Social environmental drivers of stimulant use and its impact on HIV prevention and treatment in Black men who have sex with men

男男性行为黑人使用兴奋剂的社会环境驱动因素及其对艾滋病毒预防和治疗的影响

• 批准号: 10325012
• 负责人: Justin Knox
• 金额: $ 27.12万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10325012
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affect; Back; Behavior; Behavior Therapy; Behavioral Research; Biological; Biological Markers; Bisexual; Blood specimen; Characteristics; Chicago; Cocaine; Cohort Studies; Continuity of Patient Care; Data; Dependence; Development; Drug abuse; Drug usage; Enrollment; Environmental Risk Factor; Epidemic; Epidemiology; Event; Fibrinogen; Funding; Gays; HIV; HIV Seronegativity; HIV Seropositivity; HIV risk; Immune; Immunology; Incidence; Individual; Inflammation; Infrastructure; Intervention; Interview; Link; Marijuana; Measures; Methamphetamine; Methods; National Institute of Drug Abuse; Neighborhoods; Opioid; Outcome; Overdose; Pathway Analysis; Pathway interactions; Pattern; Pharmaceutical Preparations; Pharmacoepidemiology; Pharmacotherapy; Population; Prevalence; Prevention; Public Health; Publishing; Research; Research Methodology; Research Personnel; Risk Behaviors; Sex Behavior; Sexual Partners; Site; Social Environment; Social Network; Specimen; Stigmatization; Surveys; Swab; Testing; Time; TimeLine; Treatment outcome; Typology; Urine; Viral; biological research; black men who have sex with men; cohort; condoms; cytokine; data infrastructure; innovation; meetings; men; men who have sex with men; methamphetamine user; mortality; overdose death; polysubstance use; pre-exposure prophylaxis; primary outcome; recruit; rectal; sexual risk behavior; social; social cohesion; social media; spatial epidemiology; stimulant use; substance use; success; surveillance study; transmission process; uptake

Significance. Use of stimulants is a growing problem in the US. This growing public health crisis requires expanded research to explore its reach, drivers and impact, including on marginalized groups, such as Black gay, bisexual and other men who have sex with men (MSM), a critical population that is disproportionately impacted by HIV. Estimates of the incidence and persistence of stimulant use in Black MSM is needed, as well as research on how it co-occurs with other drug use (i.e. polysubstance use), its social-environmental drivers, and its impact on HIV transmission. Research Plan. In Aim 1, we will characterize stimulant use in an established cohort of Black MSM, including co-occurring use with other drugs (i.e. polysubstance use) and use over time (e.g., incidence, persistence). In Aim 2, we will identify network-level (e.g. disassortative racial mixing, network turnover) and neighborhood-level (e.g., social cohesion, time spent in gay neighborhoods) drivers of stimulant use in Black MSM. In Aim 3, we will assess how stimulant use impacts HIV transmission in Black MSM through HIV prevention (e.g. PrEP adherence, condom use), HIV treatment (e.g. ART adherence, viral suppression) and biological vulnerability (e.g. rectal cytokines). The ongoing Neighborhoods and Networks (N2) Cohort Study (R01MH112406; PIs: Duncan & Schneider) provides an ideal opportunity to conduct the proposed study. N2 includes 186 HIV-positive and 227 HIV-negative Black MSM living in Chicago. Data being collected include stimulant use at multiple cycles, in-depth assessments of neighborhoods (including real-time geospatial methods to track mobility within and between neighborhoods), multiple social network typologies, and HIV-related prevention and treatment behaviors. The proposed study will use N2 data to conduct Aims 1-3. We also propose to use existing N2 infrastructure to recruit 30 current stimulant-using and 10 non-stimulant-using HIV-negative Black MSM from the N2 study, and conduct in-depth interviews with them using a timeline follow-back survey focused on stimulant use and sexual risk behavior, as well as collect rectal swabs, urine and blood samples as objective biomarkers, in order to explore in-depth how stimulant use contributes to HIV transmission. The results of this study will inform the development of an R34 proposal to develop and test an intervention that addresses stimulant use and HIV in a critical population. Team. Investigators with expertise in stimulant use, HIV, social network analysis, spatial epidemiology, immunology, integration of biological and behavioral research, and mixed methods research will conduct this research together. Public Health Impact. The proposed study will be a large, rigorous and innovative study of stimulant use, its social-environmental drivers and its impact on HIV transmission in Black MSM, a group with a heavy burden of stimulant use and HIV. The proposed study is aligned with multiple NIDA funding priorities, including NOT-DA-19-066 Epidemiology of Drug Abuse, has a high likelihood of success by leveraging an existing cohort, and will directly inform an R34 proposal to develop and test an intervention that addresses stimulant use and HIV in a critical population.

