Examining Modifiable Psychosocial Predictors of HIV Seroconversion in a Large Nationwide Cohort of High Risk Men

检查全国范围内大量高危男性中 HIV 血清转化的可修改心理社会预测因素

• 批准号: 10415523
• 负责人: H. Jonathon Rendina
• 金额: $ 86.78万
• 依托单位: WHITMAN-WALKER INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-19 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10415523
• 关键词: AIDS prevention; Age; Behavior; Biological; Bisexual; Child Sexual Abuse; Chlamydia; Chlamydia Infections; Cohort Studies; Color; Development; Discrimination; Distal; Enrollment; Environment; Epidemic; Epidemiology; Ethnic Origin; Future; Gays; Geographic Locations; Goals; Gonorrhea; HIV; HIV Infections; HIV Seropositivity; HIV risk; HIV/STD; Incidence; Income; Individual; Infection; Intervention; Lead; Link; Measures; Mental Depression; Mental Health; Minority; Modeling; Outcome; Patient Self-Report; Population; Predisposition; Prevalence; Prevention Research; Prevention program; Procedures; Puerto Rico; Race; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Stress; Structure; Subgroup; Testing; Time; Validity and Reliability; Work; aged; base; behavior change; cohort; condomless anal sex; design; disparity reduction; experience; high risk; high risk men; high risk population; improved; infection rate; infection risk; interest; intimate partner violence; men; men who have sex with men; mobile application; morphogens; next generation; polysubstance use; predictive modeling; preventive intervention; prospective; psychosocial; recruit; rectal; response; seroconversion; sexual minority; stressor; substance use; willingness

Project Summary Gay, bisexual and other men who have sex with men (GBMSM) remain a population in the U.S. for whom the burden of HIV is high and disproportionate, particularly among younger GBMSM and GBMSM of color, for whom HIV incidence continues to rise despite decades of HIV prevention research to curb the epidemic. However, even among these highest risk groups, risk for infection is not equivalent and the goal of this study is to better understand what factors differentiate levels of risk for HIV infection. Research to date suggests that this disproportionate burden is likely to be exacerbated by psychosocial disparities faced by this population in the form of syndemics and sexual minority stress. However, research on these factors has been limited by a focus on risk for HIV infection operationalized as risk behavior or cross-sectional prevalence of HIV, making actual vulnerability to infection and temporal associations difficult, if not impossible, to determine. We are submitting this application in response to RFA-AI-16-031 Limited Interaction Targeted Epidemiology (LITE) to Advance HIV Prevention (UG3/UH3). We propose to recruit and enroll a large and diverse cohort of approximately 8,000 GBMSM ages 16 and older in the U.S. and Puerto Rico who are at high risk for infection. We will utilize mobile sexual networking applications (“mobile apps”) to identify and enroll these men both to allow for rapid and efficient recruitment and because these apps rapidly increasing in popularity, with research demonstrating that men who use mobile apps are at higher levels of risk for HIV infection than GBMSM recruited through other means. Using this cohort, we will work to achieve three primary aims: (1) we will establish HIV prevalence as well as prevalence of rectal sexually transmitted infections (STIs; gonorrhea and chlamydia) at baseline and subsequently establish rates of HIV and rectal STI incidence among these men 12 months thereafter; (2) we will utilize baseline levels of syndemic, minority stress, and other relevant psychosocial risk factors to develop a model of those modifiable factors that contribute to increased risk for HIV seroconversion (i.e., incidence) as well as rectal STI infection; (3) we will utilize the model to target men in the highest quartile of risk for HIV seroconversion in the cohort and follow them every 6 months thereafter for an additional two years to examine the predictive utility in prospectively predicting HIV seroconversion as well as time to seroconversion. Developing a model of modifiable psychosocial risk factors for actual HIV seroconversion and subsequently testing its reliability and validity in a prospective design has high potential to improve the next generation of HIV prevention interventions aimed at reducing disparities for this population.

