BACKGROUND: Approximately every 36 seconds someone in the United States dies of cardiovascular disease (CVD). It has emerged as an important contributor to morbidity among persons with HIV. Black and Latinx sexual minority men are at higher risk of both HIV and CVD when compared to heterosexual, non-ethnic/minority men. Persons with HIV have a 1.5-to-2-time risk of CVD than HIV-negative persons. Data suggests that by the year 2030, an estimated 78% of persons with HIV will have cardiovascular disease. The relationship between HIV and CVD, in marginalized populations, is not well understood because overall awareness of HIV and CVD, as comorbid conditions, is low, which further heightens risk. This has created a critically pressing issue affecting underrepresented ethnic and racial populations with HIV and requires immediate efforts to mitigate risk. OBJECTIVE: The purpose of this formative, mixed methods study is to use a community-engaged approach to map a behavioral intervention for cardiovascular disease prevention in Black and Latinx sexual minority men with HIV in New York City.
METHODS: Literature reviews focused on behavioral prevention studies using intervention mapping. In Aim 1, we will use qualitative interviews with HIV program managers and community members to understand facilitators and barriers to CVD prevention, chronic illnesses of concern, and early design elements needed for a web-based CVD prevention intervention. In Aim 2, we will conduct qualitative interviews and administer cross-sectional validated surveys with 30 Black and Latinx sexual minority men with HIV. We will assess illness perceptions of chronic conditions, such as HIV, hypertension, and diabetes. A total of 40 participants (program managers and community members) for Aims 1 and 2 will be enrolled to participate. To develop the protocol, we will follow steps 1 through 3 (needs assessment, change objectives, implementation strategy) of intervention mapping, using mixed methods.
RESULTS: The study was approved by New York University Institutional Review Board in February 2021 (IRB-FY2021-4772) and also by the Yale University Institutional Review Board in June 2022 (2000031577). Data collection is ongoing. We anticipate completing data collection on or before December 2022. Early analyses suggested concerns about illnesses outside of HIV and associate comorbid conditions, such as COVID-19 and Monkeypox. Additionally, we noted a strong interest in using a web-based platform for CVD prevention education.
CONCLUSIONS: Web-based, behavioral, CVD prevention interventions may be promising modalities to closing the cardiovascular health disparities gap in Black and Latinx sexual minority men with HIV by extending the reach of prevention interventions using community informed approaches and technological modalities that have been underutilized in this population.
Community-engaged intervention mapping for CVD-prevention in Black and Latinx sexual minority men with HIV in New York City: Protocol for a web-based mixed method study
JMIR Research Protocols, 11 (10), e41602. doi: 10.2196/41602. PMCID: PMC9597416.