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

摘要/摘要 在性少数族裔男性中，年轻的黑人性少数族裔男性受艾滋病毒影响最不成比例， 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)是可能加剧这些差距的最未得到充分研究的因素之一。人们对此知之甚少 药物使用和IPV对HIV连续护理结局和HIV传播危险行为的影响 感染艾滋病毒的年轻黑人性少数族裔男子(YBSMM+)。IPV和导致IPV的物质使用都可能有助于解释 YBSMM+中CC参与度较低，并可能因新冠肺炎大流行而加剧 毁灭性的健康和经济影响。新冠肺炎大流行也可能干扰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，并 确定可修改的干预目标，以便在急性心理社会和经济时期加强CC 压力。我们建议使用现有数据，并从联合黑人元素+项目(UBE+；R01)收集新数据 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，以及 它们对艾滋病毒护理参与、病毒抑制、无套肛交的影响，并确定不同形式的 复原力(全球复原力、应对技能和社会支持)缓冲了这些关系之间的关联 YBSMM+在美国南部。这项研究可以为药物使用、IPV和CC之间的关系提供新的线索 成果和风险，并将支持提交干预发展赠款(R34)，以发展复原力 以宣传为基础的干预，减少物质使用和IPV对CC参与度和保留率的影响 YBSMM+中。该项目的重点是复原力因素在缓解 YBSMM+中的物质滥用和IPV是创新的。这项研究可以为人类的发展和适应提供信息 YBSMM+的药物使用、IPV和CC干预。

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+.