Developing Internet-Delivered, Mindfulness-based Intervention to Reduce HIV Risk and Promote Mental and Sexual Health among Young Adult MSM

项目摘要 男男性行为青年（18-24岁）感染艾滋病毒的比例过高。少数 YMSM的压力及其“下游”影响，包括心理健康问题，性风险行为， 不理想的艾滋病毒检测，有助于艾滋病毒周围的综合风险。正念干预（MBI） 适用于YMSM和在线交付的艾滋病毒预防，可以提供一种跨诊断，创新， 和可扩展的方法来解决这个公共卫生问题。与NCCIH在疾病方面的科学优先事项一致 预防和健康促进跨越生命周期和NIH的战略计划，以推进研究 性少数群体和性别少数群体的健康，目前的项目针对痛苦的、艾滋病毒高风险的YMSM， 动员MBI预防艾滋病毒，减少少数民族的压力，促进精神和艾滋病毒相关的行为 健康具体而言，该K23将通过适应性调整为早期探索性临床试验提供支持 正念减压（MBSR），并在YMSM中进行可行性试验。候选人： Sun是一名临床科学家，具有艾滋病毒预防和少数民族心理健康的研究背景 人口。近年来，她一直致力于正念的临床和研究发展。基础上 她之前的工作，她正在申请一个为期五年的K23职业发展奖，以获得培训，指导， 和研究经验，成为适应和评估MBI以解决艾滋病毒相关健康问题的专家 差异和一个独立的调查员能够R 01资金。导师：优秀的资深团队 调查人员担任这一建议的导师。Don Operario博士和Judson Brewer博士是 导师，他们在MSM的艾滋病毒预防和基于互联网的行为MBI方面具有互补的专业知识 健康三位共同导师带来了基于互联网的艾滋病毒干预年轻人的专业知识（拉里博士 布朗），人口健康的正念（埃里克·劳克斯博士）和压力生理学（奥黛丽·蒂尔卡博士）。 研究：在ADAPT-ITT模型的指导下，拟议的项目旨在（1）使MBSR适应痛苦，高 风险YMSM使用焦点小组与YMSM（n=30）和利益相关者（n=16），（2）完善干预方案 通过剧院测试，将适应性材料给予痛苦的高风险YMSM（n=18），以及（3）检查 通过随机选择40名抑郁、高风险、 YMSM到iMBI（n=20）和等待列表条件（n=20）。主要结果是艾滋病毒检测和性风险 行为。次要结果是压力生物标志物（头发皮质醇），心理健康，少数民族压力和 应对培训：孙博士将接受MBSR、干预适应和实施方面的量身定制培训 为YMSM，并通过课程，研讨会，讲习班， 指导阅读和指导研究。在优秀的导师团队的指导下，这些培训和 研究经验将建立候选人的职业生涯作为艾滋病毒相关的行为健康专家 通过MBI。这位候选人得到了布朗大学公共卫生学院的机构支持。

PROJECT SUMMARY Young men who have sex with men (YMSM; age 18-24) are disproportionately burdened by HIV. Minority stress and its “downstream” effects in YMSM, including mental health issues, sexual risk behaviors, and suboptimal HIV testing, contribute to syndemic risks surrounding HIV. Mindfulness-based interventions (MBI), adapted for HIV prevention among YMSM and online-based delivery, could offer a transdiagnostic, innovative, and scalable method to address this public health issue. Consistent with NCCIH’s scientific priority in Disease Prevention and Health Promotion across Lifespan and NIH’s Strategic Plan to Advance Research on the Health of Sexual and Gender Minorities, the current project targets distressed, high HIV risk YMSM and aims to mobilize MBI for HIV prevention, to reduce minority stress and promote mental and HIV-related behavioral health. Specifically, this K23 will provide support for early phase, exploratory clinical trial by adapting mindfulness-based stress reduction (MBSR) and conducting a feasibility trial among YMSM. Candidate: Dr. Sun is a clinical scientist with a research background in HIV prevention and mental health concerning minority populations. In recent years, she has pursued clinical and research development in mindfulness. Building on her prior work, she is applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert in adapting and evaluating MBI to address HIV-related health disparities and an independent investigator capable of R01 funding. Mentoring: An excellent team of senior investigators serve as mentors on this proposal. Drs. Don Operario and Judson Brewer are co-primary mentors, who have complimentary expertise in HIV prevention for MSM and internet-based MBI for behavioral health. Three co-mentors bring expertise in internet-based HIV intervention with young adults (Dr. Larry Brown), mindfulness for population health (Dr. Eric Loucks), and stress physiology (Dr. Audrey Tyrka). Research: Guided by the ADAPT-ITT model, the proposed project aims to (1) adapt MBSR for distressed, high risk YMSM using focus groups with YMSM (n=30) and stakeholders (n=16), (2) refine the intervention protocol by administering adapted materials to distressed, high risk YMSM (n=18) via theatre testing, and (3) examine the feasibility and acceptability of the adapted iMBI for HIV prevention by randomizing 40 distressed, high-risk YMSM to the iMBI (n=20) and a waitlist condition (n=20). Primary outcomes are HIV testing and sexual risk behaviors. Secondary outcomes are stress biomarker (hair cortisol), psychological health, minority stress and coping. Trainings: Dr. Sun will receive tailored training in MBSR, intervention adaptation and implementation for YMSM, and a biopsychosocial-based understanding of stress through coursework, seminars, workshops, directed readings, and mentored research. Guided by an excellent mentorship team, these training and research experiences will establish the candidate’s career as an expert in HIV-related behavioral health through MBI. The candidate is institutionally supported by Brown University School of Public Health.