AN INTERVENTION FOR MALE STD PATIENTS IN INDIA

印度男性性病患者的干预措施

• 批准号: 6078872
• 负责人: CHRISTINA P LINDAN
• 金额: $ 58.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-15 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6078872
• 关键词: AIDS /HIV test; HIV infections; India; behavior therapy; behavioral /social science research tag; clinical research; clinical trials; counseling; health behavior; human subject; human therapy evaluation; male; microorganism disease chemotherapy; sex behavior; sexually transmitted diseases

India now has the greatest number of HIV infections of any country in the world, with heterosexual transmission responsible for 75% of its reported HIV cases. In Mumbai, formerly Bombay, the prevalence of HIV among sex workers (CSWs) is 60-80%. Interventions targeting CSWs have met with limited success given these women's lack of power to negotiate condom use; concomittantly, HIV infection among male sexually transmitted disease (STD) patients, a majority of whom are regular clients Of CSWs, has risen to 36%. Targeting male STD patients can be an effective HIV prevention strategy, as these men represent a critical link in the transmission Of HW to the general population. The high prevalence of STDs, particularly genital ulcers, as well as lack of adequate diagnosis and timely treatment, also contribute to increased HIV transmission in this group. We have conducted a pilot study among male STD patients in a public clinic in Mumbai that has provided baseline information on sexual risk behavior and the feasibility of performing a behavioral intervention. We base our current proposal on this extensive pilot data. The goals of this proposal are to perform a randomized, controlled trial of a behavioral intervention when added to standard care (STD treatment, with HIV testing and counseling) compared with standard care alone, among male STD patients in two public clinics in Mumbai. We will determine the impact of the intervention using biological outcome measures, specifically, HIV incidence over a one-year follow-up period. We will also measure the program's effect on self-reported risk behaviors, including condom use, visits to sex workers, number of sexual partners and health seeking behavior. We will determine the incidence and prevalence of bacterial and viral STDs using nucleic acid amplification techniques to identify the etiology of genital ulcer disease, urethritis, and asymptomatic infections. There have been no controlled trials of behavioral interventions in India targeting male clients of sex workers or STD patients. There is an urgent need to test strategies that are feasible, effective, sustainable and applicable to similar settings in India and elsewhere in Asia. This study will provide valuable information on the added efficacy of a behavioral approach to HIV control.

印度目前是世界上艾滋病毒感染人数最多的国家，其报告的艾滋病毒病例中有 75% 是由异性性传播造成的。在孟买（以前称为孟买），性工作者 (CSW) 的艾滋病毒感染率为 60-80%。鉴于这些妇女缺乏协商使用安全套的权力，针对 CSW 的干预措施取得的成功有限；与此同时，男性性传播疾病（STD）患者（其中大多数是 CSW 的常客）的 HIV 感染率已上升至 36%。针对男性性病患者可能是一种有效的艾滋病毒预防策略，因为这些男性是将艾滋病病毒传播给普通人群的关键环节。性传播疾病（尤其是生殖器溃疡）的高患病率以及缺乏充分诊断和及时治疗，也导致该群体中艾滋病毒传播增加。我们在孟买一家公共诊所对男性性传播疾病患者进行了一项试点研究，提供了有关性危险行为和进行行为干预的可行性的基线信息。我们当前的提议基于这些广泛的试点数据。该提案的目标是在孟买两家公共诊所的男性性病患者中进行一项随机对照试验，对添加标准护理（性病治疗、艾滋病毒检测和咨询）的行为干预与单独标准护理进行比较。我们将使用生物学结果指标来确定干预措施的影响，特别是一年随访期内的艾滋病毒发病率。我们还将衡量该计划对自我报告的风险行为的影响，包括安全套的使用、拜访性工作者、性伴侣的数量和寻求健康的行为。我们将利用核酸扩增技术确定细菌和病毒性 STD 的发病率和患病率，以确定生殖器溃疡病、尿道炎和无症状感染的病因。印度还没有针对性工作者的男性顾客或性病患者进行行为干预的对照试验。迫切需要测试可行、有效、可持续且适用于印度和亚洲其他地区类似环境的战略。这项研究将为艾滋病毒控制行为方法的附加功效提供有价值的信息。