Structural Intervention to Promote HIV Care in Black Sexual Minority Men

项目总结 本研究项目的目标是使用Adapt-ITT框架来适应现有职业的要素 针对年轻的SMM和易感染艾滋病毒的有色人种妇女量身定做的准备干预措施 (工作2预防)满足18-29岁艾滋病毒携带者年轻黑人SMM(YBSMM)的需求。一旦适应，一个 将对40名YBSMM进行干预(Work2PreventPlus；W2P)的试点研究，以确定 改善护理投入的干预可行性、可接受性和有效性。 为了确保W2P能够服务于HIV阳性的YBSMM的需求，研究团队将进行形成性的 适应阶段，将从雇主那里收集定量和定性数据。一个例子 潜在雇主(n=50)将完成一项调查，重点是与招聘和留住相关的挑战 具有一系列少数族裔身份的个人。第二个样本(n=20)的潜在雇主将完成 与项目员工面谈，他们将对集中于招聘成功和挑战的小插曲做出回应 经理在试图雇佣和留住感染艾滋病毒的YBSMM员工时可能会遇到。这些 数据将为W2P的改编提供信息。接下来的一系列焦点小组将与 人群(n=40)，以确定他们在职业准备干预中最需要什么。更具体地说，这是 阶段将使用适应-ITT框架，以确保适应的干预措施解决了一系列关切 与YBSMM的就业相关，而不考虑艾滋病毒状况。接下来，研究小组将进行一项 对8名18-29岁的YBSMM和10名为YBSMM服务的利益相关者进行了剧院测试，其中利益相关者 将观察现有干预措施中的内容管理，以确定哪些内容应该 保留的，改编的或替换的接下来，将需要3至5名就业和待遇障碍方面的专家 干预修订的额外反馈。反馈将用于W2P的附加修订。最后， 计算机可读性测试将确保修订的干预手册和活动中使用的语言 可以达到六年级的阅读水平。在干预手册和交付程序之后 Adapt-ITT模式最终敲定，40名年龄在18-29岁的YBSMM将参加单一ARM试点试验，并将- 在6个月和12个月时增加评估。先导研究的主要研究成果是可行性和 可接受性。其他结果包括每周工作时间、求职自我效能感以及 错过了艾滋病护理探视。 此外，我们将使用实施科学措施来确定实现 对国会预算办公室环境的干预。主要实施结果是干预措施的相对优势和 实施环境。次要结果是为实施做好准备。

PROJECT SUMMARY The goals of this research project are to use the ADAPT-ITT framework to adapt elements of an existing career readiness interventions tailored to young SMM and trans women of color at-risk for HIV infection (Work2Prevent) to the needs of young Black SMM (YBSMM), ages 18-29, living with HIV. Once adapted, a pilot study of the intervention (Work2Prevent Plus; W2P+) will be conducted with 40 YBSMM to determine intervention feasibility, acceptability, and efficacy for improving care engagement. To ensure W2P+ can serve the needs of HIV-positive YBSMM, the research team will engage in a formative phase of adaptation, wherein quantitative and qualitative data will be collected from employers. A sample of potential employers (n=50) will complete a survey focused on challenges related to hiring and retaining individuals with a range of minority identities. A second sample (n = 20) of potential employers will complete an interview with project staff, where they will respond to vignettes focused on successes and challenges a hiring manager could encounter when trying to hire and retain employees who are YBSMM living with HIV. These data will inform the adaptation of W2P+. Next, a series of focus groups will be conducted with members of the population (n = 40) to identify what they most need in a career readiness intervention. More specifically, this phase will use the ADAPT-ITT framework to ensure the adapted intervention addresses the range of concerns associated with employment for YBSMM irrespective of HIV status. Next, the research team will conduct a theater test with 8 YBSMM aged 18-29 years old and 10 stakeholders serving YBSMM, wherein stakeholders will observe the administration of content from the existing interventions to identify which content should be retained, adapted, or replaced. Next, 3 to 5 experts on employment and treatment barriers will be asked for additional feedback for intervention revision. The feedback will be used for additional revision of W2P+. Finally, a computerized readability test will ensure that language used in the revised intervention manual and activities is accessible to a 6th grade reading level. After the intervention manual and delivery procedures with the ADAPT-ITT model are finalized, 40 YBSMM, ages 18-29, will be enrolled in a single arm pilot trial, with follow- up assessments at 6 and 12 months. The primary research outcomes for the pilot study are feasibility and acceptability. Additional outcomes include hours worked per week, job seeking self-efficacy, and proportion of missed HIV care visits. Further, we will use implementation science measures to identify the best approach for delivering the intervention in a CBO setting. Primary implementation outcomes are relative advantage of the intervention and implementation climate. Secondary outcome is readiness for implementation.