Understanding Delayed Access to HIV Prevention Services among Black MSM

了解黑人男男性接触者延迟获得艾滋病毒预防服务的情况

• 批准号: 8541304
• 负责人: RONALD D STALL
• 金额: $ 58.87万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8541304
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; African American; Behavior; Behavioral; Binding; Caring; Communities; Data; Ensure; Epidemic; Epidemiology; Ethnic Origin; Goals; HIV; HIV Seropositivity; HIV Seroprevalence; HIV diagnosis; Health; Health Services Accessibility; Healthcare; High Prevalence; Human immunodeficiency virus test; Incidence; Individual; Intervention; Interview; Knowledge; Length; Measures; Medical; Mental Depression; Population; Positioning Attribute; Positive Test Result; Prevalence; Prevention; Prevention approach; Prevention program; Prevention strategy; Recruitment Activity; Risk; Sample Size; Sampling; Services; Substance abuse problem; Surveys; Test Result; Testing; Time; United States; Victimization; Violence; Viral Load result; Viremia; Vulnerable Populations; Work; design; evidence base; health disparity; high risk; high risk men; men; men who have sex with men; prevent; prevention service; programs; psychosocial; public health relevance; racism; theories; transmission process; uptake

DESCRIPTION (provided by applicant): HIV AIDS remains a major health crisis among African American men who have sex with men (AA MSM). In a recent large-scale HIV seroprevalence survey, prevalence rates were highest among AA MSM (28%), compared to 16% among MSM of all other ethnicities. This is a health disparity that has been replicated in many different studies since the start of the AIDS epidemic. Given the scale of the HIV epidemic among AA MSM, we cannot prevent the ongoing spread of HIV in the United States until we find ways to field effective HIV prevention programs for AA MSM. Combination prevention approaches to HIV/AIDS offer considerable promise to achieve this goal by addressing some of the high risk contexts that increase transmission risk among AA MSM. However, our ability to design effective combination prevention approaches to lower HIV transmission risk among AA MSM depends on achieving a clear epidemiological understanding of both barriers and facilitators to HIV testing, receiving reactive test results for men who are HIV positive and timel access to medical care if HIV positive. Unfortunately, our ability to explain HIV testing and health care access behaviors among AA MSM is currently limited due to the difficulties of recruiting sufficiently large samples of AA MSM who are delaying access to HIV prevention and care services. These shortcomings hamper our ability to draw effective conclusions about targeted prevention efforts for AA MSM, including most fundamentally an informed evidence base upon which combination prevention strategies must be built. Syndemics theory, which examines the effects and interactions among multiple psychosocial health conditions (i.e. substance abuse, depression, violence victimization) associated with increased risks within marginalized and vulnerable populations provides an important theoretical framework to examining these behaviors, especially since it encompasses both vulnerabilities and resiliencies in high risk populations. This application proposes to address this situation by collecting data from a large scale sample of AA MSM (N=6000) to: 1. Measure the prevalence and identify syndemic associations of uptake of HIV testing among AA MSM 2. Measure the prevalence and identify syndemic associations of unknown HIV seropositivity among AA MSM 3. Measure the prevalence and identify syndemic associations of timely access to care among HIV+ AA MSM By partnering with well-established community groups to recruit large samples of vulnerable men, we will be in a position to characterize the barriers and facilitators to the essential buildig blocks of combination prevention approaches and so provide crucial information for developing effective programs to lower HIV transmission among AA MSM.

描述（由申请人提供）：艾滋病毒艾滋病仍然是一个主要的健康危机，非洲裔美国男子谁与男性发生性关系（AA MSM）。在最近的一项大规模艾滋病毒血清阳性率调查中，AA MSM的患病率最高（28%），而所有其他种族的MSM的患病率为16%。这是一个健康的差距，已被复制在许多不同的研究，因为艾滋病的流行开始。鉴于艾滋病毒在AA MSM中流行的规模，我们无法阻止艾滋病毒在美国的持续传播，直到我们找到有效的艾滋病毒预防计划。艾滋病毒/艾滋病的综合预防方法提供了相当大的希望，以实现这一目标，通过解决一些高风险的情况下，增加AA男男性行为者之间的传播风险。然而，我们设计有效的组合预防方法，以降低艾滋病毒传播的风险AA男男性行为者之间的能力取决于实现一个明确的流行病学的理解，艾滋病毒检测的障碍和促进因素，接受反应性的测试结果的男性谁是艾滋病毒阳性和及时获得医疗保健，如果艾滋病毒阳性。不幸的是，我们的能力，解释艾滋病毒检测和卫生保健的访问行为之间的AA男同性恋目前是有限的，由于招募足够大的样本AA男同性恋谁是延迟获得艾滋病毒预防和护理服务的困难。这些缺点阻碍了我们的能力，得出有效的结论，有针对性的预防工作AA男男性接触者，包括最根本的是一个明智的证据基础上，必须建立组合预防策略。综合征理论，它检查的影响和相互作用的多种心理社会健康状况（即药物滥用，抑郁症，暴力受害）与边缘化和弱势群体的风险增加，提供了一个重要的理论框架，以检查这些行为，特别是因为它包括在高风险人群的脆弱性和危害性。本申请提出通过从AA MSM的大规模样本（N=6000）收集数据来解决这种情况：1.测量AA MSM 2中艾滋病毒检测的流行率并确定其发病相关性。测量AA MSM中未知HIV血清阳性的流行率并确定其与疾病的关联性3.通过与成熟的社区团体合作，招募大量的弱势男性样本，我们将能够描述组合预防方法的基本组成部分的障碍和促进因素，从而为制定有效的计划提供重要信息，以降低艾滋病毒在AA MSM中的传播。