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: 10544182
• 负责人: Sophia A. Hussen
• 金额: $ 23.46万
• 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/10544182
• 关键词: 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; Disparity; Disparity population; Epidemic; Evaluation; Evidence based intervention; Face; Future; Gays; Geography; Goals; HIV; HIV disparities; HIV/AIDS; Home; Incidence; Individual; Institution; Intervention; Intervention Studies; Lead; Methods; Morbidity - disease rate; NIH Office of AIDS Research; Outcome; Perception; Persons; 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; behavior change; care outcomes; community based participatory research; community organizations; 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; process improvement; promote resilience; psychosocial; racism; recruit; resilience; resilience factor; satisfaction; social; social capital; social stigma; telehealth; theories; therapy design; transmission process; videoconference; 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.

项目总结 年轻的黑人同性恋、双性恋和其他男男性行为者(YB-GBMSM)遇到多层障碍 从事艾滋病毒护理，这是结构性和人际种族主义、同性恋和艾滋病毒的直接结果 耻辱。这些障碍导致了艾滋病毒差异，其中YB-GBMSM的艾滋病毒流行率和发病率很高， 但在整个艾滋病毒护理连续过程中，参与率并不理想。个人和个人的复原力 社区一级可以缓解耻辱和歧视对艾滋病毒护理参与的有害影响。我们 之前为YB-GBMSM艾滋病毒携带者开发了一种特定于文化的复原力培养干预措施 被称为兄弟建立兄弟打破障碍(B6)。B6专门针对跨部门身份 肯定(个人层面的韧性因素)和社会资本(社区层面的韧性因素)作为 改善艾滋病毒护理参与度的战略。这个R34应用程序目标是改编B6，最初 开发为面对面干预，用于在以社区为基础的背景下提供远程医疗 组织(CBO)。该项目的基本原理是远程医疗提供和CBO合作伙伴关系将 参与的障碍，并促进可伸缩性和可持续性。我们的研究将设在佐治亚州的亚特兰大- 艾滋病病毒的中心。这项研究将追求三个具体目标：(1)使B6适应远程保健交付，在 与YB-GBMSM、社区顾问和主题专家合作；(2)进行试点 YB-GBMSM人群TELE-B6可行性和可接受性的随机对照研究 (3)在我们的伙伴CBO的背景下，评估实施B6的进程。 对于第一个目标，我们将使用Adapt-ITT框架将B6从面对面转换为远程医疗 干预(Tele-B6)。对于第二个目标，我们将测试N=60YB-GBMSM的TELE-B6，并研究其可行性 以及干预的可接受性。我们还将探讨干预对社会资本、身份认同的影响 肯定，以及艾滋病毒护理的参与。在第三个目标中，我们将利用综合框架 实施研究，以检查在我们合作伙伴的结构内实施Tele-B6的流程 国会预算办公室。这项拟议的研究具有非常重要的意义，因为它有可能开发一种具有文化相关性的 针对YB-GBMSM的可扩展干预，这一群体继续受到严重和不成比例的影响 爱滋病毒。