Using Longitudinal Research to Engage African American and Latinx Sexual- and Gender-Minority Youth in the HIV Prevention and Care Continua and Reduce HIV/AIDS-Related Disparities

美国制定了到2030年结束艾滋病毒流行的目标，这一目标可以实现，但只有有针对性 对高危人群实施方法，以解决参与艾滋病毒/艾滋病沿着的已知障碍。 预防和护理持续进行。最受关注的人群包括与男性发生性关系的年轻男子 （YMSM），特别是有色人种的YMSM，他们现在占每年新感染艾滋病毒的绝大多数。 跨性别和性别不符合/非二元青年也是艾滋病毒感染的高风险，会计 每年新感染的比例都在增加。2015年，我们获得了NIDA的资助， 建立一个新的队列，包括448名非裔美国人/黑人（AA/B）和拉丁美洲YMSM，称为健康年轻人 男性（HYM）队列。我们还收到了一份行政补充文件，要求从一个 由B/AA和Latinx 108名跨性别和性别不平等/非二元青年（TGMY）组成的较小队列， 叫做真理队列HYM和TRUTH参与者在研究时的年龄都在16至24岁之间。 招聘总体目标是进行纵向研究，重点是这些年轻人的参与 继续开展艾滋病毒预防和护理工作，努力预防新的艾滋病毒感染，减少传播， 减少与艾滋病毒/艾滋病相关的差异。混合方法的研究是使用定性访谈，一个自我， 报告调查、药物筛查以及性传播感染和艾滋病毒检测。生物样本 还收集血浆、血沉棕黄层、直肠拭子并储存。迄今为止进行的分析清楚地表明， 有证据表明，两个队列中的参与者都处于艾滋病毒、药物使用和心理健康/精神病的高风险中 条件交叉柱头-即，由于多重、交叉的身份而遭受的耻辱经历1- 5-似乎也不鼓励AA/B和Latinx YMSM和TGMY参与护理，也许可能 影响其风险、传播和健康的发展弧。在这项工作的基础上，我们建议 纵向：i）检查B/L-YMSM在艾滋病毒预防和护理连续性中的参与，以及他们的 吸毒、性传播感染/艾滋病毒感染、健康和精神/心理健康的发展转变和轨迹 合并症（目标1）; ii）检查TGMY在艾滋病毒预防和护理连续性中的参与，并确定 在TGMY的药物使用、性病/艾滋病毒感染、 健康和精神/心理健康共病（目标2）;和iii）作为地方和国家资源， 合作与传播。我们将积极参与合作联盟并作出贡献 生产NIDA机会的队列（C3 PNO），NIDA U 01队列的协调中心。我们将 还与关键利益相关者（例如，社区组织、决策者），并与 培训生、早期职业教师和跨翻译领域的研究人员（目标3）。

The U.S. has set a goal to end the HIV epidemic by the year 2030, which can be achieved but only if targeted approaches are implemented with at-risk populations to address known barriers of engagement along the HIV prevention and care continua. Populations of greatest concern include young men who have sex with men (YMSM), especially YMSM of color, who now account for the vast majority of new HIV infections each year. Transgender and gender non-conforming/non-binary youth are also at high risk for HIV acquisition, accounting for an increasing proportion of new infections each year. In 2015, we were awarded a grant from NIDA to establish a new cohort of 448 African American/Black (AA/B) and Latino YMSM, called the Healthy Young Men’s (HYM) Cohort. We also received an administrative supplement to collect two waves of data from a smaller cohort of B/AA and Latinx 108 transgender and gender nonconforming/non-binary youth (TGMY), called the TRUTH Cohort. Both HYM and TRUTH participants were 16 to 24 years of age at the time of recruitment. The overarching aim was to conduct longitudinal research focused on these youths’ engagement in the HIV prevention and care continua in an effort to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities. Mixed methods research is conducted using qualitative interviews, a self- report survey, drug screening, and testing for sexually transmitted infections (STIs) and HIV. Biospecimens (plasma, buffy coat, rectal swabs) are also collected and banked. Analyses performed to date provide clear evidence that participants in both cohorts are at high risk for HIV, drug use, and mental health/psychiatric conditions. Intersectional stigma—i.e., experiences of stigma stemming from multiple, intersecting identities1- 5—also appears to discourage AA/B and Latinx YMSM and TGMY from engaging in care and perhaps may impact their developmental arcs of risk, transmission, and health. Building on this work, we are proposing to longitudinally: i) examine B/L-YMSM’s engagement in the HIV prevention and care continua, as well as their developmental transitions and trajectories in drug use, STI/HIV infection, health, and psychiatric/mental health comorbidities (Aim 1); ii) examine TGMY’s engagement in the HIV prevention and care continua and identify shared and unique transitions and trajectories with respect to TGMY’s use of drugs, infections with STI/HIV, health and psychiatric/mental health comorbidities (Aim 2); and iii) serve as a local and national resource for collaborations and dissemination. We will actively participate in and contribute to the Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO), the Coordinating Center for NIDA’s U01 cohorts. We will also partner with key stakeholders (e.g., community organizations, policy makers) and collaborate with trainees, early career faculty and investigators across the translational spectrum (Aim 3).