Intervening to improve HIV treatment and reduce drinking in young, black men who have sex with men

意义重大。在美国，与男性发生性行为的年轻黑人男性(YBMSM)受到艾滋病毒的影响截然不同。 对于许多YBMSM来说，酗酒或与酒精使用有关的问题对他们的艾滋病毒护理和 治疗。因此，改善艾滋病毒治疗结果和减少艾滋病毒感染者大量饮酒的干预措施 YBMSM在HIV治疗方面的需求十分迫切。职业发展计划。诺克斯博士的培训将包括 培养干预研究和实施科学方面的关键技能，以及艾滋病毒方面的实质性培训 护理和治疗。这将通过一项计划实现，该计划包括研讨会、讲习班、课程作业、 会议和量身定做的指导。这些活动将帮助诺克斯博士成为一名独立的调查员 有一个研究计划，重点是了解和解决弱势群体中艾滋病毒和酒精的使用问题 人口。研究计划。在目标1中，诺克斯博士提议的研究涉及进行形成性工作 通知制定一项干预措施，解决在酗酒、艾滋病毒-- 感染了，YBMSM。干预将借用两个截然不同且可能互补的组件， 以循证临床为基础的干预措施，简明扼要，以理论为导向。第一个改进了艾滋病毒的治疗 通过让感染艾滋病毒的YBMSM的一名社会网络成员参与艾滋病毒护理来支持他们的结果。 第二项干预通过使用智能手机技术让参与者每天都参与到酒精使用中来 与减少饮酒目标相关的自我监控，这是在基线的简短激励部分中形成的 干预会议。在目标2中，这项形成性工作的信息将在以下帮助下综合 由YBMSM和实施伙伴组成的顾问工作组。目标1和目标2的产品将是 一种创新的干预措施，利用社会网络支持和技术来改善艾滋病毒治疗 减少大量饮酒、感染艾滋病毒的YBMSM的结果和减少酒精使用。它将作为一个单一的- 通过简短的后续检查进行会话基线干预。在目标3中，新的干预措施将进行试点测试，以 对照随机分配的对照，评估其潜在的有效性、可接受性、可行性和实施情况 纽约市(NYC)一家艾滋病毒诊所中60名酗酒、感染艾滋病毒的YBMSM的病情。作为一种 作为艾滋病毒流行的中心，纽约市迫切需要对年轻的黑人MSM进行艾滋病毒治疗的干预。 这一试点测试的结果将为R01提案的开发提供信息，以实现完全动力的随机 对照试验，评价已开发干预措施的效果和实施情况。师徒关系。一支由 酒精和毒品使用、艾滋病毒、种族和性少数群体、干预发展、 实施科学和混合方法将支持这项研究。公共卫生影响。该项目的目标是 为了减少艾滋病毒治疗结果的差异，进而减少新艾滋病毒感染的发生率，一项高级研究 美国国立卫生研究院艾滋病研究办公室的优先事项。制定针对危重、服务不足的艾滋病毒干预措施 人口也在努力实现重要的目标--艾滋病毒流行的里程碑。

Significance. In the US, young, black men who have sex with men (YBMSM) are disparately impacted by HIV. For many YBMSM, heavy drinking or problems related to alcohol use adversely impacts their HIV care and treatment. Thus, interventions to improve HIV treatment outcomes and reduce heavy drinking in HIV-infected YBMSM in HIV treatment are urgently needed. Career Development Plan. Dr. Knox's training will include developing critical skills in intervention research and implementation science, and substantive training in HIV care and treatment. This will be achieved through a plan that includes seminars, workshops, coursework, conferences, and tailored mentoring. These activities will help Dr. Knox become an independent investigator with a research program focused on understanding and addressing HIV and alcohol use in vulnerable populations. Research Plan. In Aim 1, Dr. Knox's proposed research involves conducting formative work to inform the development of an intervention that addresses HIV treatment and alcohol use in heavy-drinking, HIV- infected, YBMSM. The intervention will borrow components from two distinct and potentially complementary, evidence-based clinic-based interventions that are brief and theory-driven. The first improves HIV treatment outcomes in HIV-infected YBMSM by involving a member of their social network to support them in HIV care. The second intervention addresses alcohol use by using smartphone technology to engage participants daily in self-monitoring relative to drinking reduction goals formed during a brief, motivational component of the baseline intervention session. In Aim 2, the information from this formative work will be synthesized with the help of consultant workgroups made up of YBMSM and implementation partners. The product of Aims 1 and 2 will be an innovative intervention that leverages both social network support and technology to improve HIV treatment outcomes and reduce alcohol use in heavy-drinking, HIV-infected YBMSM. It will be administered as a single- session baseline intervention with brief follow-up check-ins. In Aim 3, the new intervention will be pilot tested to assess its potential efficacy, acceptability, feasibility and implementation against a randomly assigned control condition among 60 heavy-drinking, HIV-infected YBMSM in an HIV clinic in New York City (NYC). As an epicenter of the HIV epidemic, interventions for young, black MSM in HIV treatment are urgently needed in NYC. The results of this pilot test will inform the development of an R01 proposal for a fully powered randomized controlled trial to evaluate the efficacy and implementation of the developed intervention. Mentorship. A team of expert investigators in alcohol and drug use, HIV, racial and sexual minorities, intervention development, implementation science and mixed methods will support this research. Public Health Impact. The project aims to reduce disparities in HIV treatment outcomes and, in turn, incidence of new HIV infections, a high research priority of the NIH Office of AIDS Research. Developing HIV interventions targeted for critical, underserved populations also works towards achieving important End the HIV Epidemic milestones.