Cannabis Use and Proximal Immune Dysregulation (CUPID)

项目摘要/摘要 背景资料。与非男性相比，黑人性少数男性(SMM)经历了与艾滋病毒相关的严重差异 西班牙裔白人男性，在生命过程的早期患上症状更严重的年龄相关疾病 死于艾滋病毒感染的比率更高。生命早期暴露在压力下与关键的生物过程有关， 特别是炎症和较短的白细胞端粒长度，这与艾滋病毒相关 合并症和年龄相关疾病。有充分的记录表明，年轻的黑人SMM经历了多层次的 性少数群体压力，如性身份隐瞒、受害和社区同性恋恐惧症- 耻辱的产物，使健康结果进一步复杂化。因此，了解可能会减弱的因素 较年轻时的炎症影响是缓解晚年与艾滋病毒相关的差异的关键时期。 大麻的使用是一个值得注意的可修改的调查因素，因为有大量证据表明它在打击 炎症过程及其迅速加速的法律和社会接受；然而，之前的严格 研究大麻对炎症和其他关键生物过程的影响的研究有限 因为研究大多是横断面的，使用的是自我报告的大麻使用衡量标准，而不是 适用于感染艾滋病毒的年轻黑人SMM。为了解决这些差距，这项K23提案-大麻使用和 近端免疫失调(丘比特)-将加强我的职业发展努力(1)了解如何 大麻的生物标志物可能会影响炎症和白细胞端粒长度，以及(2)检查 多层次的性少数应激的调节作用。这份K23提案将为实现我的长期目标开辟一条道路 成为一名R01资助的调查员的任期职业目标，具有多层次决定因素的专业知识 支持艾滋病毒相关健康差异的生物行为过程，以指导干预措施的发展 带着艾滋病毒的黑人SMM。为了实现我的职业目标，我需要培训(1)发展一个全面的 了解大麻使用、炎症和白细胞端粒长度的生物标记物；(2)促进我的 了解黑人SMM的多级性少数群体压力评估；以及(3)在以下方面发展专门知识 分析纵向数据。一支成就卓著的跨学科导师团队，致力于支持我的 向独立调查员过渡将为培训和研究活动提供指导。特定的 目的是(1)确定大麻使用与炎症和白细胞生物标志物之间的关系 端粒长度；以及(2)评估个人-人际-社区-和社会层面的性别 少数人应激缓和了大麻与炎症和白细胞端粒长度的关系。丘比特 将为R01提案的制定提供信息，以进行更明确的队列研究，以进一步阐明生物- 使用大麻和性少数应激的行为途径与炎症和白细胞有关 HIV感染的黑色SMM的端粒长度。

PROJECT SUMMARY/ABSTRACT Background. Black sexual minority men (SMM) experience profound HIV-related disparities compared to non- Hispanic White men, acquiring age-related diseases with greater symptom severity earlier in the life course and dying from HIV infection at higher rates. Early life exposure to stress is linked to key biological processes, specifically inflammation and shorter leukocyte telomere length, which are associated with HIV-related comorbidities and age-related diseases. It is well documented that young Black SMM experience multilevel sexual minority stress, such as sexual identity concealment, victimization, and community homophobia - products of stigma which further complicate health outcomes. Thus, understanding factors that may attenuate the effects of inflammation in younger ages is a critical period to mitigate HIV-related disparities later in life. Cannabis use is a noteworthy modifiable factor for investigation, given the substantial evidence of its role in anti- inflammatory processes and its rapidly accelerating legal and social acceptance; however, the rigor of prior research examining the influence of cannabis on inflammation and other key biological processes is limited because studies have mostly been cross-sectional, used self-reported measures of cannabis use, and are not generalizable to young Black SMM with HIV. To address these gaps, this K23 proposal – Cannabis Use and Proximal Immune Dysregulation (CUPID) – will fortify my Career Development efforts to (1) understand how biomarkers of cannabis may influence inflammation and leukocyte telomere length and (2) examine the modifying role of multilevel sexual minority stress. This K23 proposal will chart a pathway to achieve my long- term Career Goals of becoming an R01-funded investigator with expertise in multilevel determinants of biobehavioral processes underpinning HIV-related health disparities to guide the development of interventions with Black SMM with HIV. To accomplish my career goals, I will need training (1) to develop a comprehensive understanding of biomarkers of cannabis use, inflammation, and leukocyte telomere length; (2) to advance my understanding of multilevel sexual minority stress assessment in Black SMM; and (3) to develop expertise in analyzing longitudinal data. An accomplished, interdisciplinary Mentorship Team committed to supporting my transition to an independent investigator will provide guidance on the training and research activities. Specific Aims are (1) to determine the relationship between cannabis use and biomarkers of inflammation and leukocyte telomere length; and (2) to evaluate whether individual- interpersonal- community- and societal level sexual minority stress moderate the relationship of cannabis with inflammation and leukocyte telomere length. CUPID will inform the development of an R01 proposal for a more definitive cohort study to further elucidate the bio- behavioral pathways whereby cannabis use, and sexual minority stress are linked to inflammation and leukocyte telomere length in Black SMM with HIV.