RP4 LEAP

RP4飞跃

• 批准号: 10595904
• 负责人: Lisa B Hightow-Weidman
• 金额: $ 92.17万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-25 至 2029-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595904
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Adolescent Medicine Trials Network; Adolescent and Young Adult; Age; Behavioral; Biological; Biological Markers; Black race; Caring; Clinic; Consultations; Continuity of Patient Care; Cost Effectiveness Analysis; Data; Development; Discrimination; Drops; Economics; Education; Effectiveness; Employment; Environment; Epidemic; Gender; Geography; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; HIV disparities; HIV risk; HIV/AIDS; Health; Healthcare; Heterogeneity; Homelessness; Housing; Human immunodeficiency virus test; Hybrids; Imprisonment; Income; Individual; Inequity; Intervention; Latinx; Lawyers; Leadership; Legal; Legal system; Link; Measures; Mediator; Mentors; Modeling; Names; Outcome; Participant; Patient Self-Report; Personal Satisfaction; Persons; Population; Race; Randomized; Recording of previous events; Research; Resources; Risk; Schools; Services; Sex Behavior; Site; System; Translations; Treatment outcome; Trust; United States; Viral; Viral Load result; Work; Youth; antiretroviral therapy; arm; care outcomes; care systems; children of color; community partnership; consistent condom use; cost; economic need; effectiveness testing; effectiveness/implementation design; effectiveness/implementation study; ethnic disparity; evidence base; experience; food insecurity; gender affirmation; gender diversity; health equity; implementation framework; implementation process; improved; insight; multi-component intervention; multidisciplinary; peer; peer support; perceived discrimination; pre-exposure prophylaxis; prevention service; process evaluation; programs; prospective; racism; recruit; scale up; sexual risk behavior; social determinants; social health determinants; theories; therapy design; transgender; transmission process; treatment effect; uptake

ABSTRACT In the United States (US), transgender and gender diverse (TGD) youth have high rates of new HIV diagnoses, with Black, Latinx, and other TGD youth of color representing the majority of these cases. The HIV prevention and care continua emphasize the need to reduce HIV transmission risk via regular HIV testing, consistent condom use, and linkages to HIV prevention and care, such as pre-exposure prophylaxis (PrEP) among HIV- negative individuals and antiretroviral therapy (ART) and viral suppression among people living with HIV. However, there are inequities at each step of these continua among TGD youth of color. TGD youth of color experience intersectional oppression that results in unmet gender affirmation, legal, and economic needs, which have been linked to inequities in HIV prevention and continua outcomes. Building on formative work, this project seeks to test the effectiveness of the LEAP intervention, a HIV status-neutral intervention designed to address social determinants of health to reduce sexual risk behaviors, increase HIV prevention uptake (PrEP use), and treatment outcomes (viral suppression). LEAP will harness the resources, geographic diversity, and multidisciplinary expertise of the Adolescent Trials Network for HIV/AIDS Interventions (ATN) to provide gender-affirming individualized HIV prevention and treatment peer support, address health-harming legal needs, and improve educational and employment outcomes for translation into real-world practice. We propose a hybrid type 1 effectiveness-implementation study focused on testing the effectiveness of LEAP and secondarily conducting a prospective implementation process evaluation. HIV risk will be assessed using a composite indicator of risk, which is a binary HIV risk indicator of validated measures of sexual risk behavior, as well as self-reported and biomarkers of HIV status, PrEP use, and viral suppression. We will recruit and randomize 250 TGD youth of color from five different ATN Site Consortiums (stratified by site, HIV status, and gender), following participants for 12 months and collecting biological (i.e., HIV status, PrEP use, or viral load) and behavioral data. Findings will provide critical insights into the effectiveness of an urgently needed multicomponent intervention designed to address unmet gender affirmation, legal, and economic needs to reduce HIV inequities among TGD youth of color.

摘要 在美国，跨性别和性别多样性（TGD）青年的新艾滋病毒诊断率很高， 其中黑人、拉丁裔和其他TGD有色人种青年占这些病例的大多数。艾滋病毒预防 强调需要通过定期的艾滋病毒检测来降低艾滋病毒传播风险， 避孕套的使用，以及与艾滋病毒预防和护理的联系，如艾滋病毒感染者的暴露前预防， 在艾滋病毒感染者中，使用抗逆转录病毒疗法和病毒抑制。 然而，在TGD有色人种青年中，这些连续体的每一步都存在不平等。TGD青春的颜色 经历交叉压迫，导致性别平等、法律的和经济需求得不到满足， 这与艾滋病毒预防和持续结果的不平等有关。在形成性工作的基础上， 该项目旨在测试LEAP干预措施的有效性，这是一种艾滋病毒中性干预措施， 解决健康的社会决定因素，以减少性风险行为，增加艾滋病毒预防的吸收（PrEP 使用）和治疗结果（病毒抑制）。LEAP将利用资源，地理多样性， 艾滋病毒/艾滋病干预青少年试验网络（ATN）的多学科专业知识， 性别平等、个性化艾滋病毒预防和治疗、同伴支持、解决危害健康的法律的问题 需要，并改善教育和就业成果转化为现实世界的做法。我们提出 混合型1有效性-实施研究，重点是测试LEAP的有效性， 其次，进行前瞻性的实施过程评估。艾滋病毒风险评估将使用 风险综合指标，这是一个经验证的性风险行为衡量标准的二元艾滋病毒风险指标， 以及自我报告的HIV状态、PrEP使用和病毒抑制的生物标志物。我们将招募和 从五个不同的ATN站点联盟随机抽取250名TGD有色人种青年（按站点、HIV状态和 性别），跟踪参与者12个月并收集生物学（即，HIV状态、PrEP使用或病毒载量） 和行为数据。调查结果将为迫切需要的有效性提供重要见解 旨在解决未得到满足的性别平等、法律的和经济需求的多方面干预措施， 减少TGD有色人种青年中的艾滋病毒不平等。