CAMELLIA Cohort: A longitudinal study to understand sexual health and prevention among women in Alabama

CAMELLIA 队列：一项了解阿拉巴马州女性性健康和预防的纵向研究

• 批准号: 10701932
• 负责人: Latesha Ellen Elopre
• 金额: $ 121.12万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-08 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10701932
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Age; Alabama; Algorithms; Area; Awareness; Behavioral; Black American; Black race; Blood; Camellia sinensis; Caring; Chlamydia; Collaborations; Color; Communities; County; Data; Data Sources; Deep South; Development; Diagnosis; Disparity; Dryness; Elements; Eligibility Determination; Enrollment; Epidemic; Epidemiology; Evidence based intervention; Exposure to; Flowers; Funding; Funding Opportunities; Future; Geography; Goals; Gonorrhea; HIV; HIV Infections; HIV diagnosis; HIV risk; High Risk Woman; Hispanic; Hispanic Americans; Home; Human immunodeficiency virus test; Incidence; Individual; Inequity; Infection; Institutionalization; Interview; Longitudinal Studies; Mediator; Medical Records; Methodology; Mobile Health Application; Monitor; Names; National Institute of Allergy and Infectious Disease; North Carolina; Outcome; Outcome Study; Patient Self-Report; Persons; Population; Poverty; Prevention; Process; Public Health; Recording of previous events; Research; Research Personnel; Research Proposals; Risk; Rural; Sampling; Sexual Health; Sexually Transmitted Diseases; Spottings; Surveys; Syphilis; Syphilis Serodiagnosis; System; Techniques; Testing; United States; Universities; Woman; acceptability and feasibility; black men who have sex with men; black women; cis-female; cohort; community engaged research; design; digital; digital platform; epidemiologic data; evidence base; experience; high risk; home test; improved; innovation; member; multidisciplinary; novel; population based; pre-exposure prophylaxis; prevention service; primary outcome; programs; racism; recruit; social; social disparities; therapy development; tool; transgender women; trend; uptake; usability; women of color

Abstract Despite the availability of effective HIV prevention tools such as pre-exposure prophylaxis (PrEP), significant disparities persist among communities of color, particularly among women in the Deep South where the rate of HIV infection is fourteen-times higher for Black women compared to White women. PrEP utilization remains low among women in the Deep South with estimates of <7% eligible women receiving PrEP in Alabama. Moreover, algorithms to determine PrEP eligibility demonstrate poor predictive power for women. The proposal takes advantage of a dynamic and innovative collaboration of experienced HIV-prevention investigators from the University of Alabama-Birmingham, University of North Carolina-Chapel Hill, Centers for AIDS Research, the Alabama Department of Public Health (ADPH), and Social Scientific Systems. This novel research proposal utilizes a population-based approach to establish a geographically representative cohort of cis- and trans-gender women (‘Camellia Cohort’) at significant risk for future HIV acquisition, based on recent gonorrhea or syphilis infection, across the state of Alabama (AL), highlighted as a geographic hotspot by the federal Ending the HIV Epidemic strategy, to better understand factors associated with risk of STI and HIV diagnosis and predictors for PrEP use. The aims of this proposal are to: 1) refine the HealthMpowerment (HMP) digital platform, previously utilized to deliver evidence-based interventions to improve HIV and prevention outcomes among Black men who have sex with men and transgender women, to include key elements that optimally engage and retain a cohort of women at-risk for HIV in AL; this will be achieved via stakeholder engaged research with self-identified women on PrEP and PrEP care team members using nominal group techniques; 2) recruit and retain a geographically-diverse and rurally-enhanced cohort of 800 women ages 18-44, with recent positive gonorrhea or syphilis testing who are STI- and HIV-uninfected at enrollment, to participate in the Camellia digital cohort utilizing a geographically diverse sampling framework using public and commercially available annual county-level HIV and STI testing data and 3) evaluate predictors, mediators and moderators for STI/HIV incidence and PrEP use and adherence in the Camellia Cohort by collecting demographic, behavioral, and community level assessments via the HMP digital platform and HIV/STI testing through ADPH’s home testing program at regular intervals; we will purposefully sample women with high HIV vulnerability and/or PrEP use within the cohort for in-depth interviews (n = 30) to further explore factors contributing to PrEP use to guide future intervention development. This research will lay the groundwork for a larger research program testing the implementation of a further adapted HMP digital platform designed to improve HIV/STI testing, PrEP utilization and persistence among women in the Deep South, focusing on areas with higher HIV incidence.

抽象的 尽管有有效的艾滋病毒预防工具，例如暴露前预防 (PrEP)，但 有色人种社区之间仍然存在差距，特别是在南方腹地的妇女中，那里的 黑人女性的艾滋病毒感染率是白人女性的十四倍。 PrEP 利用率保持不变 南部腹地的女性比例较低，估计阿拉巴马州接受 PrEP 的合格女性比例低于 7%。 此外，确定 PrEP 资格的算法对女性的预测能力较差。提案 利用来自经验丰富的艾滋病毒预防研究人员的动态和创新合作 阿拉巴马大学伯明翰分校、北卡罗来纳大学教堂山分校、艾滋病研究中心、 阿拉巴马州公共卫生部 (ADPH) 和社会科学系统。这项新颖的研究 提案利用基于人口的方法建立具有地理代表性的顺式和 根据最近的研究，跨性别女性（“Camellia 群体”）未来感染艾滋病毒的风险很高 阿拉巴马州 (AL) 的淋病或梅毒感染被列为地理热点 联邦终止艾滋病毒流行战略，以更好地了解与性传播感染和艾滋病毒风险相关的因素 PrEP 使用的诊断和预测。该提案的目的是： 1) 完善 HealthMpowerment (HMP) 数字平台，以前用于提供基于证据的干预措施，以改善艾滋病毒和 男男性行为黑人和跨性别女性的预防结果，包括关键 最佳地吸引和留住 AL 中艾​​滋病毒高危妇女群体的要素；这将通过以下方式实现 利益相关者与自我认同的 PrEP 女性和 PrEP 护理团队成员一起进行研究，使用 名义组技术； 2) 招募并保留 800 名来自不同地域、农村地区的人才 年龄 18-44 岁、近期淋病或梅毒检测呈阳性且未感染性病和艾滋病毒的女性 注册，利用地理多样化的抽样框架参与 Camellia 数字队列 使用公共和商业上可获得的年度县级 HIV 和 STI 检测数据，并 3) 评估 茶花中 STI/HIV 发病率以及 PrEP 使用和依从性的预测因子、中介因子和调节因子 通过 HMP 数字平台收集人口统计、行为和社区水平评估来进行队列 通过 ADPH 的家庭检测计划定期进行 HIV/STI 检测；我们将有目的地抽样 对队列中艾滋病毒易感性高和/或使用 PrEP 的女性进行深入访谈 (n = 30)，以进一步 探索有助于 PrEP 使用的因素，以指导未来干预措施的发展。这项研究将奠定 为测试进一步调整的 HMP 数字平台的实施的更大研究计划奠定基础 旨在改善南部腹地妇女的艾滋病毒/性传播感染检测、暴露前预防的利用和坚持， 重点关注艾滋病毒发病率较高的地区。