Developing a Computer Based intervention to Prevent HIV among Native Amer. MSM

开发基于计算机的干预措施以预防美洲原住民中的艾滋病毒。

基本信息

批准号：
8350890
负责人：
KARINA L. WALTERS
金额：
$ 18.42万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-08-02 至 2017-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8350890
关键词：
AIDS diagnosis AIDS prevention AIDS/HIV problem ARHGEF5 gene Accounting Acquired Immunodeficiency Syndrome Address African American Alaska Native Alcohol or Other Drugs use American Anxiety Area Asians Behavior Cardiovascular Diseases Categories Censuses Centers for Disease Control and Prevention (U.S.)Chlamydia Chronic Disease Communities Computers Data Diabetes Mellitus Disease Drug usage Environment Epidemic Epidemiology Ethnic group Exposure to Faculty Focus Groups Forcible intercourse Gender General Population Gonorrhea HIV HIV Infections HIV Seropositivity Health Health Insurance Health behavior Heterosexuals Hispanics Homicide Household Illicit Drugs Income Indigenous Injury Insurance Coverage International Internet Intervention Interview Latino Life Location Mental Depression Mental Health Minority Morbidity - disease rate Native Americans Native-Born Needs Assessment Pacific Island Americans Pattern Personal Satisfaction Population Population Sizes Post-Traumatic Stress Disorders Poverty Premature Mortality Preventive Intervention Psychopathology Race Relative (related person)Reporting Reproductive Health Research Research Institute Research Personnel Research Project Grants Reservations Risk Risk Behaviors Rural Schools Sex Behavior Sexual Health Sexually Transmitted Diseases Social Network Source Suicide Surveys System Trauma Tribes Unemployment United States Universities Variant Vehicle crash Violence Visual Washington Woman Work alcohol misuse base combat design experience health disparity innovation interest men men who have sex with men mortality motor vehicle injury peer post intervention prevent programs racial and ethnic respiratory sex risk sexual assault socioeconomics therapy development transmission process virtual

项目摘要

As of 2003 there were 4.4 million AIAN in the U.S., constituting 1.5% of the total U.S. population, with 2.8 million or 1% self-identifying exclusively as AIAN. The U.S. Census Bureau estimates that by 2050 the AIAN population will grow to 3.2 million with a projected rate of increase of 55%, exceeding the projected rate of increase for Whites and comparable to the rate for African Americans. Despite their wealth in cultural and tribal diversity. Natives in the U.S. experience considerable socio-economic disparities. For example, in 2003, AIAN compared to the U.S. population, reported a greater likelihood of living below the poverty level (27% vs. 15%) and lower overall median household incomes ($34,700 vs. $43,500); and reported higher unemployment (15.1% vs. 5.9%).¿ Moreover, 30% of the AIAN population lacks health insurance coverage. Indigenous populations suffer from pervasive patterns of health disparities, unequal burden of chronic illnesses, as well as disproportionate levels of morbidity (e.g., diabetes, cardiovascular disease) and injury-related mortality (e.g., suicide, motor vehicle collisions). Natives also experience high rates of trauma (e.g., injury, motor vehicle accidents, homicide) and violence exposure (e.g., rape, sexual assault, combat exposure) with co-occurring disproportionate rates of psychopathology (i.e., PTSD, depression, anxiety, suicide, AOD disorders). In the U.S., Natives have escalating rates of HIV and other sexually transmitted infections (STI), respiratory and reproductive health problems, as well as premature mortality related to chronic disease states. HIV/AIDS and STI have become major sources of concern for Natives. In a comprehensive review of STI and HIV among AIAN, Kaufmann and colleagues (2007) noted that the epidemiologic evidence points to excessively high case rates of STI among AIAN compared to the general population; with a greater burden borne by Native populations living in closer proximity to one another. For example, in the U.S., AIAN have the second highest rates of Chlamydia and gonorrhea. The potential for exposure to and transmission of HIV is greatly enhanced by these elevated STI rates. Indeed, elevated rates of STI may provide a 2-5 fold increased risk for HIV infection among AIAN in the U.S. According to data from the National HIV/AIDS Surveillance System through December 2008, a cumulative total of 3,741 AIDS cases among AI/AN have been reported to the CDC. In terms of the major modes of transmission, percentages for AIAN men were: MSM (64%), IDU (14%), and MSM/IDU (14%). Note that this last category is higher for AIAN men than any other ethnic group. For AIAN women, the percentages were IDU (37%) and heterosexual contact (50%). Note that the IDU transmission category for Native women is higher than for any other ethnic group. Since 1995, the rate of AIDS diagnosis for AIAN has been consistently higher than the rate for Whites or Asian/Pacific Islanders in the U.S. Additionally, when one takes the relative population size into account, a more disturbing picture emerges. The AIDS case rates for AIAN per 100,000 were 8.5 (11.9 for HIV rates), ranking them just behind Blacks (49.3; 73.7 for HIV rates) and Hispanics/Latinos (15.0; 25.0 for HIV rates). In our research (N=447; HONOR Project, R01MH65871), 30% of Native two-spirit (i.e., AIAN sexual and/or gender minority) men reported that they were HIV+ (19% reported they did not know their status). These numbers are unprecedented and suggest that the HIV/AIDS epidemic for Native MSM may be similar to Black MSM. Natives suffer disproportionate exposure to trauma and mental health disparities. Recent reports demonstrate that Native communities experience higher rates of sexual and physical violence than any other ethnic or racial group in the U.S/^ Among MSM in our HONOR project, 31% had experienced

