Addressing Economic Marginalization to Improve HIV Prevention and Care Outcomes Among Gender Minorities in the United States

解决经济边缘化问题，改善美国性别少数群体的艾滋病毒预防和护理成果

• 批准号: 10484207
• 负责人: Emily Allen Paine
• 金额: $ 18.13万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10484207
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Area; Black race; COVID-19; Caring; Communities; Data; Data Analyses; Development; Disadvantaged; Economic Factors; Economically Deprived Population; Economics; Educational workshop; Employment; Epidemic; Exposure to; Face; Gender; General Population; Generations; Goals; HIV; HIV Seronegativity; HIV risk; Health; Health Priorities; Homelessness; Housing; Human immunodeficiency virus test; Income; Individual; Inequality; Infrastructure; Institutes; Intervention; Interview; K-Series Research Career Programs; Knowledge; Medical; Mentorship; Methods; Minority Access; Minority Groups; National Institute of Mental Health; New York; New York City; Outcome; Pathway interactions; Personal Satisfaction; Persons; Pilot Projects; Population; Poverty; Prevalence; Process; Protocols documentation; Race; Reading; Research; Research Design; Research Personnel; Research Priority; Resources; Risk; Risk Behaviors; San Francisco; Science; Scientific Advances and Accomplishments; Sexual and Gender Minorities; Shapes; Shoulder; Social Behavior; Stigmatization; Surveys; Target Populations; Testing; Training; Training Support; Unemployment; United States; United States National Institutes of Health; Universities; Viral; Waiting Lists; Work; acceptability and feasibility; base; care outcomes; care systems; career; community based participatory research; community engagement; coronavirus disease; data integration; design; effective intervention; empowerment; experience; financial literacy; food insecurity; gender minority; gender minority group; hands on research; health disparity populations; high risk; high risk sexual behavior; improved; innovation; member; men; novel; pilot test; prevention service; secondary analysis; sex; sexual relationship; skills; social; social exclusion; social factors; social inequality; social structure; theories; transgender; transgender women; urban area

7. PROJECT ABSTRACT The purpose of this career development award is to provide the candidate with the training necessary to become an independent investigator 1) advancing scientific knowledge about how social and economic factors are shaping HIV risk and outcomes among marginalized, priority health disparity populations, and 2) designing effective interventions that reduce HIV prevalence and improve health and well-being within sexual and gender minority populations. Research Aims Transgender and nonbinary people experience significant economic hardships and disproportionately shoulder the burden of the HIV/AIDS epidemic in the United States. Guided by an integrated asset theory and social ecological framework, and using a multistage mixed methods approach, the candidate plans to conduct community-based paticipatory formative research necessary to inform the adaptation of an economic empowerment intervention to improve HIV prevention and care outcomes among transgender and nonbinary people who have sex with men (TGSM) in the U.S. First, the PI will establish a robust Community Collaborative Board (CCB) comprised of key members of the target populations. With the CCB and under the guidance of the mentorship team, the PI will finalize study design and protocol, informed by current pilot study findings. Next, the PI will undertake quantitative (surveys, N=390) and qualitative (interviews, n=36) research to achieve Aim 1: to estimate and qualitatively describe how co-occurring forms of economic hardship, defined as economic marginality, are associated with HIV outcomes among TGSM. Integrated Aim 1 findings and CCB guidance will inform study Aim 2: adaptation of an HIV economic empowerment intervention for economically marginalized TGSM in the U.S. After adapting the intervention, Aim 3 is: to assess acceptability and feasibility of the adapted intervention and generate preliminary data to inform an R01 application by pilot testing with 42 TGSM using a waitlist control design, then refining the intervention with the CCB. The proposed research builds from the infrastructure and community ties developed by Project AFFIRM (R01HD079603/ R01HL151559A1; PI: Bockting) in New York City, San Francisco, and Atlanta and furthers the NIH HIV strategic goal to “advance innovative research to identify and implement effective strategies to mitigate underlying HIV- associated medical and social inequalities that diminish the health and well-being of persons living with or at risk for HIV.”1,p.12 This research is designed to support the training goals of the PI. Training Goals To become an independent investigator, the candidate requires additional training in four core areas: community-based participatory research; asset theory; quantitative methods; and how to adapt, test, assess, and refine socio- behavioral interventions to improve HIV outcomes among key populations. Hosted by The HIV Center at Columbia University and New York State Psychiatric Institute, the candidate will engage in close mentorship, coursework, directed readings, workshops, workgroups, and hands-on research to achieve these training goals.

7.项目摘要 该职业发展奖的目的是为应聘者提供必要的培训，使其成为 独立调查者1)提高关于社会和经济因素是如何 在边缘化的优先健康差距人群中塑造艾滋病毒风险和结果，以及2)设计 有效的干预措施，降低艾滋病毒感染率，改善性和性别方面的健康和福祉 少数族裔人口。研究目的是跨性别者和非双性恋者经历重大的经济 在美国，我们面临许多困难，不成比例地背负着艾滋病毒/艾滋病流行病的重担。指导原则 综合资产理论和社会生态框架，并使用多阶段混合方法方法， 候选人计划进行以社区为基础的参与性形成性研究，以告知 调整经济赋权干预措施，以改善艾滋病毒预防和护理成果 美国跨性别者和非双性恋者与男性发生性关系(TGSM)。首先，PI将建立一个强大的 由目标人群的关键成员组成的社区合作委员会(CCB)。与中国建设银行和 在指导小组的指导下，PI将根据当前的情况最终确定研究设计和方案 初步研究结果。接下来，PI将进行定量(调查，N=390)和定性(访谈，n=36) 为实现目标1而进行的研究：估计和定性描述经济困难的共生形式， 被定义为经济边缘的，与TGSM中的艾滋病毒结果有关。综合AIM 1调查结果 CCB的指导将告知研究目标2：适应艾滋病毒经济赋权干预措施 美国在经济上被边缘化的TGSM。调整干预措施后，目标3是：评估可接受性 以及适配干预的可行性，并生成初步数据以通知飞行员的R01应用 使用等待列表控制设计对42个TGSM进行测试，然后与建行改进干预措施。建议数 研究建立在项目确认开发的基础设施和社区联系上(R01HD079603/ R01HL151559A1；PI：Bockting)在纽约市、旧金山和亚特兰大，并进一步推动NIH艾滋病毒战略 目标是“推进创新研究，以确定和实施有效的战略，以减轻潜在的艾滋病毒-- 与之相关的医疗和社会不平等，降低了与人同住或处于危险之中的人的健康和福祉 这项研究的目的是为了支持PI的培训目标。培养目标成为一名 作为独立调查员，候选人需要在四个核心领域进行额外培训：以社区为基础 参与性研究；资产理论；量化方法；以及如何适应、测试、评估和完善社会 行为干预，以改善关键人群中的艾滋病毒结果。由艾滋病毒中心主办，地址为 哥伦比亚大学和纽约州精神病研究所，候选人将进行密切的指导， 通过课程作业、定向阅读、研讨会、工作组和实践研究来实现这些培训目标。