A community-based intervention to increase PrEP initiation among Black sexual minority men in Prince George's County, Maryland: Reducing internalized stigma and increasing social support

以社区为基础的干预措施，以提高马里兰州乔治王子县黑人性少数男性的 PrEP 启动率：减少内在耻辱并增加社会支持

• 批准号: 10588152
• 负责人: Rodman Emory Turpin
• 金额: $ 12.24万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-08 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588152
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Area; Behavior; Bisexual; Black Populations; Black race; Church; Collaborations; Collection; Communication; Communities; County; Data; Data Analyses; Development; Drops; Economics; Education; Epidemic; Ethnography; Evaluation; Event; Evidence based intervention; Funding; Future; Gays; Geography; Goals; HIV; HIV Infections; HIV diagnosis; HIV disparities; HIV risk; HIV/AIDS; HIV/STD; Homophobia; Improve Access; Incidence; Income; Interdisciplinary Study; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Lead; Literature; Maryland; Mentors; Methods; Modeling; Outcome; Participant; Pathway Analysis; Population; Pre-Post Tests; Prevalence; Prevention; Research; Research Ethics; Research Personnel; Research Project Grants; Resources; Respondent; Risk; Risk Behaviors; Sampling; Science; Site; Social support; Testing; Training; United States; Washington; black men who have sex with men; career; career development; community intervention; design; ethnographic method; experience; falls; improved; innovation; internalized stigma; metropolitan; peer; peer support; pilot test; pre-exposure prophylaxis; programs; racism; recruit; research and development; resilience; rural setting; sexual minority men; skill acquisition; skills; social; social determinants; social factors; social stigma; structural determinants; suburb; therapy design; uptake

ABSTRACT My goal in pursuing a Mentored Research Career Development Award is to gain the necessary training, knowledge, and practical experience needed to become an independent investigator focused on improving access to and utilization of PrEP among Black men who have sex with men (BSMM) through social, peer- based intervention research. To continue my progress towards my career goals, I propose to conduct an intervention focused on increasing PrEP acceptability through developing and maintaining peer support and resilience to intersectional racism and homophobia among BSMM in Prince George’s County, MD. Despite a clear, well-documented need for greater uptake of PrEP among BSMM in this county, PrEP uptake among BSMM in this setting remains low, and extant literature specific to PrEP use in this setting and population is extremely limited. To address this need, I propose the following: Specific Aims: 1) Understand peer-peer interactions/exchanges and HIV prevention communications among BSMM through ethnographic qualitative observations (participant and direct) of two ongoing MPowerment models, 2) conduct qualitative in depth interviews to inform designing an intervention to reduce internalized racism, internalized homophobia and increase PrEP initiation among BSMM in PG County, and 3) pilot test a community-based intervention (130 participants) to reduce internalized racism, internalized homophobia, and HIV stigma and increase social support and PrEP initiation among BSMM in PG County, based on the MPowerment model. In addition to my specific aims, my Specific Career Development Aims are the following: 1) To develop expertise in the analysis of qualitative data, particularly related to social and structural factors, 2) to develop expertise in the collection and analysis of network data collected via respondent driven sampling, 3) to gain experience in the design, conduct, and evaluation of interventions and 4) to develop research management and professional development skills needed to lead future independent research projects. The knowledge and experience gained from the proposed research will provide me the skillset necessary to successfully compete for R01 funding to conduct a larger scale peer-focused intervention to promote PrEP acceptability and adherence among BSMM. The proposal makes significant contributions to the field in several ways, including 1) identifying barriers to PrEP acceptability among BSMM in Prince George’s County, 2) Qualitatively understand factors that may impact observed quantitative associations between barriers and PrEP use and acceptability, and 3) developing and evaluating an MPowerment intervention to improve PrEP use and acceptability in this population. My rigorous education, training, and research experience in social determinants of HIV/STI risk, collaborations with BSMM populations and organizations, proficiency with quantitative data analysis, and the expertise of my multidisciplinary research team, uniquely prepares me to conduct the proposed research and significantly contribute to HIV prevention science.

摘要 我获得导师研究职业发展奖的目标是获得必要的培训， 成为专注于改进的独立调查员所需的知识和实践经验 黑人男男性行为者(BSMM)通过社会、同伴和青少年获得和利用PrEP 以干预为主的研究。为了继续朝着我的职业目标前进，我提议进行一次 干预的重点是通过发展和维持同伴支持和 在马里兰州乔治王子郡的BSMM中，对跨部门种族主义和同性恋恐惧症的韧性。尽管有一个 这个县的BSMM需要更多的PrEP，这是明确的，有充分记录的需要，PrEP的吸收 此设置中的BSMM仍然很低，现有的特定于PrEP在此设置和人群中使用的文献是 非常有限。为了满足这一需求，我提出如下建议：具体目标：1)理解同辈 BSMM之间的互动/交流和艾滋病毒预防沟通，通过民族志定性 对两个正在进行的管理模型的观察(参与者和直接)，2)深入进行定性 访谈为设计干预措施提供信息，以减少内在化的种族主义、内在化的同性恋恐惧症和 在PG县的BSMM中增加PrEP启动，以及3)试点测试基于社区的干预(130 与会者)减少内在化的种族主义、内在化的同性恋恐惧症和艾滋病毒污名，并增加社会 基于MPowerment模式的PG县BSMM支持与PrEP启动。 除了我的具体目标外，我的具体职业发展目标如下：1) 发展定性数据分析方面的专门知识，特别是与社会和结构因素有关的专门知识；2) 培养收集和分析通过受访者驱动的抽样收集的网络数据的专业知识，3) 在干预措施的设计、实施和评估方面获得经验，以及4)开展研究 具备领导未来独立研究项目所需的管理和专业发展技能。这个 从拟议的研究中获得的知识和经验将为我提供必要的技能集 成功争取R01资金，开展更大规模同行重点干预，推动PrEP BSMM之间的可接受性和坚持性。该提案在以下几个方面对该领域做出了重大贡献 方法，包括1)确定乔治王子郡BSMM接受PrEP的障碍，2) 定性地了解可能影响观察到的障碍和 准备使用和可接受性，以及3)开发和评估改善PrEP的干预措施 在这一人群中的使用率和可接受性。我在社会领域的严格教育、培训和研究经验 艾滋病毒/性传播感染风险的决定因素，与BSMM人群和组织的合作，熟练掌握 定量数据分析，以及我的多学科研究团队的专业知识，让我做好了独特的准备 开展拟议的研究，并对艾滋病毒预防科学做出重大贡献。