Young Men of Color Who Have Sex with Men Cohort Study

与男性发生性关系的年轻有色人种男性队列研究

• 批准号: 9317454
• 负责人: Michele D. Kipke
• 金额: $ 186.94万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9317454
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Affordable Care Act; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Assessment tool; Awareness; Behavior Therapy; Biological; Caring; Clinic; Cohort Studies; Color; Continuity of Patient Care; Data; Development; Diagnosis; Diffusion; Disease; Disease Progression; Disease-Free Survival; Drug Utilization; Drug usage; Ensure; Epidemic; Funding; Future; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Human immunodeficiency virus test; Illicit Drugs; Incidence; Infection; Insurance Coverage; Intervention; Intervention Studies; Latino; Los Angeles; Measures; Medical; Methods; Modeling; Monitor; National Institute of Drug Abuse; Participant; Patients; Population; Predisposition; Prevention; Prevention approach; Prevention strategy; Primary Health Care; Probability; Prophylactic treatment; Quality of life; Randomized; Recruitment Activity; Research; Research Design; Research Priority; Risk; Sampling; Services; Sexually Transmitted Diseases; Site; Specimen; Substance abuse problem; Testing; Time; United States National Institutes of Health; Viral; Viral Load result; Virus; Youth; antiretroviral therapy; black men who have sex with men; care seeking; clinical practice; cohort; design; experience; health care availability; health care service utilization; high risk; human leukocyte antigen testing; improved; member; men; men who have sex with men; microbicide; mobile computing; motivational enhancement therapy; prevent; prevention service; public health relevance; response; retention rate; sex; social media; theories; therapy design; transmission process; treatment adherence; uptake; young man; young men who have sex with men

 DESCRIPTION: U01 - Cohort Study with Young Men of Color who have Sex with Men In this fourth decade of the HIV epidemic, we continue to see 50,000 new infections annually in the U.S., particularly among Black/African American and Latino young men who have sex with men (YMSM of color), who now account for 60% of new infections among Black/African American MSM and 45% of new infections among Latino MSM. Black/African American YMSM remain five times more likely to be HIV seropositive, seven times more likely to have an undiagnosed HIV infection, and 45% more likely to be diagnosed with an STI than other YMSM. YMSM of color are also the least likely to seek and remain in HIV/AIDS care, and when they do seek care, they typically already have advanced HIV disease. Among youth who initiate antiretroviral therapy (ART), 54% will achieve viral suppression; unfortunately 57% will not be retained in care and less than 6% will remain virally suppressed. Changing the course of this epidemic is going to require a dramatically different approach to prevention. We are therefore proposing to conduct longitudinal research with a large and diverse cohort of 450 YMSM of color in order to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Building on the HIV Continuum of Care and Prevention paradigm (i.e., seek, test, treat, and retain in care) and the Syndemic Theory of Risk, we will use a mixed-methods study design to collect and analytically triangulate quantitative, qualitative, and biological measures at baseline and every six months. Participants will be recruited from public venues, HIV test sites, and HIV/AIDS clinics using randomized probability and purposeful sampling designs. All participants will be tracked to ensure a retention rate of 90% or better, which is a feasible target given our retention rates of 94% in the Healthy Young Men's (HYM) Study. The specific aims are to 1) better understand and operationally define what linkage, engagement, retention to care (both primary health and HIV/AIDS treatment) and adherence means to HIV- and HIV+ YMSM of color; 2) characterize and monitor over time YMSM of color's use of alcohol and illicit drugs; utilization of HIV testing and prevention services; incidence of HIV and STIs; insurance status and access to health care services, including primary care and HIV/AIDS treatment services; engagement in and utilization of health care and HIV/AIDS treatment services; retention in HIV/AIDS care and adherence to ART; and utilization of biomedical interventions, such as PrEP and PEP; and 3) identify barriers/facilitator of engagement along the HIV Continuum of Care and Prevention. The proposed research builds on close to two decades of NIH-funded research by our team focused on this and other high-risk youth populations.

 产品说明：U 01-对与男性发生性关系的有色人种年轻男性的队列研究在艾滋病毒流行的第四个十年里，我们继续看到美国每年有5万例新感染，特别是在黑人/非洲裔美国人和拉丁裔男男性行为者（有色人种的YMSM）中，他们现在占黑人/非洲裔美国人MSM新感染的60%，占拉丁裔MSM新感染的45%。黑人/非洲裔美国青年男男性接触者艾滋病毒血清反应阳性的可能性仍然是其他青年男男性接触者的五倍，未确诊艾滋病毒感染的可能性是其他青年男男性接触者的七倍，被诊断患有性传播感染的可能性是其他青年男男性接触者的45%。有色人种的YMSM也是最不可能寻求和留在艾滋病毒/艾滋病护理，当他们寻求护理时，他们通常已经患有晚期艾滋病毒疾病。在开始抗逆转录病毒疗法（ART）的青年中，54%的人将实现病毒抑制;不幸的是，57%的人将无法继续接受治疗，只有不到6%的人将保持病毒抑制。改变这一流行病的发展趋势将需要采取截然不同的预防方法。因此，我们建议对450名YMSM有色人种进行大型和多样化的纵向研究，以预防新的艾滋病毒感染，减少传播，并通过专注于成功参与护理来减少艾滋病毒/艾滋病相关的差异。在艾滋病毒连续护理和预防模式的基础上（即，寻求，测试，治疗，并保留在照顾）和Syndemic理论的风险，我们将使用混合方法的研究设计，收集和分析三角定量，定性和生物措施在基线和每六个月。参与者将从公共场所、艾滋病毒检测点和艾滋病毒/艾滋病诊所招募，使用随机概率和有目的的抽样设计。将跟踪所有参与者，以确保留存率达到90%或更高，鉴于我们在健康青年男性（HYM）研究中的留存率为94%，这是一个可行的目标。具体目标是：1）更好地理解和操作定义什么联系，参与，保留护理（初级卫生和艾滋病毒/艾滋病治疗）和坚持手段艾滋病毒-和艾滋病毒+有色人种YMSM; 2）表征和监测随着时间的推移YMSM的颜色的酒精和非法药物的使用;利用艾滋病毒检测和预防服务;艾滋病毒和性传播感染的发病率;保险状况和获得保健服务的机会，包括初级保健和艾滋病毒/艾滋病治疗服务;参与和利用保健和艾滋病毒/艾滋病治疗服务;继续接受艾滋病毒/艾滋病护理和坚持抗逆转录病毒疗法;以及利用生物医学干预措施，如PrEP和PEP;和3）确定参与沿着艾滋病毒连续护理和预防的障碍/促进因素。这项拟议的研究建立在近20年的NIH资助的研究基础上，我们的团队专注于这一人群和其他高危青年人群。