Body Image and Self-care in HIV-infected MSM

HIV 感染 MSM 的身体形象和自我护理

• 批准号: 8497752
• 负责人: Aaron J Blashill
• 金额: $ 17.06万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8497752
• 关键词: AIDS prevention; AIDS/HIV problem; Acute; Address; Adherence; Affect; Alcohol or Other Drugs use; Anus; Appearance; Area; Attention; Award; Behavior; Behavior Therapy; Behavioral; Body Image; Caring; Chemoprophylaxis; Child Sexual Abuse; Cities; Clinical Trials; Control Groups; Data; Development Plans; Face; General Hospitals; Goals; Grant; HIV; HIV risk; Health; Health behavior; Highly Active Antiretroviral Therapy; Individual; Intervention; Interview; Life; Link; Massachusetts; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Meta-Analysis; Mid-Career Clinical Scientist Award (K24); Modeling; Outcome; Participant; Peer Review; Population; Positioning Attribute; Postdoctoral Fellow; Preventive Intervention; Process; Prophylactic treatment; Public Health; Publications; Quality of life; Randomized; Randomized Controlled Trials; Research; Research Personnel; Research Project Grants; Risk; Risk Behaviors; Risk Reduction; Role; Secondary Prevention; Self Care; Sexual Transmission; Substance abuse problem; Testing; Training; Treatment Efficacy; Virus; active control; antiretroviral therapy; arm; behavior change; body dissatisfaction; career; career development; condoms; design; efficacy testing; experience; high risk; improved; medical schools; medication compliance; men who have sex with men; novel; primary outcome; prospective; psychosocial; research and development; secondary outcome; sex risk; skills; therapy development; transmission process; treatment as usual; trial comparing; uptake

DESCRIPTION (provided by applicant): This is an amended, previously well-received, K23 proposal addressing health risk behaviors in men who have sex with men (MSM) within the context of syndemics (co-occurring psychosocial problems), and a particular focus on body image disturbance and depression. MSM constitute, by far, the largest number (H60%) of individuals with HIV in the U.S. Modest effects of behavioral interventions for MSM may be because they generally do not address the unique and varied psychosocial context for this population. Study after study concludes that co-occurring syndemics contribute to poor self-care behaviors including, sexual risk and HAART non-adherence, and may interfere with uptake of interventions for MSM1-7. One example of an understudied psychosocial problem among HIV-infected MSM is dissatisfaction with one's appearance. It is estimated that 31% of HIV-infected MSM have elevated body dissatisfaction8, which is syndemic to depression, sexual transmission risk, and HAART non-adherence. CANDIDATE: I am a postdoctoral fellow at Massachusetts General Hospital/Harvard Medical School with 15 peer-reviewed publications (12 first-authored) on psychosocial problems such as body dissatisfaction and depression among MSM, HAART adherence, and HIV sexual transmission risk behaviors. The present proposal will allow me to acquire needed skills to achieve my goal of becoming an independent researcher studying co-occurring psychosocial and self-care problems among MSM living with and at risk for acquiring HIV. MENTORING: Dr. Steven Safren, the primary mentor, has expertise in addressing psychosocial problems in the context of interventions for self-care in HIV, including depression, HAART adherence, and HIV prevention. Drs. Kenneth Mayer and Sabine Wilhelm are secondary mentors and add considerable unique expertise to the mentoring team, with their respective research specializations in HIV prevention and body dissatisfaction interventions. RESEARCH: As an example of a way to integrate improving self-care behaviors while addressing an important psychosocial syndemic indicator, I will develop a novel intervention which addresses body dissatisfaction, syndemic to depression, secondary HIV prevention, and HAART adherence among HIV-infected MSM. With mentorship, this intervention will be developed through an initial iterative process, and then piloted in a randomized control trial. TRAINING: I will receive direct mentoring in addressing psychosocial problems in the context of self-care (HIV prevention and adherence), the iterative process of developing and testing interventions that focus on both psychosocial problems and self-care, as well as dissemination. This is directly tied to my primary mentor's K24 award (and his other grants), on which I can be part of, and observe the iterative intervention development related to syndemics. I will also receive training in advanced statistical analysis, take courses on clinical trials, longitudinal modeling, qualitative analysis, and missing data.

描述(由申请人提供)：这是一项修订后的、以前广受欢迎的K23提案，旨在解决男男性行为(MSM)中的健康危险行为(共同发生的心理社会问题)，并特别关注身体形象障碍和抑郁。到目前为止，MSM是美国艾滋病病毒携带者人数最多的(H60%)。对MSM进行行为干预的适度效果可能是因为他们通常没有解决这一人群独特而多样的心理社会背景。一项又一项研究得出结论，共同出现的综合征会导致不良的自我照顾行为，包括性风险和不遵守HAART，并可能干扰对MSM1-7的干预。在感染艾滋病毒的男男性接触者中，一个研究不足的心理社会问题的例子是对自己的外表不满意。据估计，31%感染艾滋病毒的男男性接触者的身体不满感升高，这是抑郁症、性传播风险和未遵守HAART的共同特征。候选人：我是麻省总医院/哈佛医学院的博士后研究员，有15篇同行评议的出版物(其中12篇是第一作者)，内容涉及心理社会问题，如MSM中的身体不满和抑郁、HAART坚持，以及HIV性传播风险行为。目前的提议将使我能够获得必要的技能，以实现我的目标，即成为一名独立研究员，研究感染艾滋病毒和有感染艾滋病毒风险的男男性接触者中共同出现的心理、社会和自我照顾问题。指导：主要导师Steven Safren博士在艾滋病毒自我护理干预措施的背景下，包括抑郁症、遵守HAART和艾滋病毒预防，拥有解决心理社会问题的专业知识。Kenneth Mayer博士和Sabine Wilhelm博士是二级导师，他们各自在艾滋病毒预防和身体不满干预方面的研究专长为导师团队增添了相当独特的专业知识。研究：作为一种将改善自我护理行为与解决一个重要的心理社会共同性指标相结合的方法的例子，我将开发一种新的干预措施，解决HIV感染的MSM中的身体不满、抑郁症、HIV二级预防和HAART坚持。在导师的指导下，这种干预将通过初始迭代过程进行开发，然后在随机对照试验中进行试点。培训：我将接受在自我护理(艾滋病毒预防和坚持)背景下解决心理社会问题的直接指导，这是制定和测试以心理社会问题和自我护理为重点的干预措施的迭代过程，以及传播。这与我的主要导师的K24奖励(以及他的其他奖励)直接相关，我可以参与其中，并观察与合并症相关的迭代干预开发。我还将接受高级统计分析方面的培训，参加临床试验、纵向建模、定性分析和缺失数据方面的课程。