Informal Mentors and the HIV Care Engagement of Young Minority Men in the Southern U.S.

18至29岁的年轻黑人男性同性恋者（YBMSM）受到艾滋病毒的严重影响 疫情此外，艾滋病毒+ YBMSM参与艾滋病毒护理级联的比例低于 其他亚群体，其中包括与护理挂钩、继续护理、启动和 保持对抗逆转录病毒治疗的依从性，并实现病毒抑制。艾滋病毒+ YBMSM生活在 美国南部（南方）是一个特别危险的群体，因为南方是美国的一个地区， 艾滋病死亡率最高。尽管影响艾滋病毒+的艾滋病毒发病率和死亡率存在巨大差异， 由于YBMSM生活在南方，因此缺乏干预措施来增加艾滋病毒+ YBMSM的参与，沿着 艾滋病毒护理级联。提供社会支持和角色示范的非正式导师可以帮助鼓励健康 行为，如更安全的性行为和医疗保健系统中增加的自我宣传， 青少年和年轻的成年人，一般来说。重要的是，许多年轻的男男性接触者认为， 对他们的生活产生积极的影响。因此，在艾滋病毒阳性的YBMSM的生活中纳入非正式导师， 支持艾滋病毒护理工作可能是减少艾滋病毒差距的一项有希望的战略。基于社会 行动理论（SAT）和指导理论，这一探索性的R21建议旨在研究的程度， 哪些非正式导师可以影响情境（例如，就业）和个人（例如，自信因素 SAT预测与HIV+ YBMSM中的HIV护理参与有关。定性访谈将 用于探索非正式导师如何影响HIV+ YBMSM参与的重要因素， 艾滋病毒护理。我们将采访HIV+ YBMSM（n = 48），包括成年早期和青年期，以及那些从事 和不从事护理，以及艾滋病毒+ YBMSM报告说，他们没有一个非正式的导师，探索 他们对影响艾滋病毒护理参与的背景和个人因素的看法，以及 非正式导师帮助解决了这些问题。此外，24对艾滋病毒+ YBMSM和 非正式导师（n = 48人），代表各种类型的影响艾滋病毒护理的报告因素 参与，将与对方讨论的方式，他们都可以接受，导师可以帮助 解决影响每一个艾滋病毒阳性的YBMSM参与艾滋病毒护理的可能性的特殊因素。 最后，研究小组将根据个人和二元访谈的结果，概述内容 和形式的干预，涉及非正式导师在支持艾滋病毒+ YBMSM参与沿着 艾滋病毒护理级联。该小组将征求社区咨询委员会对干预纲要的反馈意见 在整个干预纲要制定过程中，这项研究将提供重要的数据， 为R34提案奠定基础，以实现艾滋病毒护理的手册化并审查其可行性和可接受性 参与干预，涉及生活在南方的艾滋病毒阳性YBMSM的非正式导师。

Young Black men who have sex with men (YBMSM) ages 18 to 29 have been drastically affected by the HIV epidemic. Moreover, HIV+ YBMSM have lower rates of engagement in the HIV Care Cascade compared to other sub-populations, which includes the steps of being linked to care, retained in care, initiating and remaining adherent to antiretroviral therapy, and achieving viral suppression. HIV+ YBMSM living in the southern United States (the South) are a particularly at-risk group, as the South is the region in the U.S. with the highest HIV mortality. Despite the profound disparities in HIV morbidity and mortality affecting HIV+ YBMSM living in the South, there is a dearth of interventions to increase HIV+ YBMSM engagement along the HIV Care Cascade. Informal mentors who provide social support and role-modeling can help encourage health behaviors such as safer sex practices and increased self-advocacy in the healthcare system among adolescents and young adults, in general. Importantly, informal mentors are identified by many young MSM as positive influences in their lives. Thus, the inclusion of informal mentors already in the lives of HIV+ YBMSM in supporting HIV care engagement may be a promising strategy to reduce HIV disparities. Based on Social Action Theory (SAT) and Mentoring Theory, this exploratory R21 proposal seeks to examine the extent to which informal mentors can impact contextual (e.g., employment) and individual (e.g., self-confidence) factors predicted by SAT to be related to HIV care engagement among HIV+ YBMSM. Qualitative interviews will be used to explore ways informal mentors can impact factors important to the engagement of HIV+ YBMSM in HIV care. We will interview HIV+ YBMSM (n = 48), across both early and young adulthood and those engaged and not engaged in care, as well as HIV+ YBMSM reporting they do not have an informal mentor, to explore their perspectives regarding contextual and individual factors that affect HIV care engagement, and the extent to which informal mentors have helped address those factors. In addition, 24 dyads of HIV+ YBMSM and informal mentors (n = 48 people), representing a variety of types of reported factors affecting HIV care engagement, will discuss with each other ways that are acceptable to them both that mentors could help address particular factors that have affected the likelihood of each HIV+ YBMSM to engage in HIV care. Finally, based on the findings from the individual and dyadic interviews, the research team will outline content and format of an intervention involving informal mentors in supporting HIV+ YBMSM in engagement along the HIV Care Cascade. The team will elicit feedback on the intervention outline from a Community Advisory Board and Expert Panel throughout the intervention outline development process. This study will provide data vital to setting the stage for an R34 proposal to manualize and examine feasibility and acceptability of an HIV care engagement intervention that involves informal mentors for HIV+ YBMSM living in the South.