The role of relationship stigma on HIV outcomes among sexual and gender minority couples

父项目摘要 积极参与艾滋病毒护理对于优化艾滋病毒携带者的治疗结果至关重要。 对于性和性别少数民族(SGM)来说尤其如此，这一群体受到不成比例的 艾滋病毒和继续经历高发病率。社会支持，特别是在初级教育背景下 恋爱关系，一直被认为是健康行为的预测指标，包括 坚持照顾艾滋病毒和其他疾病。因此，以夫妻为基础的干预措施有可能 对参与艾滋病毒护理、感染和坚持接触前预防措施(PrEP)产生持久影响 用于预防艾滋病毒，以及与其他男性发生主要关系的SGM的其他健康行为。建房 关于多年来记录夫妻层面对艾滋病毒护理参与度的影响的形成工作 血清不一致和血清一致的SGM阳性夫妇，我们已经开发并试行了两个级别的 以社会控制理论为基础的干预措施，旨在改善护理和病毒学方面的参与度 结果。我们现在建议在一项比较病毒学的随机对照试验中评估这种干预措施 夫妇的结果随机分为夫妻水平干预或个人干预。如果这对夫妇- 水平干预被证明是有效的，它将提供一种潜在的成本效益和可持续的方法来 优化治疗结果，减少这一人群中新的艾滋病毒传播风险。这可能会， 扩展后，适用于其他夫妇、其他环境(包括PrEP)和其他健康 需要患者积极参与的疾病，如糖尿病、癌症和心脏病。

PARENT PROJECT SUMMARY Active engagement in HIV care is critical to optimize treatment outcomes among individuals living with HIV. This is especially true for sexual and gender minority (SGM) persons, a group disproportionately affected by HIV and continuing to experience high incidence rates. Social support, particularly in the context of primary romantic relationships, has consistently been documented as a predictor of health behaviors, including adherence to care for HIV and other conditions. As such, couples-based interventions have the potential to create a lasting effect on engagement in HIV care, uptake and adherence to pre-exposure prophylaxis (PrEP) for HIV prevention, and other health behaviors among SGM in primary relationships with other men. Building on years of formative work documenting couple-level effects on engagement in care among HIV serodiscordant and seroconcordant positive SGM couples, we have developed and piloted a couple-level intervention grounded in Social Control Theory aimed at improving engagement in care and virologic outcomes. We now propose to evaluate this intervention in a randomized controlled trial comparing virologic outcomes of couples randomized to the couple-level intervention or to an individual intervention. If the couple- level intervention proves efficacious, it will provide a potentially cost-effective and sustainable approach to optimizing treatment outcomes and reducing risk of new HIV transmissions among this population. This may, by extension, be subsequently adapted for other couples, other settings (including PrEP), and other health conditions that demand active patient engagement such as diabetes, cancer, and heart disease.