Development of a Multilevel HIV Prevention for Latin American Men

为拉丁美洲男性制定多层次艾滋病毒预防方案

• 批准号: 8139720
• 负责人: Susan M. KEGELES
• 金额: $ 20.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-08 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8139720
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Advocacy; Affect; American; Applications Grants; Bisexual; Collaborations; Communities; Country; Development; Discrimination; Drug usage; Epidemic; Exclusion; Gays; HIV; HIV Infections; HIV Seropositivity; Health; Health Services Accessibility; Human Rights; Immigrant; Individual; Informal Social Control; Injection of therapeutic agent; Intervention; Latin America; Latino; Leadership; Manuals; Methods; Outcome; Peru; Pilot Projects; Prevention approach; Prevention strategy; Preventive Intervention; Process; Recruitment Activity; Research; Resources; Rest; Risk; Sampling; Self Perception; Social Environment; Testing; Training; Treatment Efficacy; Violence; Work; Writing; base; cohort; cost effective; efficacy testing; empowerment; evidence base; group intervention; innovation; intervention effect; men; men who have sex with men; public health relevance; sex; sex risk; social; therapy development; working group

DESCRIPTION (provided by applicant): Peru has a concentrated HIV epidemic, in which 12% of men who have sex with men (MSM) are estimated to be HIV-positive. This situation is similar to the rest of Latin America, where sex between men drives the HIV epidemic. Yet very little research has been conducted to develop HIV prevention interventions for Peruvian or other Latin American MSM. We seek to develop an intervention approach that will be relevant to Peruvian men, but has the potential to be generalized to MSM in other Latin American countries. Therefore, we propose to conduct a three-year study to develop and pilot test a community-level HIV prevention intervention for Peruvian MSM that simultaneously focuses on individual, interpersonal, social, and structural factors affecting men's vulnerability to HIV. Our proposed intervention builds on the theoretical principles of two prevention approaches conducted in the U.S., and the previous work this team has been conducting together in Peru over the past eight years. The first intervention, the Mpowerment Project (MP), a community-level intervention, was developed for young U.S. gay/bisexual men and involves community mobilization and individual and community empowerment. The second intervention, Hermanos de Luna y Sol (HLS), was developed for U.S. Latino gay/bisexual men, and is a small-group intervention that focuses on individual empowerment. Although the MP's and HLS' theoretical principles are relevant to Peruvian MSM, a new culturally appropriate intervention needs to be developed because many of the MP's methods are difficult to use in resource-poor settings and the HLS focuses on issues regarding being immigrants and uses some activities that may not be feasible in Peru. Aim 1 is to adapt and culturally tailor two evidence-based HIV prevention interventions, the MP and HLS, and create new, additional intervention components to respond to the HIV prevention needs of MSM in Peru. Aim 1 will be accomplished by developing and maintaining an active, working collaboration with a Community Working Group of Peruvian HIV, gay, transvestite, and human rights activists with community expertise who will provide input into all parts of the intervention and will help develop some of the components. Aim 2 is to develop a multi-level HIV prevention intervention, Peruanos Diversos Unidos, based on the outcomes of Aim 1, involving small group sessions, community mobilization, and leadership development. Aim 2 will be accomplished by developing an intervention manual and trainings to implement Peruanos Diversos Unidos, which is a combination of five integrated HIV prevention strategies that focus on individual, social, and structural issues. Aim 3 will be to conduct a pilot study implementing the intervention and assessing the effect of the intervention on sexual risk behavior among a sample of MSM. To accomplish Aim 3, we will implement Peruanos Diversos Unidos for 9 months, and develop a cohort of 100 MSM that is recruited independently of the intervention. If the intervention proves to be acceptable, feasible, and potentially efficacious, this research group will proceed with an R01 application to assess the efficacy of the intervention in a trial. PUBLIC HEALTH RELEVANCE: In Peru, as well as in the rest of Latin America, sex between men drives the HIV epidemic. Yet very little research has been conducted to develop HIV prevention interventions for Peruvian or other Latin American men who have sex with men. We seek to develop an intervention approach that will be relevant to Peruvian men, but has the potential to be generalized to MSM in other Latin American countries. Therefore, we propose to conduct a three-year study to develop and pilot test a community-level HIV prevention intervention for Peruvian MSM that simultaneously focuses on individual, interpersonal, social, and structural factors affecting men's vulnerability to HIV. Our proposed intervention builds on the theoretical principles of two prevention approaches conducted in the U.S., and the previous work this team has been conducting together in Peru over the past eight years. The new intervention approach we will develop will be based on two HIV prevention interventions that were developed for MSM in the U.S. (the Mpowerment Project and Hermanos de Luna y Sol) that will be substantially adapted so that they are culturally relevant for Peruvian MSM, and we will also develop some new intervention components. Throughout the project we will work closely with a Community Working Group of individuals from the Peruvian Health Ministry, HIV/AIDS organizations, and human rights activists in Peru in order to develop an HIV prevention approach that is culturally relevant and to create an intervention approach that is feasible to be implemented and likely to be sustainable subsequent to the research. We will pilot test the intervention in a community in Peru, and examine if the intervention shows potential efficacy for changing sexual risk behavior, is acceptable by MSM, and if the intervention's methods are feasible. If the intervention proves promising in these regards, we will then write a grant proposal to conduct an experimental trial of it.