截至2003年，美国有440万Aian，占美国总人口的1.5％，有280万或1％的自我识别为Aian。美国人口普查局估计，到2050年，艾安人口将增长到320万，预计增加了55％，超过了白人的预计增长率，与非裔美国人的率相当。尽管他们在文化和部落多样性方面拥有丰富的财富。美国的当地人经历了相当大的社会经济差异。例如，在2003年，与美国人口相比，艾安（Aian）报告说，生活在贫困水平以下（27％vs.15％）和较低的家庭中位收入（34,700美元，$ 43,500）的可能性更大；并报告了较高的失业率（15.1％比5.9％）。此外，30％的AIAN人群缺乏健康保险范围。土著人口普遍存在的健康差异，慢性病不平等，发病率（例如糖尿病，心血管疾病）和与伤害相关的死亡率（例如，自杀，汽车碰撞）的不成比例。当地人还经历了高度的创伤（例如伤害，机动车事故，凶杀案）和暴力暴露（例如，强奸，性侵犯，性侵犯，战斗暴露），具有不成比例的心理病理学率（即PTSD，抑郁症，抑郁症，焦虑，焦虑，自杀，AOD DISORDERS）。在美国，当地人的艾滋病毒和其他性传播感染率（STI），呼吸和生殖健康问题以及与慢性疾病状态相关的过早死亡率都在上升。艾滋病毒/艾滋病和性传播感染已成为当地人关注的主要来源。在在Aian，Kaufmann及其同事（2007年）中对STI和HIV的全面回顾指出，与一般人群相比，流行病学证据指出，AIAN的STI案例极高。由于本地人口彼此之间的距离更大。例如，在美国，艾安（Aian）的衣原体和淋病率是第二高。这些升高的性传播感染率大大提高了接触HIV和传播HIV的可能性。实际上，根据美国国家艾滋病毒/艾滋病监测系统的数据，升高的性病可能会增加美国AIAS感染HIV感染的风险2-5倍，直到2008年12月，累计总计3,741例艾滋病案件中的AI/A/A中已将其报告给CDC。就主要传输方式而言，AIAN男性的百分比为：MSM（64％），IDU（14％）和MSM/IDU（14％）。请注意，对于艾安男子来说，最后一个类别比任何其他种族都要高。对于艾安妇女，百分比为IDU（37％）和异性恋接触（50％）。请注意，针对土著妇女的IDU传播类别高于任何其他族裔。自1995年以来，AIAN的艾滋病诊断率一直高于美国在美国的白人或亚洲/太平洋岛民的速度，当人们考虑到相对人口规模时，出现了更令人不安的情况。 AIAS每10万的AID案例率为8.5（艾滋病毒率为11.9），将它们排名仅次于黑人（49.3;艾滋病毒率为73.7）和西班牙裔/拉丁裔（15.0; 25.0; hiv率的艾滋病毒率）。在我们的研究（n = 447;荣誉项目，R01MH65871）中，有30％的本地两人PIRIT（即Aian性和/或性别少数族裔）男性报告说他们是HIV+（19％的报告说他们不知道自己的地位）。这些数字是前所未有的，表明本机MSM的HIV/AIDS流行可能与黑色MSM相似。土著人遭受创伤和心理健康差异的不成比例。最近的报告表明，与美国荣誉项目中MSM中的任何其他种族或种族群体相比，本地社区的性暴力和身体暴力率更高，31％的人经历了31％