Intervening to improve HIV treatment and reduce drinking in young, black men who have sex with men

意义在美国，与男性发生性关系的年轻黑人男性（YBMSM）受到艾滋病毒的严重影响。 对于许多YBMSM来说，大量饮酒或与酒精使用有关的问题对他们的艾滋病毒护理产生不利影响， 治疗因此，改善艾滋病毒治疗结果和减少艾滋病毒感染者大量饮酒的干预措施， YBMSM在艾滋病治疗中的应用是迫切需要的。职业发展计划。诺克斯医生的训练将包括 发展干预研究和实施科学方面的关键技能，以及艾滋病毒方面的实质性培训 护理和治疗。这将通过一项计划来实现，该计划包括研讨会、讲习班、课程， 会议和量身定制的指导。这些活动将帮助诺克斯博士成为一名独立调查员 一个研究项目，重点是了解和解决艾滋病毒和酒精使用在脆弱的 人口数量。研究计划。在目标1中，诺克斯博士提出的研究包括进行形成性工作， 为制定一项干预措施提供信息，该措施涉及艾滋病毒治疗和酗酒、艾滋病毒感染者 感染的YBMSM干预措施将借鉴两个不同但可能互补的组成部分， 以临床为基础的干预措施是简短和理论驱动的。第一个改进了艾滋病毒治疗 艾滋病毒感染的YBMSM的结果，涉及他们的社会网络的成员，以支持他们在艾滋病毒护理。 第二项干预措施通过使用智能手机技术来解决酒精使用问题，让参与者每天参与 自我监测相对于饮酒减少目标期间形成的一个简短的，动机组成部分的基线 干预会议。在目标2中，将在以下方面的帮助下综合这项形成性工作中的信息： 由YBMSM和实施伙伴组成的顾问工作组。目标1和2的乘积将是 一种创新的干预措施，利用社会网络支持和技术来改善艾滋病毒治疗 结果和减少酗酒，艾滋病毒感染的YBMSM的酒精使用。它将作为单一的管理- 在目标3中，新的干预措施将进行试点测试， 对照随机分配的对照品，评估其潜在有效性、可接受性、可行性和实施情况 在纽约市的一家HIV诊所中，60名重度饮酒、HIV感染的YBMSM的病情。作为 作为艾滋病毒流行的中心，纽约市迫切需要对年轻的黑人男男性接触者进行艾滋病毒治疗干预。 该试点测试的结果将为R01提案的制定提供信息， 对照试验，以评估开发的干预措施的有效性和实施情况。导师制。一队 酒精和药物使用、艾滋病毒、种族和性少数群体、干预发展方面的专家调查员， 实施科学和混合方法将支持这项研究。公共卫生影响。该项目旨在 减少艾滋病毒治疗结果的差异，从而减少新的艾滋病毒感染的发生率， 美国国立卫生研究院艾滋病研究办公室的优先事项。* 制定艾滋病毒干预措施， 人口还努力实现重要的"结束艾滋病毒流行"里程碑。

Significance. In the US, young, black men who have sex with men (YBMSM) are disparately impacted by HIV. For many YBMSM, heavy drinking or problems related to alcohol use adversely impacts their HIV care and treatment. Thus, interventions to improve HIV treatment outcomes and reduce heavy drinking in HIV-infected YBMSM in HIV treatment are urgently needed. Career Development Plan. Dr. Knox's training will include developing critical skills in intervention research and implementation science, and substantive training in HIV care and treatment. This will be achieved through a plan that includes seminars, workshops, coursework, conferences, and tailored mentoring. These activities will help Dr. Knox become an independent investigator with a research program focused on understanding and addressing HIV and alcohol use in vulnerable populations. Research Plan. In Aim 1, Dr. Knox's proposed research involves conducting formative work to inform the development of an intervention that addresses HIV treatment and alcohol use in heavy-drinking, HIV- infected, YBMSM. The intervention will borrow components from two distinct and potentially complementary, evidence-based clinic-based interventions that are brief and theory-driven. The first improves HIV treatment outcomes in HIV-infected YBMSM by involving a member of their social network to support them in HIV care. The second intervention addresses alcohol use by using smartphone technology to engage participants daily in self-monitoring relative to drinking reduction goals formed during a brief, motivational component of the baseline intervention session. In Aim 2, the information from this formative work will be synthesized with the help of consultant workgroups made up of YBMSM and implementation partners. The product of Aims 1 and 2 will be an innovative intervention that leverages both social network support and technology to improve HIV treatment outcomes and reduce alcohol use in heavy-drinking, HIV-infected YBMSM. It will be administered as a single- session baseline intervention with brief follow-up check-ins. In Aim 3, the new intervention will be pilot tested to assess its potential efficacy, acceptability, feasibility and implementation against a randomly assigned control condition among 60 heavy-drinking, HIV-infected YBMSM in an HIV clinic in New York City (NYC). As an epicenter of the HIV epidemic, interventions for young, black MSM in HIV treatment are urgently needed in NYC. The results of this pilot test will inform the development of an R01 proposal for a fully powered randomized controlled trial to evaluate the efficacy and implementation of the developed intervention. Mentorship. A team of expert investigators in alcohol and drug use, HIV, racial and sexual minorities, intervention development, implementation science and mixed methods will support this research. Public Health Impact. The project aims to reduce disparities in HIV treatment outcomes and, in turn, incidence of new HIV infections, a high research priority of the NIH Office of AIDS Research. Developing HIV interventions targeted for critical, underserved populations also works towards achieving important End the HIV Epidemic milestones.