Increasing engagement and improving HIV care outcomes via stigma reduction in an online social networking intervention among racially diverse young men who have sex with men and transgender women

通过在线社交网络干预减少男男性行为和跨性别女性的种族不同的年轻男性的耻辱感，提高参与度并改善艾滋病毒护理结果

• 批准号: 9765398
• 负责人: Jose Arturo Bauermeister
• 金额: $ 76.48万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-16 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9765398
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affect; Age; Anti-Retroviral Agents; Behavior; Behavior assessment; Behavioral; Biological Markers; Caring; Communities; Continuity of Patient Care; Data; Elements; Enrollment; Epidemic; Ethnic Origin; Face; Feedback; Gender; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; Human immunodeficiency virus test; Individual; Intervention; Latino; Length; Logistics; Measures; Mediating; Methods; Nature; Not Hispanic or Latino; Outcome; Outcome Measure; Participant; Patient Recruitments; Persons; Population; Race; Randomized Controlled Trials; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Sampling; Schedule; Sexual and Gender Minorities; Sexuality; Site; Social Environment; Social Network; Social support; Source; Structure; Technology; Testing; Time; United States; Viral; Viral Load result; Well in self; Work; Youth; arm; care outcomes; design; ethnic diversity; experience; improved; innovation; intersectionality; intervention effect; men who have sex with men; peer; primary outcome; racial diversity; randomized trial; recruit; research study; response; sexual minority; social; social networking website; social stigma; theories; transgender women; transgender women who have sex with men; transmission process; treatment arm; trial design; young men who have sex with men

ABSTRACT Multiple stigmas related to sexuality, race, and HIV infection negatively impact HIV testing, engagement in HIV care, and consistent viral suppression (VS) among young Black or Latino men who have sex with men and transgender women (YBLMT). At present, few interventions have addressed the effects of intersectional stigma among HIV-infected and uninfected populations. In response to RFA-MH-18-606, this study tests whether an online intervention tailored for intersectional stigma amelioration can elicit online social support, promote intervention engagement, and mitigate the impact of multiple stigmas on HIV-related outcomes. We will recruit and enroll 1,050 young (ages 15-29), racially and ethnically diverse men who have sex with men and transgender women affected by HIV across the United States. Using a HIV-status stratified randomized trial design, participants will be assigned into one of three conditions (information-only control, a researcher-driven social network intervention, or a peer-driven social network intervention). Behavioral assessments will occur at baseline, 3, 6, 9 and 12 months; biomarkers (viral load) are scheduled for baseline, 6 and 12 months. The primary outcome is stratified by HIV status and defined as successful engagement in care (consistent VS for HIV-positive participants and routine testing for HIV-negative participants). The specific aims are: 1) Test whether an online intervention that promotes user-generated content and engagement to address intersectional stigma is associated with improvements in the HIV prevention and care continuum (HIV testing, antiretroviral adherence, VS) as compared to an information-only control arm; 2) Explore whether user engagement, as measured by quantitative and qualitative paradata, mediates the intervention’s stigma- and HIV care-related outcomes; and, 3) Examine how changes in intersectional stigma and improvements across the HIV care continuum vary between the researcher-driven vs. peer-driven social network intervention conditions. Our research study is innovative given its focus on intersectional stigma as a key target of intervention, and its ability to assess how different kinds of online social network structures influence participants’ engagement over time, reduce experiences of intersectional stigma, and improve successful engagement in care. This research addresses a critical need to reduce the effects of multiple stigmas in a priority population using an intervention delivered through a highly appealing, widely-utilized technology. If effective, this form of stigma amelioration via online support can be broadly disseminated to reduce HIV transmission and improve care among YBLMT.

抽象的 与性，种族和艾滋病毒感染有关的多种污名对艾滋病毒的测试，艾滋病毒的参与对艾滋病毒的测试产生负面影响 在与男人发生性关系的年轻黑人或拉丁裔男人中，护理和一致的病毒抑制（VS） 变性妇女（YBLMT）。目前，很少有干预措施解决了际污名的影响 在感染HIV和未感染的人群中。为了响应RFA-MH-18-606，这项研究测试了是否 针对污名化的改善量身定制的在线干预措施可以引起在线社会支持，促进 干预参与，并减轻多种污名对HIV相关结果的影响。我们将招募 并注册1,050名年轻人（15-29岁），在种族和种族上与男人发生性关系的男人 全美受艾滋病毒影响的跨性别妇女。使用HIV状态分层的随机试验 设计，参与者将被分配为三个条件之一（仅信息控制，研究人员驱动的 社交网络干预或同行驱动的社交网络干预）。行为评估将发生在 基线，3、6、9和12个月；生物标志物（病毒载荷）计划用于基线，为6个月和12个月。这 主要结果按艾滋病毒状况进行分层，并定义为成功参与护理（一致与 HIV阳性参与者和HIV阴性参与者的常规测试）。具体目的是：1）测试 是否促进用户生成的内容和参与度以解决的在线干预措施解决 交叉污名与HIV预防和护理连续体的改善有关（HIV测试， 与仅信息对照组相比，抗逆转录病毒依从性，vs）； 2）探索用户是否 通过定量和定性式衡量，参与介导了干预措施的污名和 与HIV相关的结果； 3）检查交叉污名的变化和改善如何 艾滋病毒护理在研究人员驱动的与同行驱动的社交网络干预之间继续存在不同 状况。我们的研究具有创新性，鉴于其专注于交叉污名作为作为关键目标 干预及其评估不同种类的在线社交网络结构的能力 参与者随着时间的参与，减少交叉污名的经验并改善成功 参与护理。该研究地址是减少多种污名在某人中的影响的迫切需要 使用高度吸引人，广泛利用的技术提供的干预措施的优先人群。如果 有效，这种通过在线支持可以大致传播的这种形式的污名化改善以减少艾滋病毒 YBLMT之间的传播和改善护理。