A mixed methods study of syndemic factors associated with social support and viral suppression among Black men who have sex with men (MSM) in Florida".

佛罗里达州男男性行为黑人 (MSM) 中与社会支持和病毒抑制相关的流行病因素的混合方法研究”。

• 批准号: 10619832
• 负责人: Shantrel S Canidate
• 金额: $ 18万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619832
• 关键词: AIDS prevention; African American; Area; Caring; Characteristics; Clinical; Cohort Studies; Collaborations; Complex; Data; Development; Emotional; Epidemic; Florida; Funding; Future; Goals; HIV; HIV diagnosis; Health; Imprisonment; Interdisciplinary Study; Intervention; Intervention Studies; Interview; Knowledge; Literature; Longitudinal Studies; Longitudinal, observational study; Measures; Mental Depression; Mentored Research Scientist Development Award; Mentors; Methods; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Population; Poverty; Prevalence; Psychosocial Factor; Public Health; Qualitative Methods; Qualitative Research; Race; Reduce health disparities; Registries; Reporting; Research; Research Personnel; Resources; Sampling; Scientist; Social support; Structure; Subgroup; Testing; Time; Training; Validation; Viral; biobehavior; black men who have sex with men; black subgroup; career; cooking; demographics; design; experience; follow-up; health care availability; health disparity; improved; intersectionality; men who have sex with men; outreach; programs; psychosocial; racial disparity; recruit; responsible research conduct; social media; social stigma; structural determinants; substance use; syndemic; theories

Project Abstract Black men who have sex with men (MSM) in the South had the highest rate of new HIV diagnoses (48%) and the 2nd highest rate of HIV prevalence (31%) among MSM of all races in 2018. Furthermore, racial disparities exist in terms of viral suppression, with 52% of Black MSM living with HIV achieving viral suppression compared to 61% of White MSM. An extensive body of research has identified multiple co-occurring psychosocial factors and structural factors that contribute to racial disparities in HIV diagnoses, prevalence, and outcomes among Black MSM. This combination constitutes a syndemic, “the interaction of 2+ factors or health conditions” that increase HIV among Black MSM. At the same time, mounting evidence suggests social support as an effect modifier of viral suppression among Black MSM experiencing a syndemic. To date, no study has sought to identify the subgroups of Black MSM living with HIV in Florida who could benefit from a shared biobehavioral HIV intervention to improve social support and viral suppression based on their shared characteristics. Therefore, the overarching goal of the K01 award is to provide me with the resources, training, mentoring and knowledge needed to examine the intersectionality of public health, substance use and HIV, and syndemic research. In this proposal, I will employ the explanatory sequential mixed method design to accomplish the specific aims which include: 1a) application of latent class analyses (LCA) for the identification of heterogeneous syndemic classes among Black MSM living with HIV; 1b) expansion of existing literature to examine the association between syndemic classes and demographics; 2) validation of syndemic classes on scales assessing social support; 3) exploration of syndemic class group differences on measures of baseline level and one-year change in viral suppression; and 4) application of semi-structured interviews to validate and contextualize quantitative findings. These goals will be accomplished by leveraging existing data, participants, and resources from an ongoing NIAAA-funded observational longitudinal study (U24AA022002) and interviewing a sample of 20 Black MSM living with HIV in Florida. This K01 application will build on my expertise in HIV outreach, public health, qualitative research, and clinical intervention research related to substance use and HIV with advanced training in: applying a syndemic framework to Black MSM, using LCA to model syndemic conditions among Black MSM, recruiting Black MSM into biobehavioral HIV research, identifying effective biobehavioral HIV interventions and strategies to improve social support and viral suppression among this population, and responsible conduct of research. Overseeing this training are a diverse and interdisciplinary team of mentors, each of whom will bring unique areas of expertise and years of collaboration: Drs. Robert Cook and Eric Schrimshaw (co-primary mentors) and Drs. Typhanye Dyer, Mattia Prosperi, Michael Marsiske, Sheldon Fields, and Nicole Ennis (co-mentors). The proposed K01 award will allow me to establish myself as an independent scientist with an interdisciplinary research program aimed at reducing health disparities in HIV among Black MSM.

项目摘要 南方男男性行为者 (MSM) 的黑人新发艾滋病毒诊断率最高 (48%)， 2018 年，所有种族的 MSM 中艾滋病毒感染率排名第二（31%）。此外，种族差异 在病毒抑制方面存在差异，相比之下，感染艾滋病毒的黑人 MSM 中有 52% 实现了病毒抑制 到 61% 的白人男男性接触者。大量研究发现多种同时发生的社会心理因素 以及导致艾滋病毒诊断、流行率和结果方面种族差异的结构性因素 黑人男同性恋者。这种组合构成了一种综合症，即“两种以上因素或健康状况的相互作用”， 增加黑人男男性接触者中的艾滋病毒。与此同时，越来越多的证据表明社会支持是一种影响 经历综合症的黑人 MSM 中病毒抑制的修饰剂。迄今为止，还没有研究试图 确定佛罗里达州感染艾滋病毒的黑人 MSM 亚群，他们可以从共同的生物行为中受益 艾滋病毒干预旨在根据其共同特征改善社会支持和病毒抑制。所以， K01 奖的总体目标是为我提供资源、培训、指导和知识 需要检查公共卫生、药物滥用和艾滋病毒以及流行病研究的交叉性。在这个 提案中，我将采用解释性顺序混合方法设计来实现具体目标 包括： 1a) 应用潜在类别分析 (LCA) 来识别异质性流行病类别 感染艾滋病毒的黑人男男性行为者； 1b）扩展现有文献以检查之间的关联 流行病类别和人口统计； 2) 在评估社会支持的量表上验证流行病类别； 3） 探讨流行病类别组在基线水平测量和病毒一年变化方面的差异 抑制; 4）应用半结构化访谈来验证定量研究结果并将其置于背景中。 这些目标将通过利用现有数据、参与者和正在进行的资源来实现 NIAAA 资助的观察性纵向研究 (U24AA022002) 并采访了 20 名黑人 MSM 样本 生活在佛罗里达州的艾滋病毒携带者。这个 K01 申请将建立在我在艾滋病毒外展、公共卫生、定性 与物质使用和艾滋病毒相关的研究和临床干预研究，并接受以下方面的高级培训： 黑人 MSM 的流行病框架，使用 LCA 来模拟黑人 MSM 的流行病状况，招募 黑人 MSM 参与艾滋病毒生物行为研究，确定有效的艾滋病毒生物行为干预措施和策略 改善该人群的社会支持和病毒抑制，并负责任地进行研究。 监督这次培训的是一个多元化、跨学科的导师团队，每个人都会带来独特的 专业领域和多年的合作：博士。罗伯特·库克 (Robert Cook) 和埃里克·施里姆肖 (Eric Sc​​hrimshaw)（联合主要导师）以及 博士。 Typhanye Dyer、Mattia Prosperi、Michael Marsiske、Sheldon Fields 和 Nicole Ennis（共同导师）。这 拟定的 K01 奖项将使我能够确立自己作为一名跨学科独立科学家的地位 旨在减少黑人男男性接触者之间艾滋病毒健康差异的研究计划。