Understanding secondary prevention along the HIV care continuum among HIV+ Thai YMSM

项目摘要 曼谷男男性行为者(MSM)的艾滋病毒危机是不稳定的，31%的艾滋病毒感染者和 在15-24岁的年轻男男性接触者(YMSM)中，HIV发病率无节制，每年从8.8%到12.2%不等。 因此，曼谷基督教男同性恋者的艾滋病毒发病率是亚洲最高的，在缺乏有效的初级和初级保健服务的情况下 二次预防艾滋病病毒，将继续增加。扩大ART已成为 应对泰国的这场危机。然而，没有关于艾滋病毒护理连续体的数据，因此严重 限制为联系设计基于证据的二级预防干预措施所需的关键信息， 艾滋病毒护理中的保留和重新参与。根据R21筹资机制，这一探索性的 这项研究寻求使用适应的社会生态框架来1)对+YMSM，HIV进行形成性研究 临床医生和CBO领导人将调查与曼谷艾滋病毒护理连续体系相关的多层次因素 +YMSM；和2)量化+YMSM中的艾滋病毒护理连续体，并检查相关的促进者和 障碍通过9个月的纵向虚拟队列。一个次要目标是评估在线服务的可行性 +未来在线干预试验的YMSM队列。这项由一名新调查员提出的研究数据将 确定必须调整哪些二级预防战略，以实现联合国艾滋病规划署的90-90-90目标。 这项研究的发现不仅将填补艾滋病毒护理连续文献中的关键空白，它还将确定 最被排除在卫生系统之外并作为次要目标的+YMSM亚群 应制定预防干预措施。

Project Summary The HIV crisis in Bangkok men who have sex with men (MSM) is volatile with 31% HIV-infected and HIV incidence unbridled and ranging from 8.8% to 12.2% annually in young MSM (YMSM) aged 15-24 years. Consequently, HIV incidence in Bangkok YMSM is Asia’s highest, and in the absence of effective primary and secondary HIV prevention, will continue to increase. Scaling up ART has become the highest priority in responding to this crisis in Thailand. However, data are not available on the HIV care continuum, thus severely limiting critical information needed to design evidence-based secondary prevention interventions for linkage, retention and reengagement in HIV care. In accordance with the R21 funding mechanism, this exploratory study seeks to use the adapted socio-ecological framework to 1) conduct formative research with +YMSM, HIV clinicians and CBO leaders to investigatethe multi-level factors related to the HIV care continuum in Bangkok +YMSM; and 2) quantify the HIV care continuum in +YMSM, and examine the associated facilitators and barriers through a 9-month longitudinal, virtual cohort. A sub aim is to assess the feasibility of an online +YMSM cohort for future online intervention trials. Data from this proposed study by a new investigator will identify which secondary prevention strategies must be scaled in order to meet UNAIDS’ 90-90-90 goals. Findings from this study will not only fill critical gaps in the HIV care continuum literature, it will identify subgroups of +YMSM who are most left out from the health system and to whom targeted secondary prevention interventions should be developed.