意义在美国，使用兴奋剂是一个日益严重的问题。这场日益严重的公共卫生危机需要 扩大研究，探讨其范围、驱动因素和影响，包括对黑人等边缘化群体的影响 男同性恋、双性恋和其他男男性行为者（MSM），这是一个不成比例的关键人群， 受艾滋病毒影响。还需要估计黑人MSM使用兴奋剂的发生率和持续性 作为关于其如何与其他药物使用（即多种物质使用）共同发生的研究，其社会环境驱动因素， 及其对艾滋病毒传播的影响。研究计划。在目标1中，我们将描述已建立的 黑人MSM队列，包括与其他药物同时使用（即多种物质使用）和随时间推移使用 (e.g.,发生率、持续性）。在目标2中，我们将确定网络级别（例如，歧视性种族混合，网络 营业额）和邻居级（例如，社会凝聚力，在同性恋社区度过的时间）兴奋剂的驱动因素 在黑色MSM中使用。在目标3中，我们将评估兴奋剂使用如何影响黑人男男性行为者的艾滋病毒传播， 艾滋病毒预防（例如坚持PrEP，使用避孕套），艾滋病毒治疗（例如坚持ART，病毒抑制）和 生物脆弱性（如直肠细胞因子）。社区和网络（N2）队列研究 （R 01 MH 112406; PI：邓肯和施耐德）提供了进行拟定研究的理想机会。N2 包括居住在芝加哥的186名HIV阳性和227名HIV阴性的黑人MSM。收集的数据包括 在多个周期使用刺激物，深入评估社区（包括实时地理空间方法 追踪社区内和社区之间的流动性），多种社交网络类型，以及与艾滋病毒相关的 预防和治疗行为。拟议研究将使用N2数据执行目标1-3。我们亦建议 利用现有的N2基础设施招募30名目前使用兴奋剂和10名非兴奋剂的艾滋病毒阴性者 N2研究中的黑人男男性接触者，并使用时间轴跟踪调查对他们进行深入访谈 重点是兴奋剂使用和性风险行为，以及收集直肠拭子，尿液和血液样本， 客观的生物标志物，以深入探讨兴奋剂的使用如何有助于艾滋病毒的传播。结果 这项研究的结论将为R34提案的制定提供信息，以制定和测试一项干预措施， 兴奋剂使用和艾滋病毒在一个关键的人口。团队在兴奋剂使用、艾滋病毒、社会 网络分析，空间流行病学，免疫学，生物和行为研究的整合，以及混合 方法研究将共同进行这项研究。公共卫生影响。拟议的研究将是一个大型的， 对兴奋剂使用、其社会环境驱动因素及其对艾滋病毒的影响进行严格和创新的研究 在黑人男男性行为者中传播，这是一个有着兴奋剂使用和艾滋病毒沉重负担的群体。拟议的研究与 有多个NIDA资助优先事项，包括NOT-DA-19-066药物滥用流行病学， 成功的可能性，并将直接告知R34提案， 测试一项干预措施，解决兴奋剂使用和艾滋病毒在一个关键的人口。