A Trauma-Informed Intervention for Sexual Minority Men Recently Diagnosed with HIV

针对最近诊断出感染艾滋病毒的性少数男性的创伤知情干预

• 批准号: 10770718
• 负责人: NATHAN B HANSEN
• 金额: $ 72.18万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-13 至 2026-09-12
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10770718
• 关键词: Acute Post Traumatic Stress Disorder; Address; Adverse effects; Affect; Age; Applications Grants; Appointment; Area; Back; Black race; Caring; Case Manager; Client; Clinic; Cognitive Therapy; Communities; Consultations; Continuity of Patient Care; Data; Decision Making; Development; Diagnosis; Disclosure; Enrollment; Epidemic; Evaluation; Event; Feedback; Focus Groups; General Population; Goals; HIV; HIV diagnosis; HIV/AIDS; Health; Health Promotion; Human immunodeficiency virus test; Infrastructure; Intervention; Interview; Life; Link; Manuals; Maps; Market Research; Marketing; Mental Depression; Mental Health; Methods; Modeling; NIH Office of AIDS Research; National Institute of Mental Health; Newly Diagnosed; Participant; Perception; Persons; Procedures; Process; Professional counselor; Qualitative Methods; Questionnaires; Random Allocation; Randomized; Reaction; Reporting; Research; Research Priority; Site; Social Sciences; Social support; Stress; Stressful Event; Surveys; Techniques; Technology; Testing; Text Messaging; Thinking; Trauma; Treatment Efficacy; United States; Viral; Work; acute stress; acute traumatic stress disorder; antiretroviral therapy; community organizations; comorbidity; digital health; experience; feasibility trial; follow-up; improved; innovation; member; online delivery; pilot test; pilot trial; post intervention; preference; primary outcome; promote resilience; recruit; resilience; response; satisfaction; secondary outcome; service delivery; service providers; sexual identity; sexual minority men; social engagement; stress reactivity; stress reduction; stress related disorder; stressor; tailored text messaging; telehealth; theories; therapy development; three-dimensional modeling; trauma symptom; traumatic stress; treatment adherence; treatment disparity; vector; visit adherence

Project Summary/Abstract Compared to the general population in the United States, people living with HIV (PLWH) show high rates of trauma- and stress-related disorders and severe acute stress reactivity to events that are, diagnostically, not considered traumatic. Trauma is highly correlated with depression, a robust predictor of antiretroviral treatment (ART) non-adherence. Additionally, reporting a high number of recent stressful events is associated with ART non-adherence. Despite Black sexual minority men (BSMM), particularly those under age 40, being disproportionately affect by HIV and trauma and less likely to be linked to HIV care after diagnosis, BSMM remain grossly underserved with respect to their mental health. Further, although interventions exist that address trauma for PWLH, few HIV-related interventions emphasize the traumatic stress cycle and acute stress reactivity immediately following an HIV diagnosis. To address the need for early mental health intervention immediately after HIV diagnosis, in general, as well as the under-addressed mental-health needs of HIV+ BSMM (+BSMM), in particular, we will develop and pilot-test a resilience-focused, trauma-informed intervention called, Resilience- Based Intervention for Stress Reduction and HIV-Related Efficacy (RISE). RISE will be based on approaches and techniques of Cognitive-Behavior Therapy (CBT) and the framework of Resilience Theory. It will address trauma- and stress-related symptomology and acute stress reactivity within three months of an HIV diagnosis to facilitate linkage to HIV care. The brief RISE will include six online sessions, a booster session, and text messaging. Innovative commercial marketing techniques will be used to develop highly targeted messages to supplement the CBT- and resilience-based approach of RISE. First, Aim 1 will involve formative research to assess +BSSM's needs, preferences, and perceptions regarding their mental health and their engagement in HIV care via in-depth interviews with +BSMM and service providers. Next, Aim 2 will include development of the RISE intervention manual and digital health infrastructure. Tailored text messages and health-promotion materials will be developed via in-depth interview-derived quantitative surveys with 50 +BSMM. The Aim will also include an iterative process of intervention development, including focus groups with +BSMM and service providers, respectively, and intervention theatre tests with 6 +BSMM. Finally, Aim 3 will consist of a randomized, controlled pilot trial for feasibility (e.g., recruitment and enrollment rates, fidelity), acceptability (i.e., feedback interview, satisfaction questionnaire), and preliminary efficacy (i.e., increased HIV care engagement, including attending an HIV care appointment, antiretroviral treatment [ART] initiation, and ART adherence [primary outcome]; reduced trauma symptoms, including intrusive experiences, avoidance, and hyperarousal [secondary outcome]) with 40 +BSMM diagnosed within the past three months. Participants will be assessed at baseline, post-intervention, and 6- and 9-month follow-ups post-baseline. We will develop and maintain a community advisory board for consultation throughout the study.

项目总结/文摘