Examining a Multicomponent Intervention to Improve HIV Health among Black Men in Southern Ending the HIV Epidemic in the U.S. Jurisdictions

检查改善南部黑人男性艾滋病毒健康的多成分干预措施，结束美国司法管辖区的艾滋病毒流行

• 批准号: 10744410
• 负责人: Devin English
• 金额: $ 70.09万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10744410
• 关键词: Address; Anxiety; Area; Behavioral; Caring; Collaborations; Communities; Economics; Effectiveness; Elements; Ensure; Epidemic; Evaluation; Evidence based intervention; Fostering; Funding; HIV; HIV diagnosis; HIV disparities; Health; Health Promotion and Education; Health Status; Health behavior; Health education; Healthcare; Housing; Hybrids; Individual; Inequity; Institution; Intervention; Leadership; Link; Maintenance; Mental Health; Mental health promotion; Methods; Modeling; Monitor; Motivation; National Institute of Mental Health; Outcome; Pathway interactions; Patient Self-Report; Population; Race; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Research Personnel; Resource-limited setting; Running; Service delivery model; Social Work; Social isolation; Social support; Testing; Time; Transportation; Unsafe Sex; Waiting Lists; antiretroviral therapy; anxiety symptoms; arm; behavioral health; behavioral outcome; black men; black men who have sex with men; combat; community based participatory research; community organizations; depressive symptoms; diaries; effective intervention; effectiveness testing; effectiveness/implementation trial; emotion dysregulation; emotion regulation; empowerment; evidence base; experience; implementation design; improved; improved outcome; innovation; member; multi-component intervention; multidisciplinary; pilot trial; primary outcome; psychologic; psychological outcomes; research study; secondary outcome; sexual minority; skills; social capital; social stigma; substance use; theories; therapy design; treatment adherence; trend; uptake

PROJECT SUMMARY/ABSTRACT Black men who have sex with men (BMSM) in the U.S. continue to experience a vastly inequitable HIV burden, particularly in Southern Ending the HIV Epidemic in the U.S. (EHE) jurisdictions. To combat this alarming trend, there is a need for innovative, accessible, and community-developed interventions to promote HIV health among BMSM in these areas. Given research that daily and multilevel intersectional stigma contributes to HIV inequities among BMSM, a multicomponent intervention that addresses multilevel barriers to HIV health and combats intersectional stigma is essential. In collaboration with THRIVE SS, a leading BMSM- led community-based organization serving BMSM living with HIV in the Atlanta area, we developed THRIVE365, an evidence-based multicomponent HIV intervention that provides individual-level health education and motivation, builds social support among BMSM, facilitates access to culturally-affirmative healthcare, and combats barriers to housing and economic empowerment in line with the Information- Motivation-Behavioral skills, social capital, and socioecological models of health. Pilot evidence indicates THRIVE365 is feasible, acceptable, and efficacious in promoting daily antiretroviral treatment (ART) adherence and reducing daily depressive symptoms, anxiety symptoms, and emotion regulation difficulties among BMSM living with HIV. THRIVE365 is ready for a full-scale evaluation guided by the RE-AIM framework that includes a robust examination of its effectiveness for HIV-related behavioral and psychological outcomes, its moderation effects on intersectional stigma, and its maintenance and reach over time. We will do so with a fully-powered hybrid type 2 implementation-effectiveness trial using daily diary methods, self-report follow-ups over 6 months, and paradata to examine daily and longer-term intervention engagement, effects, and adaptations. The overarching aims of this research are to: 1) Test the effectiveness of THRIVE365 in improving daily and longer-term HIV-related behavioral health (primary outcome: ART adherence) and psychological health (e.g., secondary outcomes: lower depressive and anxiety symptoms) in a 6-month waitlist randomized controlled trial with 350 BMSM living with HIV in the four Atlanta-area EHE jurisdictions; 2) Examine the moderating effect of THRIVE365 on associations between intersectional stigma and our primary and secondary HIV outcomes; 3) Evaluate THRIVE365 maintenance and reach at the user-level (e.g., within-user changes in engagement and daily effects) and setting-level (e.g., intervention adaptations, BMSM community uptake). Together, these results will establish the effectiveness of THRIVE365, a community-led, multicomponent intervention, for improving HIV-related behavioral and psychological health among BMSM living with HIV in four of the EHE jurisdictions with the greatest HIV burden. THRIVE365 was designed for implementation and is poised to offer a model for effective HIV care among BMSM in high-stigma, low-resource areas of the U.S. South and beyond.

项目总结/摘要 在美国，与男性发生性关系的黑人（BMSM）继续经历着非常不公平的艾滋病毒感染。 在美国结束艾滋病毒流行（EHE）管辖区。打击这一 由于这一趋势令人担忧，需要采取创新的、可获得的和社区开发的干预措施， 这些地区BMSM的艾滋病毒健康状况。研究表明，日常和多层次的交叉污名 导致BMSM中艾滋病毒的不平等，这是一种多成分干预措施， 艾滋病毒健康和打击交叉污名至关重要。在与繁荣SS，一个领先的BMSM合作- 领导的社区为基础的组织服务BMSM艾滋病毒感染者在亚特兰大地区，我们开发了 THRIVE 365是一种基于证据的多组分艾滋病毒干预措施，可提供个人层面的健康 教育和动机，在BMSM中建立社会支持，促进获得文化上的肯定 医疗保健，并打击住房和经济赋权的障碍，符合信息- 动机行为技能，社会资本，和健康的社会生态模型.飞行员的证据表明 THRIVE 365在促进每日抗逆转录病毒治疗（ART）依从性方面是可行、可接受和有效的 减少BMSM的日常抑郁症状、焦虑症状和情绪调节困难 艾滋病毒携带者THRIVE 365已准备好在RE-AIM框架的指导下进行全面评估，该框架包括 对艾滋病毒相关行为和心理结果的有效性进行了强有力的检查， 对交叉柱头的影响，以及随着时间的推移其维持和到达。我们将用一个充满动力的 采用每日日记法的混合2型实施-有效性试验，自我报告随访超过6 个月，并paradise检查日常和长期干预的参与，效果和适应。 本研究的总体目标是：1）测试THRIVE 365在改善日常生活和 长期HIV相关行为健康（主要结果：ART依从性）和心理健康（例如， 次要结果：较低的抑郁和焦虑症状）在6个月的等待名单随机对照试验 与350 BMSM艾滋病毒感染者在四个EHE地区管辖; 2）检查的调节作用， THRIVE 365关于交叉羞辱与我们的主要和次要艾滋病毒结果之间的关联; 3） 评估THRIVE 365维护并达到用户级别（例如，用户参与度的内部变化， 日常效果）和设置水平（例如，干预适应，BMSM社区吸收）。所有这些 结果将确定THRIVE 365的有效性，这是一种社区主导的多成分干预措施， 改善四个EHE中感染艾滋病毒的BMSM的艾滋病毒相关行为和心理健康 艾滋病负担最重的地区。THRIVE 365是为实施而设计的， 在美国南部及其他地区的高耻辱，低资源地区的BMSM中有效的艾滋病毒护理模式。