3）试点测试多种 在感染艾滋病毒的性和性别少数群体中进行可接受性和可行性的水平干预， 医疗保健提供者。我们将计划在年内提交的R 01中对干预措施进行全面测试 5.摘要：最近宣布的结束艾滋病毒流行病（EtHE）由卫生和公众服务部和可持续发展 联合国艾滋病毒/艾滋病方案的发展目标3强调迫切需要进行研究， 解决SGM和其他关键人群之间的差距，以寻求到2030年在全球范围内遏制艾滋病毒感染。 拟议的研究和培训活动将使我能够进行创新的，高影响力的研究， 解决资源匮乏环境中感染艾滋病毒的SGM患者的交叉污名化、暴力和心理健康问题 改善艾滋病毒治疗的参与。