扩大和加强南佛罗里达州拉丁裔性少数男性的艾滋病预防和行为健康服务：多层次实施障碍、促进因素和策略。
Scaling Up and Out HIV Prevention and Behavioral Health Services to Latino Sexual Minority Men in South Florida: Multi-Level Implementation Barriers, Facilitators, and Strategies.
机构信息
Department of Public Health Sciences and University of Miami, Miami, Florida, USA.
Department of Psychology, University of Miami, Miami, Florida, USA.
出版信息
AIDS Patient Care STDS. 2021 May;35(5):167-179. doi: 10.1089/apc.2021.0018.
Latino sexual minority men (LSMM) are disproportionately affected by HIV in the United States. Concurrently, behavioral health disparities, including mental health and substance use concerns, worsen HIV disparities affecting LSMM. Yet, evidence-based HIV prevention and behavioral health services are insufficiently scaled up and out to this population, perpetuating health disparities, thwarting efforts to control the HIV epidemic, and highlighting the need for culturally relevant evidence-based implementation strategies that address these disparities. Participants included 28 LSMM with varying degrees of engagement in HIV prevention and behavioral health services, and 10 stakeholders with experience delivering HIV prevention and behavioral health services to LSMM in South Florida, an HIV epicenter in general and in particular for LSMM. Participants completed semistructured interviews (English/Spanish) regarding LSMM's barriers and facilitators to engaging in HIV prevention and behavioral health services. Interviews were audio recorded and analyzed using thematic analysis. The 16 themes that emerged from the qualitative analysis were consistent with the consolidated framework for implementation research, an implementation research framework that articulates barriers and facilitators to implementing clinical interventions. Findings suggested the need for implementation strategies that simplify and reduce costs of HIV prevention and behavioral health services, address syndemic challenges impacting service use among LSMM, reduce stigma about service utilization, leverage peer networks, increase provider and community knowledge about services, and build LSMM's readiness and motivation to engage in services. Such strategies may ultimately address HIV and behavioral health disparities among LSMM and facilitate achievement of goals in this disproportionally affected population.
美国的拉丁裔性少数群体男性（LSMM）受到 HIV 的不成比例影响。同时，行为健康方面的差距，包括心理健康和药物使用问题，使影响 LSMM 的 HIV 差距更加恶化。然而，针对 LSMM 的基于证据的 HIV 预防和行为健康服务的规模扩大和推广仍然不足，这使得健康差距持续存在，阻碍了控制 HIV 流行的努力，并突出了需要制定针对这些差距的文化相关的基于证据的实施策略。参与者包括 28 名 LSMM，他们在不同程度上参与了 HIV 预防和行为健康服务，以及 10 名在南佛罗里达州（总体上是 HIV 高发地区，尤其是对 LSMM 而言）为 LSMM 提供 HIV 预防和行为健康服务的利益相关者。参与者完成了关于 LSMM 参与 HIV 预防和行为健康服务的障碍和促进因素的半结构化访谈（英语/西班牙语）。访谈通过音频记录，并使用主题分析进行分析。从定性分析中出现的 16 个主题与实施研究的综合框架一致，该框架阐明了实施临床干预的障碍和促进因素。研究结果表明，需要实施策略来简化和降低 HIV 预防和行为健康服务的成本，解决影响 LSMM 服务利用的综合征挑战，减少对服务利用的污名化，利用同伴网络，增加提供者和社区对服务的了解，并培养 LSMM 参与服务的准备度和动机。这些策略最终可能会解决 LSMM 中的 HIV 和行为健康差距，并促进实现这一受到不成比例影响的人群的目标。
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