Brothers building brothers by breaking barriers (B6): A resilience-focused intervention for young Black gay and bisexual men living with HIV

兄弟通过打破障碍建立兄弟（B6）：针对感染艾滋病毒的年轻黑人男同性恋和双性恋男子进行以复原力为重点的干预措施

• 批准号: 10402586
• 负责人: Sophia A. Hussen
• 金额: $ 24.88万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10402586
• 关键词: AIDS/HIV problem; Address; Age; Area; Belief; Bisexual; Black race; Brothers; Buffers; Caring; Clinical; Collaborations; Communities; Consolidated Framework for Implementation Research; Continuity of Patient Care; Control Groups; County; Development; Discrimination; Epidemic; Evaluation; Evidence based intervention; Face; Future; Gays; Geography; Goals; HIV; Home; Incidence; Individual; Intervention; Intervention Studies; Lead; Methods; Morbidity - disease rate; NIH Office of AIDS Research; Outcome; Perception; Persons; Population; Positioning Attribute; Prevalence; Prevention Research; Process; Public Health; Race; Randomized; Randomized Controlled Trials; Research; Research Methodology; Resources; Safety; Series; Sexuality; Site; Social Environment; Social Network; Structural Racism; Structure; Sum; Testing; Translating; United States National Institutes of Health; Viral; Waiting Lists; Work; Youth; acceptability and feasibility; barrier to care; base; behavior change; community based participatory research; design; disparity reduction; effectiveness implementation trial; efficacy trial; evidence base; homonegativity; improved; intervention effect; medication compliance; men; men who have sex with men; mortality; multidisciplinary; novel; online resource; pilot test; pilot trial; psychosocial; racism; recruit; resilience; satisfaction; social; social capital; social stigma; telehealth; theories; therapy design; transmission process; young man

PROJECT SUMMARY Young Black gay, bisexual and other men who have sex with men (YB-GBMSM) encounter multilevel barriers to engaging in HIV care, as a direct result of structural and interpersonal racism, homonegativity and HIV stigma. These barriers lead to HIV disparities in which YB-GBMSM have high HIV prevalence and incidence, but suboptimal rates of engagement across the HIV Care Continuum. Resilience at both the individual and community levels can buffer the deleterious effects of stigma and discrimination on HIV care engagement. We have previously developed a culturally-specific resilience-building intervention for YB-GBMSM living with HIV called Brothers Building Brothers by Breaking Barriers (B6). B6 specifically targets intersectional identity affirmation (an individual-level resilience factor) and social capital (a community-level resilience factor) as a strategy for improving engagement in HIV care. The objective of this R34 application is to adapt B6, originally developed as an in-person intervention, for telehealth delivery within the context of a community-based organization (CBO). The rationale for the project is that telehealth delivery and CBO partnership will remove barriers to participation and facilitate scalability and sustainability. Our study will be based in Atlanta, Georgia – an HIV epicenter. This study will pursue three specific aims: (1) to adapt B6 for telehealth delivery, in collaboration with YB-GBMSM, community advisors, and subject matter experts; (2) to conduct a pilot randomized controlled trial (RCT) to evaluate feasibility and acceptability of tele-B6 among YB-GBMSM living with HIV in Atlanta; and (3) to evaluate the process of implementing B6 within the context of our partner CBO. For the first aim, we will use the ADAPT-ITT framework to convert B6 from an in-person to a telehealth intervention (tele-B6). For the second aim, we will test tele-B6 with N=60 YB-GBMSM and examine feasibility and acceptability of the intervention. We will also explore intervention impacts on social capital, identity affirmation, and HIV care engagement. In the third aim, we will utilize the Consolidated Framework for Implementation Research to examine the process of implementing tele-B6 within the structure of our partner CBO. The proposed research is highly significant because of its potential to develop a culturally relevant, scalable intervention for YB-GBMSM, a group who continues to be heavily and disproportionately impacted by HIV.

项目概要 年轻黑人同性恋、双性恋和其他男男性行为者 (YB-GBMSM) 遇到多层次的障碍 参与艾滋病毒护理，这是结构性和人际种族主义、同性恋消极和艾滋病毒的直接结果 柱头。这些障碍导致艾滋病毒差异，其中 YB-GBMSM 的艾滋病毒患病率和发病率很高， 但整个艾滋病毒护理连续体的参与率并不理想。个人和个人的复原力 社区层面可以缓冲耻辱和歧视对艾滋病毒护理参与的有害影响。我们 此前曾为感染艾滋病毒的 YB-GBMSM 制定了针对特定文化的复原力建设干预措施 称为“打破障碍，建立兄弟”（B6）。 B6专门针对交叉身份 肯定（个人层面的复原力因素）和社会资本（社区层面的复原力因素） 提高艾滋病毒护理参与度的战略。这个R34应用程序的目标是适应B6，最初 作为一种现场干预措施，在基于社区的背景下提供远程医疗服务 组织（国会预算办公室）。该项目的理由是远程医疗服务和 CBO 合作将消除 参与障碍并促进可扩展性和可持续性。我们的研究将设在佐治亚州亚特兰大—— 艾滋病毒震中。这项研究将追求三个具体目标：(1) 使 B6 适应远程医疗服务， 与 YB-GBMSM、社区顾问和主题专家合作； （二）开展试点 随机对照试验 (RCT) 评估 YB-GBMSM 生活中远程 B6 的可行性和可接受性 亚特兰大感染艾滋病毒； (3) 在我们的合作伙伴 CBO 的背景下评估实施 B6 的过程。 对于第一个目标，我们将使用 ADAPT-ITT 框架将 B6 从面对面医疗转变为远程医疗 干预（远程 B6）。对于第二个目标，我们将使用 N=60 YB-GBMSM 测试 tele-B6 并检查可行性 以及干预措施的可接受性。我们还将探讨干预措施对社会资本、身份的影响 肯定和艾滋病毒护理参与。在第三个目标中，我们将利用综合框架 实施研究，检查在我们合作伙伴的结构内实施 tele-B6 的过程 国会预算办公室。拟议的研究非常重要，因为它有可能开发出与文化相关的、 对 YB-GBMSM 进行可扩展的干预，该群体继续受到严重且不成比例的影响 艾滋病病毒。