Modeling perceptions of social location and decision-making to develop targeted messaging promoting HIV care engagement and ART adherence among women living with HIV in the South

项目摘要/总结 南方妇女艾滋病毒感染者（WLWH）的病毒抑制率在所有妇女中最低 美国（US）的地区。迄今为止，艾滋病毒护理参与和抗逆转录病毒疗法坚持 旨在减少南方WLWH病毒抑制差异的干预措施数量很少， 没有考虑到女性的不同社会地位。社会位置，一个关键的概念， 框架，广义上指的是背景因素和人们在社会等级中所处的地位， 他们的交叉身份和健康的社会决定因素，如性别，种族/民族和阶级不平等; 地理位置;和艾滋病毒相关的耻辱。在交叉框架的指导下， 该应用程序旨在为WLWH开发有针对性的艾滋病毒护理参与和ART依从性信息， 在南方的不同社会位置。具体而言，该项目将在农村和非农村地区实施， 北卡罗来纳州是继续推动美国疫情蔓延的南部九个州之一， 受艾滋病毒影响最严重的人中有相当大比例（46%）居住在大城市地区以外。具体 目标是：1）确定艾滋病毒护理参与的社会位置和决策过程， WLWH报告的南方的抗逆转录病毒疗法坚持率; 2）制定高度针对性的信息， 参与南方WLWH的艾滋病毒护理和坚持抗逆转录病毒疗法; 3）评估可理解性， 有针对性的艾滋病毒护理参与和抗逆转录病毒疗法依从性信息的可接受性和个人相关性。 对于第一个目标，深入访谈（n=36）将进行与顺式和变性WLWH从不同的 社会地点在南方通知知觉映射调查的发展。对于第二个目标， 知觉映射调查将管理顺性别和跨性别WLWH（n=108），分析，并使用 来创建由多维缩放软件生成的感知图。感知映射和向量 消息建模是一种新颖的方法，它可以生成数学三维模型， 制定了针对性强的信息。对于第三个目标，将进行焦点小组（n=30）评估 目标消息的可理解性、可接受性和个人相关性。拟议 研究是创新的，在其概念取向，以解决交叉的身份和社会 南方WLWH健康的决定因素以及感知映射和矢量的新应用 建模方法这项拟议中的研究意义重大，因为它有望提供高度针对性的艾滋病毒 旨在减少WLWH病毒抑制差异的护理参与和ART依从性信息 在南方

PROJECT ABSTRACT/SUMMARY Women living with HIV (WLWH) in the South have the lowest rates of viral suppression among women in all regions in the United States (US). To date, HIV care engagement and antiretroviral (ART) adherence interventions aimed at decreasing viral suppression disparities for WLWH in the South are few in number and have failed to consider the women's diverse social locations. Social location, a key concept in intersectional frameworks, refers broadly to contextual factors and the position people occupy in a social hierarchy based on their intersecting identities and social determinants of health like gender-, race/ethnic-, and class inequities; geographic location; and HIV-related stigma. Guided by an intersectional framework, the overall objective of this application is to develop targeted HIV care engagement and ART adherence messaging for WLWH from diverse social locations in the South. Specifically, this project is to be implemented in rural and non-rural regions of North Carolina, one of the nine southern states that continues to drive the US epidemic and has a substantial percentage (46%) of people most impacted by HIV living outside large urban areas. The specific aims are to: 1) determine the social locations and decision-making processes for HIV care engagement and ART adherence as reported by WLWH in the South; 2) develop highly targeted messages to enhance engagement in HIV care and ART adherence for WLWH in the South; and 3) assess the comprehensibility, acceptability and personal relevance of the targeted HIV care engagement and ART adherence messaging. For the first aim, in-depth interviews (n=36) will be conducted with cis and transgender WLWH from diverse social locations in the South to inform the development of perceptual mapping surveys. For the second aim, perceptual mapping surveys will be administered to cis and transgender WLWH (n=108), analyzed, and used to create perceptual maps generated from multidimensional scaling software. Perceptual mapping and vector message modeling is a novel method that produces mathematical, three-dimensional models, resulting in the development of highly targeted messages. For the third aim, focus groups (n=30) will be conducted to assess the comprehensibility, acceptability, and personal relevance of the targeted messaging. The proposed research is innovative in its conceptual orientation to addressing the intersecting identities and social determinants of health for WLWH in the South and novel application of perceptual mapping and vector modeling method. The proposed research is significant because it is expected to provide highly targeted HIV care engagement and ART adherence messages aimed at decreasing viral suppression disparities for WLWH in the South.