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 南方与男性发生性关系的黑人（MSM）的新艾滋病毒诊断率最高（48％）和 2018年所有种族的MSM中，HIV患病率的第二高率（31％）。此外，种族分布 在病毒抑制方面存在，有52％的黑色MSM患有艾滋病毒可实现病毒抑制 占白色MSM的61％。广泛的研究已经确定了多个共同发生的社会心理因素 以及在HIV诊断，患病率和结果中促进种族分布的结构性因素 黑色MSM。这种组合构成了一个集团的“ 2+因素或健康状况的相互作用” 在黑色MSM中增加HIV。同时，越来越多的证据表明社会支持是一种影响 黑色MSM中病毒抑制的修饰符经历了辛迪克斯特。迄今为止，尚无研究 识别佛罗里达州艾滋病毒的黑人MSM的亚组，这些子群可以从共享的生物行为中受益 艾滋病毒干预以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，心理和知识 需要检查公共卫生，药物使用和艾滋病毒以及联合研究的交叉性。在这个 提案，我将采用利用顺序混合方法设计来实现特定目的 包括：1a）应用潜在类别分析（LCA）用于识别异质联合类别 在艾滋病毒的黑人MSM中； 1b）扩展现有文献以检查 联合阶级和人口统计学； 2）在评估社会支持的量表上验证集团类别； 3） 基线水平的度量和一年变化病毒的综合级群体差异的探索 抑制; 4）应用半结构化访谈以验证和上下文化定量发现。 这些目标将通过利用正在进行的现有数据，参与者和资源来实现 NIAAA资助的观察性纵向研究（U24AA022002），访谈了20个黑色MSM样本 与艾滋病毒一起在佛罗里达生活。该K01申请将基于我在艾滋病毒外展，公共卫生，定性方面的专业知识基础 研究和临床干预研究与药物使用和HIV有关的研究和艾滋病毒和高级培训： 黑色MSM的联合框架，使用LCA在黑色MSM中建模联合条件，招募 黑色MSM进入生物行为HIV研究，确定有效的生物行为HIV干预措施和策略 改善该人群中的社会支持和病毒抑制，以及负责任的研究。 监督这项培训是一个潜水员和跨学科的导师团队，每个团队都会带来独特的 专业知识和合作年份的领域：Drs。罗伯特·库克（Robert Cook）和埃里克·施里姆肖（Eric Sc​​hrimshaw）（联合主导）和 博士。 Typhanye Dyer，Mattia Prosperi，Michael Marsiske，Sheldon Fields和Nicole Ennis（联合官）。 拟议的K01奖将使我能够确立自己的独立科学家的跨学科科学家 研究计划旨在降低黑人MSM中HIV的健康差异。