Modeling perceptions of social location and decision-making to develop targeted messaging promoting HIV care engagement and ART adherence among women living with HIV in the South

项目摘要/摘要 在所有女性中，南部艾滋病毒携带者(WLWH)的病毒抑制率最低 美国(US)地区。到目前为止，艾滋病毒护理参与度和抗逆转录病毒(ART)坚持 旨在减少南方WLWH病毒抑制差距的干预措施数量很少，而且 没有考虑到女性的不同社交位置。社会位置，交叉口的一个关键概念 框架，广义上指的是背景因素和人们在基于以下因素的社会等级中所占的地位 他们相互交错的身份和健康的社会决定因素，如性别、种族/族裔和阶级不平等； 地理位置；与艾滋病毒有关的耻辱。在一个跨部门框架的指导下， 此应用程序旨在为WLWH开发有针对性的HIV关怀参与和ART遵守信息 南方不同的社会位置。具体地说，该项目将在农村和非农村实施。 北卡罗来纳州的几个地区，南部九个州之一，继续推动美国疫情，并有 受艾滋病毒影响最大的人中有相当大比例(46%)居住在大城市地区以外。具体的 目标是：1)确定参与艾滋病毒护理的社会位置和决策过程，以及 WLWH在南方报道的对ART的坚持；2)制定具有高度针对性的信息，以增强 南方妇幼保健院参与艾滋病毒护理和坚持抗逆转录病毒治疗；以及3)评估可理解性， 目标艾滋病毒关怀参与和抗逆转录病毒治疗遵守信息的可接受性和个人相关性。 对于第一个目标，将对来自不同地区的顺位和变性人进行深入访谈(n=36)。 在南方的社会位置提供信息，以便开展感知测绘调查。对于第二个目的， 将对顺式和变性人WLWH(n=108)进行知觉图谱调查，分析并使用 创建由多维缩放软件生成的感知地图。知觉映射和向量 消息建模是一种新的方法，它生成数学的三维模型，导致 制定具有高度针对性的信息。对于第三个目标，将进行重点小组(n=30)评估 目标消息的可理解性、可接受性和个人相关性。建议数 研究在概念定位上是创新的，以解决交叉的身份和社会 南方WLWH的健康决定因素及知觉测绘和矢量的新应用 建模方法。这项拟议的研究意义重大，因为它有望提供高度靶向的艾滋病毒 旨在减少WLWH病毒抑制差异的护理参与和ART坚持信息 在南方。

PROJECT ABSTRACT/SUMMARY Women living with HIV (WLWH) in the South have the lowest rates of viral suppression among women in all regions in the United States (US). To date, HIV care engagement and antiretroviral (ART) adherence interventions aimed at decreasing viral suppression disparities for WLWH in the South are few in number and have failed to consider the women's diverse social locations. Social location, a key concept in intersectional frameworks, refers broadly to contextual factors and the position people occupy in a social hierarchy based on their intersecting identities and social determinants of health like gender-, race/ethnic-, and class inequities; geographic location; and HIV-related stigma. Guided by an intersectional framework, the overall objective of this application is to develop targeted HIV care engagement and ART adherence messaging for WLWH from diverse social locations in the South. Specifically, this project is to be implemented in rural and non-rural regions of North Carolina, one of the nine southern states that continues to drive the US epidemic and has a substantial percentage (46%) of people most impacted by HIV living outside large urban areas. The specific aims are to: 1) determine the social locations and decision-making processes for HIV care engagement and ART adherence as reported by WLWH in the South; 2) develop highly targeted messages to enhance engagement in HIV care and ART adherence for WLWH in the South; and 3) assess the comprehensibility, acceptability and personal relevance of the targeted HIV care engagement and ART adherence messaging. For the first aim, in-depth interviews (n=36) will be conducted with cis and transgender WLWH from diverse social locations in the South to inform the development of perceptual mapping surveys. For the second aim, perceptual mapping surveys will be administered to cis and transgender WLWH (n=108), analyzed, and used to create perceptual maps generated from multidimensional scaling software. Perceptual mapping and vector message modeling is a novel method that produces mathematical, three-dimensional models, resulting in the development of highly targeted messages. For the third aim, focus groups (n=30) will be conducted to assess the comprehensibility, acceptability, and personal relevance of the targeted messaging. The proposed research is innovative in its conceptual orientation to addressing the intersecting identities and social determinants of health for WLWH in the South and novel application of perceptual mapping and vector modeling method. The proposed research is significant because it is expected to provide highly targeted HIV care engagement and ART adherence messages aimed at decreasing viral suppression disparities for WLWH in the South.