Development of Culturally Tailored Content for Smoking Cessation and HIV Care Improvement among Latinx Adults: A Pilot Study

项目总结/摘要 少数种族/族裔群体受到艾滋病毒的影响不成比例，艾滋病毒/艾滋病感染者（PWH） 吸烟的风险，吸烟对艾滋病毒感染者的健康构成重大危害， 管理例如，吸烟是艾滋病毒相关和非艾滋病毒相关发病率的主要危险因素 和死亡率之间的PWH，甚至在那些服用抗逆转录病毒（ART）药物，并有助于更多的生命- 在接受ART有效治疗的拉丁裔/西班牙裔成人中， 艾滋病毒感染者（简称拉丁裔）吸烟者面临与吸烟有关的健康差异和反应较差的高风险 艾滋病治疗。携带艾滋病毒的拉丁裔吸烟者戒烟更困难，不太可能使用药物 支持戒烟，并且与感染艾滋病毒的非拉丁裔白色吸烟者相比，以前吸烟的可能性更小。 管理与拉丁裔吸烟者经历的耻辱和歧视有关的躯体干扰的挑战， 艾滋病毒可能导致戒烟困难，并随后影响艾滋病毒疾病的管理。焦虑敏感性（AS）是一种 核心情感脆弱性因素牵连在内部的痛苦，已成为一个领先的机械目标， 行为健康干预，与吸烟行为和戒烟有关，并与艾滋病毒有关 症状困扰严重程度。减少AS可改善PWH患者的焦虑、抑郁并提高生活质量， 这可以改善艾滋病毒特异性结果，包括ART依从性和治疗参与。戒烟 专门针对AS的治疗在PWH中导致更好的吸烟结果。然而，没有一项工作利用了 在易于获得的、 为携带艾滋病毒的拉丁裔吸烟者量身定制的干预措施。当前提案的目标是发展适合文化的 在三个独特的拉丁裔群体中减少AS、戒烟和HIV疾病管理的内容 携带艾滋病毒的吸烟者：墨西哥裔美国人、中美洲人和南美洲人。为了实现这一目标，我们的团队 将调整我们现有的材料，以减少AS，戒烟和艾滋病毒护理的参与，以纳入独特的 文化方面的墨西哥裔美国人吸烟者与艾滋病毒，然后试点这些材料之间的40墨西哥裔美国人 吸烟者携带艾滋病毒干预内容将根据两个国家独特的文化因素进行改进和调整， 拉丁裔人口的其他亚组：（1）中美洲人和（2）南美洲人，随后 在中美洲（N = 20）和南美洲（N = 20）进行试验。在完成建议的研究后，我们 将开发文化定制的内容，以改善戒烟和艾滋病毒护理参与/管理 在较大的拉丁裔人口的三个独特的亚群中， 研究人员团队、治疗目标人群的社区成员和目标人群。一旦精炼， 这些材料将准备在一个基于智能手机的应用程序中进行集成和测试， 结果。拟议的项目与公共卫生密切相关，因为它可以帮助指导 在感染艾滋病毒的拉丁裔吸烟者中进行新的文化定制戒烟干预和艾滋病毒护理。

PROJECT SUMMARY/ABSTRACT Racial/ethnic minority groups are disproportionately affected by HIV, people with HIV/AIDS (PWH) are at increased risk for smoking, and smoking presents a major health hazard to individuals with HIV and affects disease management. For example, cigarette smoking is a leading risk factor for HIV-related and non-HIV-related morbidity and mortality among PWH, even among those taking antiretroviral (ART) medications, and contributes to more life- years lost than HIV-related complications among those effectively treated with ART. Latinx/Hispanic adults (hereafter referred to as Latinx) with HIV who smoke are at high-risk for smoking-related health disparities and poorer response to HIV treatment. Latinx smokers with HIV experience more difficulty quitting, are less likely to use pharmacological support for smoking cessation, and are less likely to be a former smoker than non-Latinx White smokers with HIV. Challenges managing somatic perturbation related to stigma and discrimination experienced by Latinx smokers with HIV may contribute to quit difficulty and subsequently impact HIV disease management. Anxiety sensitivity (AS) is a core affective vulnerability factor implicated in internal distress that has emerged as a leading mechanistic target for behavioral health interventions, is related to smoking behavior and cessation, and has been implicated in HIV symptom distress severity. AS reduction improves anxiety, depression, and enhances quality of life among PWH, which can improve HIV-specific outcomes including ART adherence and treatment engagement. Smoking cessation treatment that specifically targets AS leads to better smoking outcomes among PWH. Yet, no work has leveraged the potential to target AS reduction to improve smoking cessation and HIV care outcomes in the context of an accessible, tailored intervention for Latinx smokers with HIV. The goal of the current proposal is to develop culturally tailored content for AS reduction, smoking cessation, and HIV disease management among three unique groups of Latinx smokers with HIV: Mexican Americans, Central Americans, and South Americans. To achieve this objective, our team will adapt our existing materials for AS reduction, smoking cessation, and HIV care engagement to incorporate unique cultural aspects for Mexican American smokers with HIV and then pilot these materials among 40 Mexican American smokers with HIV. Intervention content will then be refined and adapted to the unique cultural considerations for two additional subgroups of the Latinx population: (1) Central Americans and (2) South Americans, and subsequently piloted on Central Americans (N = 20) and South Americans (N = 20). Following completion of the proposed study, we will have developed culturally tailored content to improve smoking cessation and HIV care engagement/management among three unique subpopulations of the larger Latinx population that will have been informed and vetted by a strong team of researchers, community members who treat the target population, and the target population. Once refined, these materials will be ready for integration and testing within a smartphone-based application targeting improved outcomes. The proposed project is centrally relevant to public health because it can help guide the development of novel culturally tailored smoking cessation interventions and HIV care among Latinx smokers with HIV.