An HIV Intervention Tailored for Black YMSM in the House Ball Community

为 House Ball 社区中的黑人 YMSM 量身定制的艾滋病毒干预措施

• 批准号: 8012312
• 负责人: Sybil Hosek
• 金额: $ 17.82万
• 依托单位: HEKTOEN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8012312
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Adopted; Affect; Age; Appearance; Area; Attitude; Beauty; Behavior Therapy; Categories; Centers for Disease Control and Prevention (U.S.); Characteristics; Chicago; Child; Communities; Coupled; Dancing; Data; Development; Diffusion; Discrimination; District of Columbia; Elements; Employee Strikes; Epidemic; Ethnography; Exercise; Exposure to; Family; Fathers; Focus Groups; Friends; Gatekeeping; Gays; Gender; Gender Identity; HIV; HIV Infections; Health; Health Personnel; Health Services Research; Hispanics; Home environment; Housing; Human Resources; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Intervention Trial; Life; Manuals; Marketing; Measures; Minority; Modeling; Mothers; Names; New York; Parents; Perception; Persons; Population; Population Sizes; Prevalence; Prevention; Prevention Research; Preventive Intervention; Procedures; Public Health; Recruitment Activity; Reporting; Research; Research Project Grants; Research Training; Resistance; Resources; Risk; Risk Assessment; Risk Reduction; Rosa; Sampling; Schedule; Schools; Series; Seroprevalences; Sex Orientation; Sexual Partners; Social Change; Social Network; Social support; Stigmata; Structure; Surveys; Target Populations; Techniques; Test Result; Testing; Time; Training; Voice; Walking; Work; Youth; aged; base; condoms; design; experience; follow up assessment; high risk; innovation; member; men; men who have sex with men; metropolitan; novel strategies; pilot trial; prevention service; programs; public health relevance; safer sex; sex; sex risk; skills; social; social stigma; success; surveillance data; transmission process

DESCRIPTION (provided by applicant): Recent HIV surveillance data show that men who have sex with men (MSM) are the only risk group in which the number of new infections rose annually from 2001-2006 (Hall et al., 2008). Among persons aged 13-24, Blacks are disproportionately affected by HIV infection accounting for 55% of all HIV infections reported (CDC, 2005). These racial disparities among MSM persist in the Chicago area, with the HIV prevalence rate among Black MSM (30.1%) more than twice that of White (11.3%) and Hispanic MSM (12.0%) (Chicago Department of Public Health, 2009). The racial disparity in HIV prevalence rate is even more striking among youth ages 18-24, with 24.2% among Black YMSM compared to 2.3% for White YMSM and 6.5% for Hispanic YMSM (CDPH, 2009). Despite the urgent need, there are no theoretically based, culturally appropriate behavioral interventions to reduce the risk of sexual acquisition or transmission of HIV among BYMSM. Furthermore, there are no HIV prevention interventions specifically targeting the House Ball community, an understudied and clandestine subculture of the Black gay community with high HIV prevalence (Sanchez et al., 2009; Marks et al., 2008; Murill et al., 2005). The d-up! Defend Yourself" intervention, which has shown efficacy with BMSM (Jones et al., 2008), may be particularly well-suited for reaching BYMSM in the House Ball community. An adaptation of Kelly's Popular Opinion leader (POL) intervention ((Kelly et al., 1991,1992,1997,2006; Fernandez et al., 2003, 2005), d-up! Defend Yourself! utilizes opinion leaders from within the community to change social norms and perceptions of BMSM regarding safer sex practices (Jones et al., 2008). d-up! is delivered by members of the targeted community, thus providing "intravention", an approach most appropriate for insulated and marginalized communities such as the House Ball community (Bailey, 2009; Friedman et al., 2004). In this application, we propose to tailor the d-up! intervention for relevance with the Chicago House Ball community and then conduct a small, pilot trial to test for feasibility and acceptability. We will begin by conducting a series of focus groups in order to identify persuasive, culturally-appropriate messages and identify intervention targets. Based on focus group data, we will then tailor the intervention to be relevant for the Chicago House Ball community. We will then use Kelly and colleagues (2004) procedures for identifying popular opinion leaders from within the community and inviting them to participate in the study. We will implement a baseline community risk assessment by obtaining a convenience sample of approximately 150 youth attending the School of Opulence over three consecutive weeks. Then, opinion leaders will be trained on the tailored intervention over a period of four weeks. We will conduct four equally spaced (3, 6, 9, 12 months post-baseline) cross-sectional follow-up assessments of convenience samples of youth (i.e. approximately 150 youth at each time point) from the House Ball community. The follow-up assessments will include measures of sexual risk behavior in the past 3 months and exposure to the intervention through opinion leaders and marketing materials over the past 3 months. Opinion leaders will be asked to rate the acceptability of the intervention and the feasibility of communicating risk reduction messages within their social networks. Feasibility of the overall intervention will also be assessed by the number of opinion leaders recruited that agreed to be trained, the number of risk reduction conversations documented by opinion leaders, and retention of the opinion leaders over the project period. PUBLIC HEALTH RELEVANCE: For this application, we will examine the feasibility and acceptability of a popular opinion leader intervention for use with Black, young men who have sex with men that participate in the House Ball community in Chicago. The aim of such an intervention is to decrease HIV infections in a community already disproportionately impacted by HIV. This intervention has great potential to directly impact the lives of young men who have sex with men in the House Ball community and to decrease HIV transmission to sexual partners inside and outside of the community.

