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.

 描述：U01 - 针对男男性行为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中，我们每年在美国看到 50,000 名新感染者，特别是男男性行为的黑人/非裔美国人和拉丁裔青年男性（有色人种 YMSM），他们目前占黑人/非裔美国人 MSM 新增感染者的 60%，占拉丁裔 MSM 新增感染者的 45%。与其他 YMSM 相比，黑人/非裔美国人 YMSM 的 HIV 血清阳性可能性高出 5 倍，未确诊的 HIV 感染可能性高出 7 倍，被诊断患有性传播感染的可能性高出 45%。有色人种 YMSM 也最不可能寻求并继续接受艾滋病毒/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。在开始抗逆转录病毒治疗 (ART) 的青少年中，54% 将实现病毒抑制；不幸的是，57% 的人不会继续接受治疗，只有不到 6% 的人会保持病毒抑制状态。改变这种流行病的进程需要采取截然不同的预防方法。因此，我们建议对 450 名 YMSM 有色人种的大型多元化队列进行纵向研究，以通过重点关注成功参与护理来预防新的 HIV 感染、减少传播并减少与 HIV/艾滋病相关的差异。基于艾滋病毒连续护理和预防范式（即寻求、检测、治疗和保留护理）和流行病风险理论，我们将使用混合方法研究设计来收集基线和每六个月的定量、定性和生物学测量值并进行分析三角测量。参与者将采用随机概率和有目的的抽样设计从公共场所、艾滋病毒检测点和艾滋病毒/艾滋病诊所招募。我们将对所有参与者进行跟踪，以确保保留率达到 90% 或更高，考虑到我们在健康年轻人 (HYM) 研究中的保留率为 94%，这是一个可行的目标。具体目标是 1) 更好地理解和操作性地定义对 HIV-和 HIV+ YMSM of color 的联系、参与、护理保留（初级卫生保健和 HIV/艾滋病治疗）和坚持意味着什么； 2) 随着时间的推移，描述和监测有色人种使用酒精和非法药物的 YMSM；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；保险状况和获得医疗保健服务的情况，包括初级保健和艾滋病毒/艾滋病治疗服务；参与和利用医疗保健和艾滋病毒/艾滋病治疗服务；继续接受艾滋病毒/艾滋病护理并坚持接受抗逆转录病毒疗法；以及生物医学干预措施的利用，例如 PrEP 和 PEP； 3) 确定艾滋病毒连续护理和预防过程中参与的障碍/促进因素。拟议的研究建立在美国国立卫生研究院资助的近二十年研究的基础上，该研究由我们的团队专注于这一群体和其他高危青年群体。