LEVERAGING FAMILY-BASED ASSETS FOR BLACK MSM IN HOUSE BALL COMMUNITIES

在家庭舞会社区中利用家庭资产支持黑人男男性接触者

• 批准号: 10012605
• 负责人: Jeffrey M Birnbaum
• 金额: $ 33.52万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10012605
• 关键词: AIDS prevention; Address; Affect; Area; Behavior; Behavior Therapy; Biological; Buffers; Caring; Clinical Trials; Collaborations; Communication; Communities; Complement; Data; Elderly; Epidemic; Evidence based intervention; Face; Family; Feedback; Focus Groups; Future; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; Homophobia; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Lesbian Gay Bisexual Transgender; Manuals; Modeling; Modification; Outcome; Parents; Prevention; Protocols documentation; Randomized; Randomized Controlled Trials; Research; Risk; Sexual Partners; Siblings; Social Network; Social support; Testing; Training; Viral; Voice; Waiting Lists; Work; antiretroviral therapy; authority; base; black men who have sex with men; care outcomes; caregiving; condomless anal sex; design; effectiveness testing; effectiveness trial; empowerment; expectation; experience; improved; informal caregiving; intervention effect; member; men; post intervention; pre-exposure prophylaxis; primary outcome; racism; recruit; secondary outcome; sex; skills; social norm; social relationships; social stigma; social structure; standard of care; time use; tool; transmission process; trial design; willingness

1 Despite the advent of highly effective prevention tools such as HIV pre-exposure prophylaxis (PrEP), Black men 2 who have sex with men (MSM) continue to have the highest incidence of new HIV diagnoses in the US. The risk 3 of onward HIV transmission is reduced to zero in HIV-positive individuals who are virally suppressed; however, 4 Black MSM are least likely to be engaged in care or to be suppressed. Many Black MSM face multiple stigmas 5 (e.g., racism, homophobia) and rejection from their biological families, but some have found refuge in the House 6 Ball Community (HBC)—a national network of Black LGBT kinship commitments (families) that provide (informal) 7 care giving, affirmation and survival skills-building for its members. Regarding skills-building and HIV prevention, 8 Many Men Many Voices (3MV) is a six-session, group-level behavioral intervention and is the only “best- 9 evidence” intervention for Black MSM. Family-based interventions have shown HIV prevention efficacy; however, 10 3MV is not a family-based intervention. In 3MV, HIV-negative Black MSM are recruited into artificial group 11 settings with individuals with whom they may have little social relationship. 3MV neither leverages the 12 connections and commitments nor addresses the variability in HIV-status that exists in house ball families. 13 Because Black MSM in the HBC have closer social relationships, 3MV requires adaptation to be more responsive 14 to this social structure and dynamic. Our goal in this clinical trial planning grant is to prepare for a cluster 15 randomized controlled trial (CRCT) to test the effectiveness of the modified 3MV vs. standard of care in reducing 16 new HIV infections and increasing rates of viral suppression among Black MSM in HBC families. Based on our 17 formative work, that MSM social networks predict HIV prevention behaviors and that HBC family cultural norms 18 are primed for communication about HIV prevention and treatment, our central hypothesis is that a modified 3MV 19 intervention incorporating family asset-building will have an amplifying effect on HIV prevention and treatment 20 outcomes. We will investigate this hypothesis with the specific aims: Aim 1: Conduct formative research to 21 identify key modifications to the 3MV intervention manual and implementation protocol. The eight-step ADAPT- 22 ITT model will guide our approach to modifying 3MV into Our Family Our Voices (OFOV), which accommodates 23 the lived experience of HBC families. Aim 2: Conduct a pilot CRCT to determine the feasibility and acceptability 24 of the modified 3MV trial protocol (OFOV) vs. waitlisted standard of care control. We will determine the feasibility/ 25 acceptability of OFOV as well as the CRCT design (n=6 families; 100 individuals) with NYC HBC families. This 26 study will provide necessary data to design and conduct a full-scale CRCT effectiveness trial of OFOV on HIV 27 prevention and care outcomes in Black MSM. The HBC is a large, yet underserved, community within the LGBT 28 community. By precision-tailoring an evidence-based intervention for the HBC, our research to improve HIV 29 testing and care engagement will complement national efforts to End the Epidemic by 2030, especially among 30 Black MSM—the highest priority group for domestic HIV prevention.

1 尽管出现了艾滋病毒暴露前预防 (PrEP) 等高效预防工具，但黑人男性 2 男男性行为者 (MSM) 仍然是美国新诊断艾滋病毒的发病率最高的人群。风险 3 在病毒受到抑制的艾滋病毒阳性个体中，艾滋病毒的进一步传播减少至零；然而， 4 黑人男男性接触者最不可能受到照顾或受到压制。许多黑人男男性接触者面临多重耻辱 5（例如种族主义、恐同症）和被亲生家庭拒绝，但有些人在众议院找到了庇护所 6 Ball Community (HBC)——黑人 LGBT 亲属关系承诺（家庭）的全国网络，提供（非正式） 7 为其成员提供照顾、肯定和生存技能培养。关于技能建设和艾滋病毒预防， 8 Many Men Many Voices (3MV) 是一个为期六次的小组级行为干预，是唯一的“最佳- 针对黑人 MSM 的 9 个证据”干预措施。以家庭为基础的干预措施已显示出预防艾滋病毒的功效；然而， 10 3MV 不是基于家庭的干预措施。在3MV中，HIV阴性黑人MSM被招募到人工群体中 11 种可能与他们没有什么社交关系的人的环境。 3MV 既不利用 12 联系和承诺也没有解决家庭球家庭中存在的艾滋病毒状况的变异性。 13 由于 HBC 中的黑人 MSM 具有更密切的社会关系，3MV 需要适应才能更具响应性 14.这种社会结构和动态。我们在这项临床试验计划拨款中的目标是为集群做好准备 15 项随机对照试验 (CRCT) 测试改良 3MV 与标准护理在减少 HBC 家庭中的黑人 MSM 新增 16 例 HIV 感染，病毒抑制率不断上升。基于我们的 17 形成性工作，MSM 社交网络预测 HIV 预防行为以及 HBC 家庭文化规范 18 已准备好进行有关艾滋病毒预防和治疗的交流，我们的中心假设是经过修改的 3MV 19 结合家庭资产建设的干预措施将对艾滋病毒预防和治疗产生放大效应 20 个结果。我们将带着具体目标来研究这一假设： 目标 1：进行形成性研究 21 确定了 3MV 干预手册和实施方案的关键修改。八步 ADAPT- 22 ITT 模型将指导我们将 3MV 修改为我们的家庭我们的声音 (OFOV)，其中包含 23 HBC 家庭的生活经历。目标 2：进行 CRCT 试点以确定可行性和可接受性 24 修改后的 3MV 试验方案 (OFOV) 与候补标准护理控制。我们将确定可行性/ 25 OFOV 以及 CRCT 设计（n=6 个家庭；100 人）与纽约市 HBC 家庭的可接受性。这 26项研究将为设计和开展 OFOV 对 HIV 的全面 CRCT 有效性试验提供必要的数据 27 黑人 MSM 的预防和护理结果。 HBC 是 LGBT 内的一个大型但服务不足的社区 28个社区。通过为 HBC 精确定制基于证据的干预措施，我们改善艾滋病毒的研究 29 检测和护理参与将补充国家到 2030 年结束流行病的努力，特别是在 30 黑人男男性接触者——国内艾滋病毒预防的最优先群体。