An Intervention for Male STD Patients in India

针对印度男性性病患者的干预措施

• 批准号: 7085430
• 负责人: CHRISTINA P LINDAN
• 金额: $ 40.97万
• 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 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7085430
• 关键词: AIDS /HIV test; AIDS education /prevention; HIV infections; India; alcoholic beverage consumption; behavior therapy; behavioral /social science research tag; bisexual; clinical research; clinical trials; combination therapy; condoms; counseling; culture; high risk behavior /lifestyle; human subject; human therapy evaluation; male; microorganism disease chemotherapy; patient oriented research; public health; questionnaires; sex behavior; sexually transmitted diseases; substance abuse related behavior

DESCRIPTION (provided by applicant): We request 3 years of funding to complete an ongoing randomized trial of a behavioral intervention compared to STI treatment/HIV testing and counseling alone, among male STI patients in Mumbai, India. Trial outcomes include HIV/STI incidence and self-reported risk behavior. The cumulative prevalence of HIV among men screened to date is 14%. We have recruited over half the total 1800 HIV negative men required for randomization, and have an excellent research infrastructure on site including data management, laboratory, and trained staff. Preliminary data indicate the primary risk factor for HIV is exposure to female sex workers (FSW) and HSV2 infection; preliminary analysis of trial results reveal a strong effect in both arms over time, and a difference in self-reported risk behavior between the two arms. We found a strong association of alcohol use during sex with FSW and increased HIV risk, HSV2, syphilis, and number of episodes of unprotected sex. In addition, many men have sex with both women and other high-risk men. To address this, we propose to expand our evaluation of MSM and the role of alcohol in risky sex among men being enrolled the study. Data from the trial will supplement information obtained from the large community based STI trials in Africa, which have shown differing results. It is possible that specific STI diagnosis and treatment including HSV2, if accompanied by HIV testing and quality counseling, is an affordable and effective prevention strategy in our setting. Overall goals of the study are to develop and evaluate a feasible, culturally appropriate intervention to reduce HIV transmission in India. To be widely effective, prevention programs in south Asia should be instituted within the public health system. For this reason, we implemented this trial within the public health structure, despite the inherent difficulties of this approach. The study has already succeeded in changing public health STI treatment guidelines. Additional time and funding are required due to a short initial 4-year funding period, time required to perform such a trial in India, and slower than anticipated recruitment of subjects due to demographic shifts in the high risk population. To address these issues, we propose to add an additional recruitment site and evening follow-up clinics to enhance enrollment and retention.

描述（由申请人提供）：我们请求 3 年的资金来完成一项正在进行的随机试验，该试验针对印度孟买的男性性传播感染患者，与单独的性传播感染治疗/艾滋病毒检测和咨询进行比较。 试验结果包括艾滋病毒/性传播感染的发病率和自我报告的危险行为。 迄今为止，接受筛查的男性艾滋病毒累计患病率为 14%。 我们已经招募了随机化所需的 1800 名 HIV 阴性男性中的一半以上，并拥有出色的现场研究基础设施，包括数据管理、实验室和训练有素的工作人员。 初步数据表明，HIV 的主要危险因素是接触女性性工作者 (FSW) 和感染 HSV2；对试验结果的初步分析显示，随着时间的推移，两组都产生了强烈的影响，并且两组之间自我报告的风险行为也存在差异。 我们发现，性交过程中饮酒与 FSW 以及 HIV、HSV2、梅毒和无保护性行为次数的增加有很强的相关性。 此外，许多男性同时与女性和其他高风险男性发生性关系。 为了解决这个问题，我们建议扩大对 MSM 以及酒精在参与研究的男性危险性行为中的作用的评估。 该试验的数据将补充从非洲大型社区性传播感染试验中获得的信息，这些试验显示了不同的结果。在我们的环境中，包括 HSV2 在内的特定 STI 诊断和治疗，如果辅之以 HIV 检测和质量咨询，可能是一种负担得起且有效的预防策略。该研究的总体目标是制定和评估可行的、文化上适当的干预措施，以减少印度的艾滋病毒传播。 为了广泛有效，南亚的预防计划应在公共卫生系统内制定。因此，我们在公共卫生结构内实施了这项试验，尽管这种方法存在固有的困难。 该研究已经成功改变了公共卫生性传播感染治疗指南。 由于最初的 4 年资助期很短，在印度进行此类试验需要时间，而且由于高危人群的人口结构变化，受试者招募速度比预期慢，因此需要额外的时间和资金。 为了解决这些问题，我们建议增加一个额外的招聘网站和晚间随访诊所，以提高入学率和保留率。

项目成果

Utility of pooled urine specimens for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in men attending public sexually transmitted infection clinics in Mumbai, India, by PCR.

使用聚合尿液样本，通过 PCR 检测前往印度孟买公共性传播感染诊所的男性中的沙眼衣原体和淋病奈瑟菌。

• 发表时间: 2005-04
• 作者: Lindan, Christina;Mathur, Meenakshi;Kumta, Sameer;Jerajani, Hermangi;Gogate, Alka;Schachter, Julius;Moncada, Jeanne
• 通讯作者: Moncada, Jeanne

Characterization of HIV Recent Infection Among High-Risk Men at Public STI Clinics in Mumbai.

孟买公共性传播感染诊所高危男性近期艾滋病毒感染的特征。

• 发表时间: 2018-07
• 影响因子: 4.4
• 作者: Truong, Hong;Fatch, Robin;Grant, Robert M;Mathur, Meenakshi;Kumta, Sameer;Jerajani, Hemangi;Kellogg, Timothy A;Lindan, Christina P
• 通讯作者: Lindan, Christina P