Brothers building brothers by breaking barriers (B6): A resilience-focused intervention for young Black gay and bisexual men living with HIV

项目摘要 年轻的黑人同性恋，双性恋和其他与男性发生性关系的男性（YB-GBMSM）遇到多层次的障碍 参与艾滋病毒护理，这是结构性和人际间种族主义、同性恋否定和艾滋病毒的直接结果。 耻辱这些障碍导致了艾滋病毒的差异，其中YB-GBMSM的艾滋病毒流行率和发病率很高， 但在整个艾滋病护理连续体中的参与率并不理想。个人和 社区一级可以缓冲污名化和歧视对艾滋病毒护理工作的有害影响。我们 先前已经为感染艾滋病毒的YB-GBMSM开发了一种文化特异性的建立免疫力的干预措施 《打破障碍，兄弟结兄弟》（B6）B6专门针对交叉身份 肯定（个人层面的复原力因素）和社会资本（社区层面的复原力因素）， 改善艾滋病毒护理参与的战略。此R34应用程序的目标是调整B6，最初 作为一种面对面的干预措施，在以社区为基础的 组织（CBO）。该项目的基本原理是，远程医疗服务和CBO伙伴关系将消除 参与的障碍，并促进可扩展性和可持续性。我们的研究将在格鲁吉亚的亚特兰大进行- 一个艾滋病中心这项研究将追求三个具体目标：（1）调整B6用于远程保健服务， 与YB-GBMSM、社区顾问和主题专家合作;（2）进行试点 随机对照试验（RCT），以评估远程B6在YB-GBMSM生活中的可行性和可接受性 （3）评估在我们的合作伙伴国会预算办公室的范围内实施B6的过程。 对于第一个目标，我们将使用ADAPT-ITT框架将B6从面对面转换为远程医疗 干预（远程B6）。对于第二个目标，我们将使用N=60的YB-GBMSM测试tele-B6并检查可行性 干预的可接受性。我们还将探讨干预对社会资本、身份认同 肯定和艾滋病毒护理参与。在第三个目标中，我们将利用综合框架， 实施研究，以检查在我们的合作伙伴的结构内实施tele-B6的过程 国会预算办公室拟议的研究是非常重要的，因为它有可能发展一个文化相关的， 对YB-GBMSM进行可扩展的干预，YB-GBMSM是一个继续受到严重和不成比例影响的群体， 艾滋病。

PROJECT SUMMARY Young Black gay, bisexual and other men who have sex with men (YB-GBMSM) encounter multilevel barriers to engaging in HIV care, as a direct result of structural and interpersonal racism, homonegativity and HIV stigma. These barriers lead to HIV disparities in which YB-GBMSM have high HIV prevalence and incidence, but suboptimal rates of engagement across the HIV Care Continuum. Resilience at both the individual and community levels can buffer the deleterious effects of stigma and discrimination on HIV care engagement. We have previously developed a culturally-specific resilience-building intervention for YB-GBMSM living with HIV called Brothers Building Brothers by Breaking Barriers (B6). B6 specifically targets intersectional identity affirmation (an individual-level resilience factor) and social capital (a community-level resilience factor) as a strategy for improving engagement in HIV care. The objective of this R34 application is to adapt B6, originally developed as an in-person intervention, for telehealth delivery within the context of a community-based organization (CBO). The rationale for the project is that telehealth delivery and CBO partnership will remove barriers to participation and facilitate scalability and sustainability. Our study will be based in Atlanta, Georgia – an HIV epicenter. This study will pursue three specific aims: (1) to adapt B6 for telehealth delivery, in collaboration with YB-GBMSM, community advisors, and subject matter experts; (2) to conduct a pilot randomized controlled trial (RCT) to evaluate feasibility and acceptability of tele-B6 among YB-GBMSM living with HIV in Atlanta; and (3) to evaluate the process of implementing B6 within the context of our partner CBO. For the first aim, we will use the ADAPT-ITT framework to convert B6 from an in-person to a telehealth intervention (tele-B6). For the second aim, we will test tele-B6 with N=60 YB-GBMSM and examine feasibility and acceptability of the intervention. We will also explore intervention impacts on social capital, identity affirmation, and HIV care engagement. In the third aim, we will utilize the Consolidated Framework for Implementation Research to examine the process of implementing tele-B6 within the structure of our partner CBO. The proposed research is highly significant because of its potential to develop a culturally relevant, scalable intervention for YB-GBMSM, a group who continues to be heavily and disproportionately impacted by HIV.