Neighborhoods, Networks, and the HIV Care Continuum among HIV-infected MSM in NYC

纽约市感染 HIV 的 MSM 的社区、网络和 HIV 护理连续体

• 批准号: 10534034
• 负责人: Hong Van Nhu Tieu
• 金额: $ 21.29万
• 依托单位: NEW YORK BLOOD CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534034
• 关键词: Americas; Anti-Retroviral Agents; Black race; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 testing; COVID-19 treatment; Caring; Continuity of Patient Care; Data; Enrollment; Epidemic; Funding; HIV; Health; Healthcare; Interview; Longitudinal Studies; Medical; Methods; Minority Groups; Morbidity - disease rate; National Institute of Mental Health; Neighborhoods; New York City; Outcome; Participant; Patients; Population; Provider; Research; Sampling; United States Dept. of Health and Human Services; Viral; Viral Load result; Work; base; black men who have sex with men; cohort; experience; follow-up; improved; medical appointment; medication compliance; men; men who have sex with men; mortality; pandemic disease; psychosocial; racism; social stigma; therapy adherence

Abstract Rapid HIV treatment and sustained viral suppression is one of the 4 strategies in the U.S. Department of Health and Human Services (HHS) plan to end the HIV epidemic in America. HIV disparities among Black men who have sex with men (BMSM) have been documented along all stages of the HIV care continuum, with BMSM having higher morbidity and mortality rate, less likely to engaged in HIV care and achieve viral suppression. While many factors influence engagement in HIV care, it is particularly important to understand psychosocial deterrents such as stigma and medical mistrust among BMSM, as this population often experience overlapping stigmas. Intersectional stigma, medical mistrust, and decreased likelihood of referral for HIV or COVID-19 testing and treatment have been shown to be associated with reduced engagement in care among minority populations and individuals living with HIV. Patient-provider relationship has been shown to negatively influence engagement in HIV care; however, this association is not well document among BMSM who are living with HIV especially in the context of a pandemic. The specific aims of the proposed research in this 1-year Diversity Supplement are to: Aim 1. Using the baseline and follow-up data from the CASI, determine the association between patient- provider interaction and perceived racism in healthcare and engagement in HIV care (medical appointment attendance, antiretroviral medical therapy adherence, and viral suppression) among BMSM; and examine the effect of the COVID-19 pandemic on BMSM’s ability to navigate the HIV care continuum. Aim 2. Conduct a qualitative sub-study involving in-depth interviews among 50 NNHIV participants who self-identify as Black using stratified random sampling based on viral load suppression to: (a) Characterize experiences of provider interaction and perceived racism in healthcare among BMSM; (b) Examine the ways in which patient-provider relationship influences navigation of the HIV care continuum, and how it has been impacted by the COVID-19 pandemic; (c) Characterize intersectional stigma associated with COVID-19 and HIV and how it impacts navigation of the HIV care continuum and overall health outcomes among Black MSM; (d) Identify strategies that participants believe should be implemented to improve patient- provider interaction, reduce racism in health care and help BMSM navigate the HIV care continuum. This work is a sub-study of the ongoing NIMH R01-funded longitudinal study called Neighborhoods, Networks and HIV Care (NNHIV) among BMSM living with HIV who reside in New York City. The findings of this study will help us elucidate the NNHIV quantitative data and advance our understanding of the ways in which the COVID-19 pandemic, patient-provider interaction and HIV and COVID-19 stigmas influence engagement in care and viral suppression among BMSM.

抽象的 快速HIV治疗和持续的病毒抑制是美国部门的四种策略之一 卫生与公共服务（HHS）计划结束美国的艾滋病毒流行。黑人中的艾滋病毒差异 与男性发生性关系（BMSM）已在艾滋病毒护理连续体的各个阶段都记录下来 BMSM具有较高的发病率和死亡率，从事艾滋病毒护理并获得病毒的可能性较小 抑制。尽管许多因素会影响参与艾滋病毒护理，但要了解 BMSM中的污名和医学不信任等社会心理决定者，因为这个人群经常 体验重叠的污名。交叉污名，医学不信任和提高转诊的可能性 对于HIV或COVID-19的测试和治疗，已显示与参与度降低有关 少数民族和艾滋病毒感染者的照顾。已经显示了患者支持者的关系 负面影响参与艾滋病毒护理；但是，该协会在BMSM中的记录不佳 患有艾滋病毒的人，尤其是在大流行的背景下。拟议研究的具体目的 这种为期1年的多样性补充是：AIM 1。使用CASI的基线和后续数据， 确定患者提供者互动与医疗保健中感知的种族主义之间的关联和 参与艾滋病毒护理（医疗预约出勤，抗逆转录病毒药物疗法依从性和病毒 BMSM中的抑制）；并检查COVID-19大流行对BMSM导航能力的影响 HIV护理连续性。目标2。进行定性次级学生，涉及50种的深入访谈 NNHIV参与者使用基于病毒载荷抑制的分层随机抽样自我识别为黑色 到：（a）表征提供者互动和BMSM中医疗保健中种族主义的经历； （b） 检查患者支持者关系影响艾滋病毒护理连续体的导航的方式，以及 它如何受到19日大流行的影响； （c）表征与 COVID-19和HIV及其如何影响HIV护理连续体的导航和整体健康成果 在黑色MSM中； （d）确定参与者认为应该实施改善患者的策略 - 提供者互动，减少医疗保健中的种族主义，并帮助BMSM导航艾滋病毒护理连续性。这项工作 是正在进行的NIMH R01资助的纵向研究的子研究名为邻里，网络和艾滋病毒 居住在纽约市的艾滋病毒的BMSM中的护理（NNHIV）。这项研究的结果将帮助我们 阐明NNHIV定量数据并提高我们对Covid-19的方式的理解 大流行，患者培训的互动以及HIV和Covid-19污名会影响参与护理和病毒 BMSM中的抑制作用。