PrEP Uptake and Adherence Among Young Black MSM: Neighborhood and Network Determinants

年轻黑人男男性接触者中 PrEP 的采用和依从性：社区和网络决定因素

• 批准号: 9356579
• 负责人: Dustin T Duncan
• 金额: $ 73.4万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-22 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9356579
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Area; Attention; Behavior; Biological; Bisexual; Characteristics; Chicago; Code; Cohort Studies; Communication; Communities; Crime; Data; Data Set; Detection; Devices; Eligibility Determination; Enrollment; Environment; Epidemic; Exposure to; Feedback; Frequencies; Funding; Gays; Geographic Locations; Geography; Goals; HIV; HIV Infections; HIV Seronegativity; HIV risk; Hate; Health behavior; Incidence; Individual; Intervention; Lesbian Gay Bisexual Transgender; Link; Literature; Location; Longitudinal Studies; Measures; Methodology; Methods; Neighborhoods; Network-based; Outcome; Participant; Pathway Analysis; Patient Self-Report; Pattern; Physical activity; Police; Policies; Polygamy; Population; Positioning Attribute; Poverty; Prevalence; Prevention; Preventive Intervention; Protocols documentation; Publishing; Recruitment Activity; Research; Research Design; Research Project Grants; Risk; Risk Factors; Risk Reduction Behavior; Sampling; Social Environment; Social Network; System; Technology; Time; Travel; Typology; United States; United States National Institutes of Health; Work; base; black men who have sex with men; built environment; cohort; combat; contextual factors; experience; fluidity; follow-up; health care availability; health care service; health disparity; improved; innovation; member; men who have sex with men; metropolitan; multidisciplinary; pre-exposure prophylaxis; racial disparity; research study; skills; social; success; uptake; willingness

PROJECT SUMMARY This project seeks to use real-time geospatial methods to investigate relationships between Global Positioning System (GPS)-defined activity space neighborhoods, social and sexual networks, and HIV pre-exposure prophylaxis (PrEP) uptake and adherence cross-sectionally and longitudinally among young Black men who have sex with men (MSM) in the Chicago IL metropolitan statistical area (MSA) followed over two years. We will enroll 350 Black MSM in the proposed NIH-funded uConnect Neighborhoods and Networks Cohort Study to address the aims of the research. Eligibility requirements include: HIV-seronegative; self-report no restrictions to usual physical activity; no plans to move outside of Chicago IL MSA in the next two years; and willingness to complete a two-week GPS protocol at nine time-points over two years. Participants will wear the GPS device following protocols we have used in our previous feasibility research projects, including studies among Black MSM. In this longitudinal study, three months after completing the initial 2-week GPS protocol, participants will carry the GPS device for an additional 2-weeks every three-months over the two-year study period—for a total of nine times. GPS activity space environment and social/sexual networks data at baseline could potentially influence PrEP outcomes over time. Also, multiple GPS measures and social/sexual networks (at different time points) can better capture the breadth of people’s exposure to neighborhood-level factors and dynamics in social/sexual networks. The proposed study will be the largest GPS study of HIV disparities in any MSM population and presents a remarkable opportunity to study environmental influences on HIV prevention. Findings from the proposed research will impact HIV prevention intervention activities. First, it will inform specific neighborhood-level policy interventions. For example, increased community efforts to combat lesbian, gay, bisexual and transgender hate crime neighborhood rates through increased local police attention in high- crime locations may be an HIV prevention intervention that can reduce HIV health disparities. Second, from the GPS dataset we will know the travel patterns of Black MSM and therefore be able to identify optimal geographic locations for HIV prevention interventions. This will advance the literature given that such interventions are seldom geographically targeted. Third, this research will facilitate the identification of geographic locations suitable for recruiting Black MSM in research studies, an improved method of venue- based sampling, in this understudied population. Fourth, examining changes in spatial mobility (i.e. activity spaces) over time will be useful in knowing whether the risks of particular spaces changes or remain constant because different neighborhoods will have different risk profiles. Changing risk environments would suggest that prevention requires significant dynamism and fluidity, as well as rapid change-detection feedback loops. Finally, our dynamic network analysis we propose will deepen understanding of the effects of social and sexual networks on HIV prevention behaviors and will improve network-based HIV prevention interventions.

项目摘要 本项目旨在使用实时地理空间方法来调查全球定位系统 系统（GPS）定义的活动空间社区，社交和性网络，以及艾滋病毒暴露前 预防（PrEP）吸收和坚持横断面和纵向的年轻黑人男子， 在芝加哥IL大都会统计区（MSA），对男男性接触者（MSM）进行了两年的跟踪调查。我们 将招募350名黑人男男性行为者参加NIH资助的uConnect社区和网络队列研究 研究以解决研究的目的。资格要求包括：艾滋病毒血清阴性;自我报告没有 限制日常体力活动;在未来两年内没有计划搬到芝加哥IL MSA以外的地方;以及 愿意在两年内的九个时间点完成为期两周的GPS方案。参加者将佩戴 GPS设备遵循我们在以前的可行性研究项目中使用的协议， 黑人男同性恋者在这项纵向研究中，在完成最初的2周GPS方案后3个月， 在为期两年的研究中，参与者每三个月将携带GPS设备额外两周 共9次。基线全球定位系统活动、空间环境和社会/性网络数据 随着时间的推移可能会影响PrEP结果。此外，多个GPS测量和社交/性网络 (at不同的时间点）可以更好地捕捉人们暴露于邻里水平因素的广度， 社交/性网络的动态。这项拟议中的研究将是全球范围内最大的艾滋病毒差异研究。 男男性接触人群，并提出了一个显着的机会，研究环境对艾滋病毒预防的影响。 拟议研究的结果将影响艾滋病毒预防干预活动。首先，它将告知 具体的周边政策干预。例如，加强社区打击女同性恋的努力， 同性恋，双性恋和变性人仇恨犯罪邻里率通过增加当地警方的高度关注， 犯罪地点可能是一种艾滋病毒预防干预措施，可以减少艾滋病毒健康差距。二是从 GPS数据集，我们将知道黑色MSM的旅行模式，因此能够确定最佳的 艾滋病毒预防干预的地理位置。这将推动文献，因为这样的 干预措施很少有地域针对性。第三，这项研究将有助于确定 适合在研究中招募黑人男男性接触者的地理位置，一种改进的场地方法- 在这个未被充分研究的人群中。第四，研究空间流动性（即活动）的变化 空间）随时间的变化将有助于了解特定空间的风险是变化还是保持不变 因为不同的社区会有不同的风险状况。不断变化的风险环境表明， 这种预防需要很大的活力和流动性，以及迅速发现变化的反馈循环。 最后，我们提出的动态网络分析将加深对社会和性的影响的理解。 艾滋病毒预防行为网络，并将改善基于网络的艾滋病毒预防干预措施。