Understanding Patterns of Healthy Aging among Men Who Have Sex with Men

了解男男性行为者的健康老龄化模式

• 批准号: 9150674
• 负责人: RONALD D STALL
• 金额: $ 59.23万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-25 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9150674
• 关键词: AIDS prevention; Accounting; Acquired Immunodeficiency Syndrome; Age; Aging; Alcohol consumption; Alcohol or Other Drugs use; Biological Markers; CD4 Positive T Lymphocytes; CD8-Positive T-Lymphocytes; Cell Count; Cohort Studies; Communities; Data Collection; Drug usage; Elderly; Enrollment; Exhibits; Goals; HIV; HIV Seropositivity; HIV risk; Health; Health Promotion; Highly Active Antiretroviral Therapy; Homophobia; Individual; Institution; Life Cycle Stages; Measures; Mental Depression; Modeling; Monitor; Outcome; Pathway interactions; Pattern; Pharmaceutical Preparations; Population; Prevalence; Preventive Intervention; Process; Production; Property; Research; Risk; Substance abuse problem; Testing; Theoretical model; Time; Tobacco use; Treatment Efficacy; Viral Load result; base; cognitive function; cohort; experience; health disparity; healthy aging; improved; innovation; meetings; men; men who have sex with men; partner violence; programs; psychosocial; rate of change; sex; social exclusion; theories; therapy design; treatment adherence

 DESCRIPTION (provided by applicant): One of the happy consequences of HAART is that HIV-positive (HIV+) individuals now have available to them medications that allow them to reach old age. This means that we have the previously unexpected challenge of finding ways to support healthy aging in communities with high HIV prevalence rates. This challenge is likely to be particularly difficult among men who have sex with men (MSM) due to not only their very high background HIV prevalence rates but also the general dearth of proven models to promote healthy aging among older MSM. To meet this challenge, we need to develop health promotion programs that are more potent than the efficacious but time-limited effects found among HIV prevention interventions. Thus, we need to identify mechanisms to raise levels of intervention efficacy to support healthy aging beyond those that have already been tapped to support other health promotion efforts among MSM. In previous research by our group, we documented that specific resiliencies among MSM appear to have robust health-promoting properties. Resiliencies research conducted among aging MSM is an innovative agenda on several counts. The dominant approach to explaining patterns of health among MSM has been to study the effects of deficits in creating health disparities. While an emphasis on deficits is useful in explaining the life course trajectories of men who have multiple psychosocial health problems that result in poor health outcomes, this focus is less helpful in explaining the trajectories of te far larger proportion of MSM who have also experienced cultural marginalization and yet remain healthy well into later life. This application proposes the following aims to test a theory-based approach to identifying both deficits and resiliencies among aging MSM over six waves of data collection (N=1850) using an ongoing cohort study.1)To measure changes in prevalence rates of psychosocial health problems and resiliencies over time; 2)To test if changing rates of resiliencies over time are associated with changes in substance use and other psychosocial health problems and to test whether resiliencies moderate the pathway to syndemics; and 3)To test if changing rates of resiliencies over time are associated with better HIV-related outcomes and biomarkers among HIV-positive MSM and to test if resiliencies moderate the impact of syndemics on these same outcomes. By identifying the resiliencies already used by some aging MSM to stay healthy but which have yet to be incorporated in current health promotion efforts for MSM, we can progress to the testing of potentially efficacious health promotion programs to support healthy aging among MSM.

 描述（由申请人提供）：HAART 的令人高兴的结果之一是 HIV 阳性 (HIV+) 个体现在可以获得使他们能够延年益寿的药物。这意味着我们面临着之前意想不到的挑战，即寻找支持艾滋病毒高感染率社区健康老龄化的方法。对于男男性行为者 (MSM) 来说，这一挑战可能尤其困难，因为他们不仅艾滋病毒背景患病率非常高，而且普遍缺乏促进老年 MSM 健康老龄化的经过验证的模型。为了应对这一挑战，我们需要制定比艾滋病毒预防干预措施中有效但有时限的效果更有效的健康促进计划。因此，我们需要确定机制来提高干预效力水平，以支持健康老龄化，超越已经用于支持 MSM 中其他健康促进工作的机制。在我们小组之前的研究中，我们记录了 MSM 之间的特定弹性似乎具有强大的健康促进特性。在老龄 MSM 中进行的恢复力研究在几个方面都是一项创新议程。解释 MSM 健康模式的主要方法是研究缺陷对造成健康差异的影响。虽然对缺陷的强调有助于解释患有多种社会心理健康问题并导致健康结果不佳的男性的生命历程轨迹，但这种关注对于解释更大比例的男男性行为者的轨迹却没有多大帮助，他们也经历了文化边缘化，但在晚年仍保持健康。本申请提出以下目标：使用正在进行的队列研究，测试一种基于理论的方法，通过六波数据收集（N = 1850）来识别老年 MSM 的缺陷和弹性。1）测量心理社会健康问题的患病率和弹性随时间的变化； 2）测试弹性率随时间的变化是否与药物使用和其他社会心理健康问题的变化有关，并测试弹性是否会缓和流行病的途径； 3) 测试随着时间的推移，弹性率的变化是否与 HIV 阳性 MSM 中更好的 HIV 相关结果和生物标志物相关，并测试弹性是否会减轻综合症对这些相同结果的影响。通过确定一些老年 MSM 已经使用的弹性来保持健康，但尚未纳入当前 MSM 的健康促进工作中，我们可以进一步测试潜在有效的健康促进计划，以支持 MSM 的健康老龄化。