Understanding secondary prevention along the HIV care continuum among HIV+ Thai YMSM

了解泰国艾滋病毒 YMSM 中艾滋病毒护理连续性的二级预防

• 批准号: 9348687
• 负责人: THOMAS E GUADAMUZ
• 金额: $ 15.15万
• 依托单位: MAHIDOL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-25 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9348687
• 关键词: AIDS prevention; Address; Adherence; Alcohol consumption; Anus; Asia; CD4 Lymphocyte Count; Car Phone; Caring; Clinic; Communities; Complex; Continuity of Patient Care; Data; Development; Diagnosis; Discrimination; Drug usage; Early treatment; Exploratory/Developmental Grant; Focus Groups; Forcible intercourse; Foundations; Funding Mechanisms; Future; Goals; Government; HIV; HIV Seropositivity; HIV diagnosis; HIV risk; Health Personnel; Health system; High Prevalence; Home environment; Human immunodeficiency virus test; Incidence; Individual; Internet; Intervention; Intervention Trial; Interview; Left; Link; Literature; Medical; Minority Groups; Modeling; Morbidity - disease rate; Online Systems; Outcome; Persons; Population; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Process; Public Health; Recruitment Activity; Research; Research Personnel; Secondary Prevention; Social isolation; Subgroup; Surveys; Thailand; Treatment outcome; United States National Institutes of Health; Visit; Vulnerable Populations; aged; base; cohort; design; effective intervention; ethnic minority population; evidence base; follow-up; health disparity; improved; men who have sex with men; mortality; prevent; racial minority; scale up; social; social stigma; transmission process; uptake; virtual; young men who have sex with men

Project Summary The HIV crisis in Bangkok men who have sex with men (MSM) is volatile with 31% HIV-infected and HIV incidence unbridled and ranging from 8.8% to 12.2% annually in young MSM (YMSM) aged 15-24 years. Consequently, HIV incidence in Bangkok YMSM is Asia’s highest, and in the absence of effective primary and secondary HIV prevention, will continue to increase. Scaling up ART has become the highest priority in responding to this crisis in Thailand. However, data are not available on the HIV care continuum, thus severely limiting critical information needed to design evidence-based secondary prevention interventions for linkage, retention and reengagement in HIV care. In accordance with the R21 funding mechanism, this exploratory study seeks to use the adapted socio-ecological framework to 1) conduct formative research with +YMSM, HIV clinicians and CBO leaders to investigatethe multi-level factors related to the HIV care continuum in Bangkok +YMSM; and 2) quantify the HIV care continuum in +YMSM, and examine the associated facilitators and barriers through a 9-month longitudinal, virtual cohort. A sub aim is to assess the feasibility of an online +YMSM cohort for future online intervention trials. Data from this proposed study by a new investigator will identify which secondary prevention strategies must be scaled in order to meet UNAIDS’ 90-90-90 goals. Findings from this study will not only fill critical gaps in the HIV care continuum literature, it will identify subgroups of +YMSM who are most left out from the health system and to whom targeted secondary prevention interventions should be developed.

项目摘要 曼谷男男性行为者（MSM）的艾滋病毒危机不稳定，31%的艾滋病毒感染者， 在15-24岁的年轻男男性行为者（YMSM）中，艾滋病毒感染率无节制，每年从8.8%到12.2%不等。 因此，曼谷YMSM的艾滋病毒发病率是亚洲最高的，在缺乏有效的初级和初级保健的情况下， 艾滋病毒二级预防将继续增加。扩大抗逆转录病毒疗法的规模已成为 应对泰国的危机然而，没有关于艾滋病毒护理连续体的数据，因此， 限制设计循证二级预防干预措施所需的关键信息， 保持和重新参与艾滋病毒护理。根据R21供资机制， 研究旨在使用适应的社会生态框架，1）对+YMSM，HIV进行形成性研究 临床医生和CBO领导人调查与曼谷艾滋病护理连续体相关的多层次因素 +YMSM; 2）量化+YMSM中的艾滋病毒护理连续体，并检查相关的促进因素， 通过为期9个月的纵向虚拟队列来评估障碍。一个子目标是评估在线 +YMSM队列用于未来的在线干预试验。新研究者的这项拟议研究的数据将 确定哪些二级预防战略必须扩大规模，以实现联合国艾滋病规划署的90-90-90目标。 这项研究的结果不仅将填补艾滋病毒护理连续文献的关键空白， 被卫生系统排除在外最多的+YMSM亚组， 应制定预防干预措施。