项目摘要 同性恋、双性恋和其他与男性发生性关系的男性（GBMSM）仍然是美国的一个人口群体， 艾滋病毒的负担很高，而且不成比例，特别是在年轻的GBMSM和有色人种的GBMSM中， 尽管几十年来进行了艾滋病毒预防研究以遏制这一流行病，但艾滋病毒的发病率仍在继续上升。 然而，即使在这些最高风险群体中，感染风险也不相等，本研究的目的是 以更好地了解哪些因素区分艾滋病毒感染的风险水平。迄今为止的研究表明， 这一不成比例的负担很可能因这一群体面临的心理社会差异而加剧， 综合症和性少数压力的形式。然而，对这些因素的研究一直受到限制， 重点关注艾滋病毒感染的风险，将其作为风险行为或艾滋病毒的横断面流行， 很难，如果不是不可能的话，确定感染的实际脆弱性和时间关联。我们 根据RFA-AI-16-031有限相互作用靶向流行病学（LITE）提交本申请， 艾滋病毒高级预防（UG 3/UH 3）。我们建议招募和招募一个庞大而多样化的队列， 在美国和波多黎各约有8，000名年龄在16岁及以上的GBMSM，他们处于感染的高风险中。 我们将利用移动的性网络应用程序（“移动的应用程序”）来识别和登记这些男性， 允许快速和有效的招聘，因为这些应用程序迅速增加受欢迎程度，研究 这表明使用移动的应用程序的男性比GBMSM感染艾滋病毒的风险更高 通过其他方式招募。利用这一群体，我们将努力实现三个主要目标：（1）我们将 确定艾滋病毒流行率以及直肠性传播感染（性病、淋病和 衣原体），随后确定这些男性中艾滋病毒和直肠性传播感染的发病率12 （2）我们将利用基线水平的syndemic，少数民族的压力，和其他相关的 心理社会风险因素，以建立导致艾滋病毒风险增加的可改变因素模型 血清转化（即，发病率）以及直肠STI感染;（3）我们将利用该模型针对 队列中HIV血清转化风险最高的四分位数，此后每6个月随访一次， 另外两年，检查前瞻性预测HIV血清转换的预测效用， 血清转化时间。开发一个可改变的艾滋病毒实际心理社会风险因素模型 血清转化并随后在前瞻性设计中测试其可靠性和有效性具有很高的潜力， 改进下一代艾滋病毒预防干预措施，以减少这一人群的差距。

项目成果

Reactions to Testing HIV Negative: An Assessment of Measurement Invariance and Associations with Condomless Anal Sex among English and Spanish-speaking Latinx Sexual Minority Men in the United States.

对艾滋病毒检测呈阴性的反应：对美国讲英语和西班牙语的拉丁裔性少数男性的测量不变性及其与无套肛交的关联的评估。

• DOI: 10.1007/s10461-023-04081-5
• 发表时间: 2023
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Robles,Gabriel;Lee,JaneJ;Reynolds,Addam;Rodríguez-Díaz,CarlosE;Rendina,HJonathon
• 通讯作者: Rendina,HJonathon

Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men.

• DOI: 10.1136/sextrans-2021-055047
• 发表时间: 2022-06
• 期刊: Sexually transmitted infections
• 影响因子: 3.6

Rates of Pre-exposure Prophylaxis Use and Discontinuation Among a Large U.S. National Sample of Sexual Minority Men and Adolescents.

美国全国性少数男性和青少年大型样本中暴露前预防药物的使用和停用率。

• DOI: 10.1007/s10508-019-01602-z
• 发表时间: 2020
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Whitfield,ThomasHF;Parsons,JeffreyT;Rendina,HJonathon
• 通讯作者: Rendina,HJonathon

The Use of HIV Pre- and Postexposure Prophylaxis Among a Web-Based Sample of HIV-Negative and Unknown Status Cisgender and Transgender Sexual Minority Men: Cross-sectional Study.

• DOI: 10.2196/31237
• 发表时间: 2022-12-16
• 期刊: JMIR PUBLIC HEALTH AND SURVEILLANCE
• 影响因子: 8.5
• 作者: John, Steven A.;Sizemore, Marie;Jimenez, Ruben H.;Jones, S. Scott;Petroll, Andrew E.;Rendina, H. Jonathon
• 通讯作者: Rendina, H. Jonathon

Use of the Bio-Rad Geenius HIV-1/2 supplemental assay for the testing of oral fluids for the presence of HIV antibody.

使用 Bio-Rad Geenius HIV-1/2 补充检测检测口腔液中是否存在 HIV 抗体。

• DOI: 10.1016/j.jcv.2020.104422
• 发表时间: 2020
• 期刊: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
• 作者: Elma,Maria;Krusel,Kathryn;Crumpler,Megan;Tavella,Nico;Talan,Ali;Rendina,Jonathon;Pandori,Mark
• 通讯作者: Pandori,Mark