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

 描述(由申请人提供)：HAART的一个令人高兴的结果是，艾滋病毒阳性(HIV+)患者现在可以获得使他们进入老年的药物。这意味着，我们面临着以前意想不到的挑战，即如何在艾滋病毒感染率较高的社区找到支持健康老龄化的方法。这一挑战在男男性行为者(MSM)中可能尤其困难，因为不仅他们的背景艾滋病毒流行率很高，而且普遍缺乏成熟的模式来促进老年MSM的健康老龄化。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更有效但有时间限制的健康促进计划。因此，我们需要确定机制，以提高干预效果水平，以支持健康老龄化，而不是那些已经被用于支持MSM中其他健康促进努力的机制。在我们小组之前的研究中，我们记录了MSM中特定的弹性似乎具有强大的促进健康的特性。在老年MSM中进行的恢复力研究在几个方面都是一项创新议程。解释男男性接触者健康模式的主要方法一直是研究造成健康差距的缺陷的影响。虽然对缺陷的强调有助于解释患有多种心理社会健康问题并导致不良健康结果的男性的生命轨迹，但这种关注不太有助于解释更大比例的MSM的轨迹，这些人也经历过文化边缘化，但在晚年仍保持健康。本申请提出以下目的是测试一种基于理论的方法，通过正在进行的队列研究在六波数据收集(N=1850)中识别老年MSM中的缺陷和弹性1)测量心理社会健康问题和弹性随时间的变化；2)测试弹性随时间的变化是否与物质使用和其他心理社会健康问题的变化有关，并测试弹性是否调节通向综合症的途径；以及3)测试弹性随时间的变化是否与HIV阳性MSM中更好的艾滋病毒相关结果和生物标记物相关，并测试弹性是否缓和了综合症对这些结果的影响。通过识别一些老年MSM已经用来保持健康但尚未纳入当前MSM健康促进努力的弹性，我们可以进行潜在有效的健康促进计划的测试，以支持MSM的健康老龄化。

 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.