Investigating the Impact of Substance Use, Intimate Partner Violence, and COVID-19 on HIV Care Engagement among Young Black Sexual Minority Men with HIV in the US South

总结/摘要 在性少数群体男子中，年轻的黑人性少数群体男子受艾滋病毒影响最大， 性少数男性中的大多数新感染发生在这一群体中。亲密伴侣 暴力（IPV）是可能加剧这些差异的最未得到充分研究的因素之一。很少有人知道的 物质使用和IPV对艾滋病毒护理连续体（CC）结果和艾滋病毒传播风险行为的影响 年轻的黑人性少数男性艾滋病毒（YBSMM+）。IPV和导致IPV的物质使用可能有助于解释 YBSMM+之间的CC参与度较差，并且可能因COVID-19大流行而加剧， 破坏性的健康和经济影响。COVID-19大流行也可能干扰CC的参与 和病毒抑制。我们提出的研究旨在克服这些差距和限制， 确定可修改的干预目标，以便在严重的心理社会和经济危机时期加强社区协调 应力我们建议使用现有的数据，并从联合黑元素+项目（UBE+; R 01）收集新的数据 MH102171）。我们将使用结构方程模型来探索物质使用和IPV之间的关联， 它们对艾滋病毒护理参与、病毒抑制、无避孕套肛交的影响，并确定不同形式的 弹性（全球弹性，应对技能和社会支持）缓冲这些关系之间的关联， YBSMM+在美国南部。这项研究可以为物质使用，IPV和CC之间的关联提供新的见解 结果和风险，并将支持提交干预发展赠款（R34），以发展弹性 和基于药物的干预，减少药物使用和IPV对CC参与和保留的影响 在YBSMM+中。该项目的重点是弹性因素可能在缓和有害影响方面发挥的作用， YBSMM+中的药物滥用和IPV是创新的。这项研究可以告知发展和适应 YBSMM+的物质使用，IPV和CC干预措施。

SUMMARY/ABSTRACT Among sexual minority men, young Black sexual minority men are the most disproportionately impacted by HIV, with the majority of new infections among sexual minority men occurring among this group. Intimate partner violence (IPV) is one of the most understudied factors that may exacerbate these disparities. Little is known about the impact of substance use and IPV on HIV care continuum (CC) outcomes and HIV transmission risk behaviors among young Black sexual minority men with HIV (YBSMM+). Both IPV and substance use leading to IPV may help explain poorer CC engagement among YBSMM+ and are likely to be exacerbated by the COVID-19 pandemic, which is having devastating health and economic impacts. The COVID-19 pandemic is also likely to interfere with CC engagement and viral suppression. The research that we propose is designed to overcome these gaps and limitations, and to identify modifiable intervention targets for strengthening the CC during times of acute psychosocial and economic stress. We propose to use existing data and to collect new data from the United Black Element+ project (UBE+; R01 MH102171). We will use structural equation modeling to explore the associations between substance use and IPV and their impact on HIV care engagement, viral suppression, condomless anal sex, and to determine if distinct forms of resilience (global resiliency, coping skills, and social support) buffer associations between these relationships among YBSMM+ in the U.S. South. This study can shed new light on the associations between substance use, IPV and CC outcomes and risk and will support the submission of an intervention development grant (R34) to develop a resiliency and advocacy-based intervention that reduces the impact of substance use and IPV on CC engagement and retention among YBSMM+. The project’s focus on the role that resiliency factors may play in moderating harmful effects of substance abuse and IPV among YBSMM+ is innovative. This research can inform the development and adaptation of substance use, IPV, and CC interventions for YBSMM+.