描述（申请人提供）：最近的 HIV 监测数据显示，男男性行为者 (MSM) 是 2001 年至 2006 年间新感染人数逐年上升的唯一危险群体（Hall 等人，2008 年）。在 13-24 岁的人群中，黑人受艾滋病毒感染的影响尤为严重，占报告的所有艾滋病毒感染者的 55%（CDC，2005）。在芝加哥地区，男男性行为者之间的种族差异依然存在，黑人男男性行为者的艾滋病毒感染率（30.1%）是白人（11.3%）和西班牙裔男男性行为者（12.0%）的两倍多（芝加哥公共卫生部，2009年）。 18-24 岁青年中艾滋病毒感染率的种族差异更为显着，黑人 YMSM 为 24.2%，而白人 YMSM 为 2.3%，西班牙裔 YMSM 为 6.5%（CDPH，2009 年）。尽管迫切需要，但目前还没有基于理论、文化上适当的行为干预措施来降低 BYMSM 中性感染或传播艾滋病毒的风险。 此外，没有专门针对 House Ball 社区的艾滋病毒预防干预措施，这是一种未经充分研究的黑人同性恋社区的秘密亚文化，艾滋病毒感染率很高（Sanchez 等人，2009 年；Marks 等人，2008 年；Murill 等人，2005 年） ）。 d-up！ “捍卫自己”干预措施已显示出对 BMSM 的有效性（Jones 等人，2008 年），可能特别适合在 House Ball 社区中达到 BYMSM。凯利的大众意见领袖 (POL) 干预措施的改编（(Kelly 等人)等人，1991、1992、1997、2006；费尔南德斯等人，2003、2005）， d-up! Defend Yourself! 利用社区内的意见领袖来改变 BMSM 对安全性行为的看法（Jones 等人，2008 年），从而提供了目标社区的支持。 “干预”，一种最适合孤立和边缘化社区的方法，例如 House Ball 社区（Bailey，2009；Friedman 等人，2004）。在本申请中，我们提出了这种方法。定制与芝加哥 House Ball 社区相关的 d-up! 干预措施，然后进行小型试点试验以测试可行性和可接受性。信息并确定干预目标。然后，我们将根据焦点小组数据调整干预措施，使其与芝加哥众议院舞会社区相关。然后，我们将使用 Kelly 和同事（2004）的程序来识别社区内的流行意见领袖并邀请他们参与研究。我们将通过连续三周抽取大约 150 名在富裕学校就读的青少年的便利样本来实施基线社区风险评估。然后，意见领袖将接受为期四个星期的定制干预培训。我们将对 House Ball 社区的青少年便利样本（即每个时间点大约 150 名青少年）进行四次等间隔（基线后 3、6、9、12 个月）的横断面后续评估。后续评估将包括过去 3 个月内的性风险行为测量以及过去 3 个月内通过意见领袖和营销材料进行的干预措施的暴露程度。将要求意见领袖评估干预措施的可接受性以及在其社交网络中传达降低风险信息的可行性。 总体干预的可行性还将根据同意接受培训的招募意见领袖的数量、意见领袖记录的降低风险对话的数量以及项目期间意见领袖的保留情况来评估。 公共卫生相关性：对于此应用程序，我们将研究对参与芝加哥 House Ball 社区的男男性行为黑人年轻男性进行流行意见领袖干预的可行性和可接受性。这种干预措施的目的是减少已经受到艾滋病毒影响严重的社区中的艾滋病毒感染。这项干预措施具有巨大的潜力，可以直接影响 House Ball 社区中男男性行为者的生活，并减少艾滋病毒向社区内外性伴侣的传播。