Continuous Traumatic Violence and the HIV Continuum of Care Outcomes Among BMSM

BMSM 中持续的创伤性暴力和 HIV 连续护理结果

• 批准号: 9913255
• 负责人: Katherine G Quinn
• 金额: $ 21.46万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2022-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9913255
• 关键词: Affect; Alcohol or Other Drugs use; Anxiety; Caring; Chicago; Child Sexual Abuse; Chronic; Color; Communities; Continuity of Patient Care; Development; Dimensions; Discrimination; Economics; Event; Exposure to; Future; Gays; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; HIV risk; Health; Homophobia; Individual; Intervention; Interview; Life; Link; Longitudinal Studies; Mediating; Mental Depression; Modeling; Outcome; Pathway interactions; Police; Population; Prevalence; Public Health; Quality of life; Race; Research; Resources; Risk; Risk Behaviors; Sampling; Self Efficacy; Sexual Partners; Sexual abuse; Sexuality; Structure; Testing; Trauma; Treatment outcome; United States; Victimization; Violence; Viral; Viral Load result; Youth; aged; base; black men who have sex with men; care outcomes; cost; early life adversity; experience; improved; intimate partner violence; male; medication compliance; men; men who have sex with men; outreach; physical abuse; protective factors; psychologic; psychological distress; psychosocial; resilience; social; social stigma; theories; uptake; violence exposure; young adult; young men who have sex with men

Project Summary The goals of this project are to (1) examine how exposures to continuous traumatic violence are related to engagement and retention in HIV care; (2) illuminate the pathways through which violence exposures affect HIV engagement and retention to care; and (3) identify factors that promote resilience among people living with HIV who have been exposed to violence. Continuous traumatic violence is conceptualized as chronic violence exposure, continuous danger, or ongoing threats that can manifest as structural, economic, psychological, interpersonal and social violence. This study examines continuous traumatic violence as inclusive of community and police violence, intimate partner violence, race- and sexuality-based stigma and discrimination, and the lingering effects of childhood sexual abuse, and explore these types of violence through the syndemic framework. Each of these various dimensions of violence disproportionately affects Black males, including YBMSM and a syndemic approach to continuous traumatic violence itself, may, therefore, better explain disparities in HIV care outcomes. Experiences of violence have been identified as an important aspect of syndemics that significantly contribute to lower engagement in HIV care and lower rates of viral suppression among Black MSM. Yet, much like multiple syndemic conditions contribute to disparities in HIV risk and outcomes, the experience of violence is not monolithic. Various types of violence exposures may cluster to have negative interactive effects on HIV care outcomes. This study will promote a deeper understanding of how these multiple dimensions of violence may have an additive and interactive correlation to poor engagement and retention in HIV care of YBMSM, despite significant outreach and retention efforts. This study focuses on YBMSM, a high priority population with regard to improving HIV outcomes. We will test an empirically informed conceptual model describing mediating and moderating factors that link continuous traumatic violence exposure to HIV care cascade outcomes. This model is based on our two decades of focused research on how violence impacts HIV risks and health outcomes among Black youth and young adults and BMSM. Documenting significant correlations among various dimensions of violence across a single sample of YBMSM is a necessary first step before developing costly longitudinal studies and interventions. Study results will inform a trauma-informed R34 application for HIV positive YBMSM.

项目概要 该项目的目标是 (1) 研究持续遭受创伤性暴力与参与度和参与度之间的关系。 保留艾滋病毒护理； (2) 阐明暴力暴露影响艾滋病毒参与的途径，以及 保留护理； (3) 确定能够提高曾接触过病毒的艾滋病毒感染者的复原力的因素 暴力。 持续的创伤性暴力被概念化为慢性暴力暴露， 持续的危险，或持续的危险 可能表现为结构性、经济、心理、人际和社会暴力的威胁。这项研究考察 持续的创伤性暴力，包括社区和警察暴力、亲密伴侣暴力、种族和暴力 基于性的耻辱和歧视，以及儿童期性虐待的挥之不去的影响，并探讨这些类型 通过流行病框架消除暴力。暴力的这些不同方面中的每一个都对黑人产生了不成比例的影响 因此，男性，包括 YBMSM 和针对持续创伤性暴力本身的同步方法，可能会更好地解释 艾滋病毒护理结果的差异。 暴力经历已被确定为流行病的一个重要方面， 显着降低了黑人 MSM 中艾滋病毒护理参与度和病毒抑制率。然而， 就像多种综合症导致艾滋病毒风险和结果的差异一样，暴力经历 不是单一的。各种类型的暴力暴露可能会对艾滋病毒护理产生负面的相互作用影响 结果。 这项研究将促进人们更深入地了解暴力的这些多重维度如何影响 尽管显着，但 YBMSM 的艾滋病毒护理参与度和保留率低与加性和交互相关 外展和保留工作。本研究重点关注 YBMSM，这是改善艾滋病毒的高度优先人群 结果。我们将测试一个基于经验的概念模型，该模型描述了链接的中介和调节因素 持续的创伤性暴力暴露于艾滋病毒护理级联结果。这个模型是基于我们二十年的经验 重点研究暴力如何影响黑人青少年和年轻人的艾滋病毒风险和健康结果， BMSM。记录 YBMSM 单个样本中暴力各个维度之间的显着相关性 这是开展昂贵的纵向研究和干预措施之前必要的第一步。研究结果将告知 HIV 阳性 YBMSM 的创伤知情 R34 应用。