START: Study of Trauma and Reduction of HIV Transmission

开始：创伤和减少艾滋病毒传播的研究

• 批准号: 8846874
• 负责人: Kimberly Michelle Rush
• 金额: $ 3.53万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8846874
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Affect; Alcohol or Other Drugs use; Awareness; Behavior Therapy; Behavioral Research; Caring; Clinical Research; Computer Assisted; Cross-Sectional Studies; Data; Data Collection; Data Set; Development; Disease Progression; Ensure; Epidemic; Feedback; Frequencies; Funding; Grant; HIV; Impulsivity; Individual; Influentials; Interdisciplinary Study; Intervention; Interview; Lead; Link; Literature; Manuscripts; Measurement; Measures; Mediating; Mentors; Methods; Modeling; Nurse Psychotherapist; Nurses; Outcome; Paper; Parents; Pathway Analysis; Pathway interactions; Patient Self-Report; Pharmaceutical Preparations; Population; Preparation; Prevention; Prevention approach; Psychiatric Nursing; Psychosocial Factor; Public Health; Publishing; Randomized Controlled Trials; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Research Training; Risk; Risk Behaviors; Risk Factors; Role; Self Efficacy; Social Desirability; Stress; Substance abuse problem; Symptoms; Techniques; Testing; Training; Training Programs; Trauma; Treatment Effectiveness; United States; Viral; Viral Load result; Virus Diseases; analog; antiretroviral therapy; base; contingency management; coping; data management; design; high risk; high risk behavior; innovation; insight; men who have sex with men; modifiable risk; novel; polysubstance abuse; prevent; programs; psychological distress; public health relevance; sexual risk taking; theories; therapy design; transmission process

 DESCRIPTION (provided by applicant): Background: START, a Study of Trauma and Reduction of HIV Transmission, is a cross-sectional study that will examine whether traumatic stress contributes to "potentially amplified transmission" (PAT) risk behavior (the co-occurrence of detectable HIV viral load and HIV transmission risk) among stimulant-using men who have sex with men (MSM). Stimulant-using MSM are most heavily affected by HIV, despite the widespread availability of antiretroviral therapy (ART).1 "Treatment as Prevention" (TasP), defined as expanded ART access to achieve sustained viral suppression, is a promising biomedical prevention approach that will be utilized. While literature supports that early ART initiation decreases HIV transmission rates, stimulant-using MSM were excluded from these landmark trials. Stimulant-using MSM are known for low utilization and low engagement in HIV-related care thereby resulting in higher viral loads and high HIV transmission rates.2 The overarching objective of this proposed study is to identify modifiable risk factors associated with PAT to inform the development of innovative, theory-based interventions to optimize the effectiveness of TasP in stimulant-using MSM. Resulting information will inform the development of HIV/AIDS prevention approaches enhancing the effectiveness of TasP in stimulant-using MSM, thereby decreasing HIV transmission rates. Relation to Training: This proposal is designed to provide in-depth research training. Pathway analysis will be conducted to understand the role of psychosocial factors in the relationship between traumatic stress and PAT. The results will provide preliminary data for the preparation of a K99/R00 grant, which will be used to develop and pilot test a behavioral intervention to reduce traumatic stress symptoms and HIV transmission in stimulant- using MSM. This F31 proposal is a logical step in becoming an independent nurse investigator. Innovation: The study is innovative in three ways. First, PAT, a co-occurring outcome variable, will be utilized to model an outcome most closely linked with high HIV-viral transmission efficiency; second, the potential mediational role of psychosocial factors in the relationship between traumatic stress and PAT will be explored; and third, novel techniques will be utilized, including (a) the Balloon Analogue Risk Task (BART) measure of impulsivity while eliminating the limitation of a self-report measure requiring self-insight and awareness, and (b) Audio Computer Assisted Self Interviewing (ACASI), which is used in behavioral research to minimize recall and social desirability bias and enhance the veracity of self-report, thereby increasing internal and external validity.

 描述（由申请人提供）：背景：START是一项关于创伤和减少HIV传播的研究，是一项横断面研究，将检查创伤应激是否有助于使用兴奋剂的男男性行为者（MSM）的“潜在放大传播”（PAT）风险行为（可检测的HIV病毒载量和HIV传播风险的共同发生）。尽管抗逆转录病毒疗法（ART）广泛可用，但使用兴奋剂的MSM受艾滋病毒影响最严重。1“治疗即预防”（TasP）被定义为扩大ART获得以实现持续的病毒抑制，是一种将被利用的有希望的生物医学预防方法。虽然文献支持早期ART开始降低HIV传播率，但这些里程碑式的试验排除了使用兴奋剂的MSM。已知使用兴奋剂的MSM对HIV相关护理的利用率和参与度较低，从而导致病毒载量较高和HIV传播率较高。2这项拟议研究的总体目标是确定与以下因素相关的可改变的风险因素： PAT为创新的、基于理论的干预措施的发展提供信息，以优化TasP在使用兴奋剂的MSM中的有效性。由此产生的信息将为艾滋病毒/艾滋病预防方法的发展提供信息，提高TasP在使用兴奋剂的MSM中的有效性，从而降低艾滋病毒传播率。 与培训的关系：本建议旨在提供深入的研究培训。将进行路径分析，以了解心理社会因素在创伤应激和PAT之间的关系中的作用。研究结果将为准备K99/R 00赠款提供初步数据，该赠款将用于开发和试点测试一种行为干预措施，以减少使用兴奋剂的MSM的创伤应激症状和艾滋病毒传播。这个F31提案是成为独立护士调查员的一个合乎逻辑的步骤。创新：本研究在三个方面具有创新性。首先，PAT，一个共同发生的结果变量，将被用来建模 结果最密切相关的高艾滋病毒传播效率;第二，心理社会因素之间的关系创伤压力和PAT的潜在中介作用将进行探讨;第三，将利用新的技术，包括（a）冲动性的气球锚固风险任务（BART）测量，同时消除需要自我洞察力和意识的自我报告测量的限制，和（B）音频计算机辅助自我访谈（ACASI），用于行为研究，以尽量减少回忆和社会期望偏差，提高自我报告的准确性，从而增加内部和外部 效度