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

尽管出现了非常有效的预防工具，如艾滋病毒暴露前预防1（PrEP），布莱克 在美国，男男性行为者（MSM）仍然是艾滋病毒新诊断的最高发病率。 在病毒受到抑制的艾滋病毒抗体阳性者中，艾滋病毒进一步传播的风险降至零; 然而，黑人男男性行为者最不可能参与照料或受到压制。许多黑人男男性接触者的脸 多个柱头（例如，种族主义，同性恋恐惧症）和拒绝从他们的亲生家庭，但有些人发现， 庇护在众议院球社区（HBC）-一个全国网络的黑人LGBT亲属承诺（家庭） 为成员提供（非正式）照顾、肯定和生存技能培养。关于技能- 建设和艾滋病毒预防，许多人许多声音（3 MV）是一个六届会议，小组级的行为 干预，是唯一的“最佳证据”干预黑人男男性行为者。基于家庭的干预措施 显示出艾滋病毒预防效果;然而，3 MV不是一种基于家庭的干预措施。在3 MV中，HIV阴性黑人 男男性接触者被招募到人工群体环境中，与他们可能很少社交的个人一起 关系3 MV既没有利用联系和承诺，也没有解决艾滋病毒的变异性， 在家庭舞会中的地位，3 MV需要适应，以更好地适应这种社会结构 充满活力我们在这个临床试验计划补助金的目标是准备一个集群随机对照试验 （CRCT），以测试改良的3 MV与标准护理相比在减少新发艾滋病毒感染方面的有效性， HBC家族中黑人MSM的病毒抑制率增加。根据我们的初步工作， 男男性接触者社交网络可预测艾滋病预防行为及HBC家庭文化规范 关于艾滋病毒预防和治疗的交流，我们的中心假设是，修改后的3 MV干预 将家庭资产建设纳入其中，将对艾滋病毒预防和治疗成果产生放大效应。 我们将调查这个假设的具体目标：目标1：进行形成性研究，以确定关键 对3 MV介入手册和实施方案的修改。八步ADAPT 22 ITT模型 将指导我们将3 MV修改为Our Family Our Voices（OFOV）的方法， HBC家庭的经验目标2：开展试点CRCT，以确定 改良3 MV试验方案（OFOV）与等待标准治疗对照。康贝特人将以 OFOV和CRCT设计（n=6个家庭; 100名个体）与NYC HBC家庭的可行性/可接受性。 本研究将为设计和实施OFOV的全面CRCT有效性试验提供必要的数据， 艾滋病毒预防和护理结果在黑人男男性行为者。HBC是一个庞大但服务不足的社区， LGBT社群通过为HBC精确定制基于证据的干预措施，我们的研究可以改善 艾滋病毒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 黑人男男性接触者是国内艾滋病预防的最优先群体。

Despite the advent of highly effective prevention tools such as HIV pre-exposure prophylaxis 1 (PrEP), Black men who have sex with men (MSM) continue to have the highest incidence of new HIV diagnoses in the US. The risk of onward HIV transmission is reduced to zero in HIV-positive individuals who are virally suppressed; however, Black MSM are least likely to be engaged in care or to be suppressed. Many Black MSM face multiple stigmas (e.g., racism, homophobia) and rejection from their biological families, but some have found refuge in the House Ball Community (HBC)—a national network of Black LGBT kinship commitments (families) that provide (informal) care giving, affirmation and survival skills-building for its members. Regarding skills- building and HIV prevention, Many Men Many Voices (3MV) is a six-session, group-level behavioral intervention and is the only “best evidence” intervention for Black MSM. Family-based interventions have shown HIV prevention efficacy; however, 3MV is not a family-based intervention. In 3MV, HIV-negative Black MSM are recruited into artificial group settings with individuals with whom they may have little social relationship. 3MV neither leverages the connections and commitments nor addresses the variability in HIV- status that exists in house ball families., 3MV requires adaptation to be more responsive to this social structure and dynamic. Our goal in this clinical trial planning grant is to prepare for a cluster randomized controlled trial (CRCT) to test the effectiveness of the modified 3MV vs. standard of care in reducing new HIV infections and increasing rates of viral suppression among Black MSM in HBC families. Based on our formative work, that MSM social networks predict HIV prevention behaviors and that HBC family cultural norms primed for communication about HIV prevention and treatment, our central hypothesis is that a modified 3MV intervention incorporating family asset-building will have an amplifying effect on HIV prevention and treatment outcomes. We will investigate this hypothesis with the specific aims: Aim 1: Conduct formative research to identify key modifications to the 3MV intervention manual and implementation protocol. The eight-step ADAPT22ITT model will guide our approach to modifying 3MV into Our Family Our Voices (OFOV), which accommodates the lived experience of HBC families. Aim 2: Conduct a pilot CRCT to determine the feasibility and acceptability of the modified 3MV trial protocol (OFOV) vs. waitlisted standard of care control. We will determine the feasibility/acceptability of OFOV and the CRCT design (n=6 families; 100 individuals) with NYC HBC families. This study will provide necessary data to design and conduct a full-scale CRCT effectiveness trial of OFOV on HIV prevention and care outcomes in Black MSM. The HBC is a large, yet underserved community within the LGBT community. By precision-tailoring an evidence-based intervention for the HBC, our research to improve HIV testing and care engagement will complement national efforts to End the Epidemic by 2030, especially among Black MSM—the highest priority group for domestic HIV prevention.