描述（由申请人提供）：秘鲁患有浓缩的HIV流行，其中12％与男性发生性关系（MSM）估计是HIV阳性的。这种情况类似于拉丁美洲的其他地方，那里的男人之间的性别驱动了艾滋病毒的流行。然而，很少有研究对秘鲁或其他拉丁美洲MSM开发艾滋病毒预防干预措施。我们试图开发一种与秘鲁男子有关的干预方法，但有可能在其他拉丁美洲国家中推广到MSM。因此，我们建议对秘鲁MSM进行三年的研究，以开发和试点测试社区级的HIV预防干预措施，同时着重于影响男性易受HIV的个人，人际，社会，社会和结构性因素。我们提出的干预措施建立在美国进行的两种预防方法的理论原则上，并且该团队在过去八年中一直在秘鲁一起进行的先前工作。第一个干预措施是社区级别的MP项目（MP），是针对年轻的美国同性恋/双性恋男人开发的，涉及社区动员以及个人和社区赋权。第二种干预措施是为美国拉丁裔男同性恋者/双性恋男子开发的Hermanos de Luna y Sol（HLS），是一种小组干预，重点介绍个人赋权。尽管国会议员和HLS的理论原理与秘鲁MSM有关，但需要开发一种新的文化化干预措施，因为许多国会议员的方法在资源贫乏的环境中很难使用，而HLS专注于有关移民的问题，并使用一些在秘鲁中可能不可用的活动。目的1是适应和文化量身定制两种基于证据的HIV预防干预措施，即国会议员和HLS，并创建新的，额外的干预组件，以响应秘鲁MSM的HIV预防需求。 AIM 1将通过与具有社区专业知识的秘鲁艾滋病毒，同性恋，transvestite和人权活动家的社区工作组开发和维持积极的，合作的合作，他们将为干预的各个部分提供意见，并将帮助开发一些组成部分。 AIM 2是根据AIM 1的成果，开发多层艾滋病毒预防干预措施，佩鲁亚诺斯·多元化群岛（Peruanos Divers）Unidos，涉及小组会议，社区动员和领导力发展。 AIM 2将通过制定干预手册和培训来实现佩鲁阿诺斯·多维斯（Peruanos Diversos Unidos），该手册和培训是五种综合艾滋病毒预防策略的组合，该策略侧重于个人，社会和结构性问题。目标3将是进行一项试点研究，以实施干预并评估MSM样本中干预对性风险行为的影响。为了完成AIM 3，我们将在9个月内实施佩鲁亚诺斯·多诺斯（Peruanos Diversos Unidos），并开发由100个MSM组成的队列，该队列与干预无关招募。如果事实证明干预措施是可以接受的，可行的和可能有效的，则该研究小组将继续进行R01应用，以评估试验中干预的功效。 公共卫生相关性：在秘鲁以及拉丁美洲的其他地区，男性之间的性别驱动了艾滋病毒的流行。然而，很少有研究对与男性发生性关系的秘鲁或其他拉丁美洲男性进行预防艾滋病毒预防干预措施。我们试图开发一种与秘鲁男子有关的干预方法，但有可能在其他拉丁美洲国家中推广到MSM。因此，我们建议对秘鲁MSM进行三年的研究，以开发和试点测试社区级的HIV预防干预措施，同时着重于影响男性易受HIV的个人，人际，社会，社会和结构性因素。我们提出的干预措施建立在美国进行的两种预防方法的理论原则上，并且该团队在过去八年中一直在秘鲁一起进行的先前工作。我们将开发的新干预方法将基于美国MSM开发的两种HIV预防干预措施（MSPower项目和Hermanos de Luna y Sol），这些干预措施将基本上适应，以便它们在文化上与秘鲁MSM相关，我们还将开发一些新的干预组件。在整个项目中，我们将与秘鲁卫生部，艾滋病毒/艾滋病组织和秘鲁的人权活动家的一个社区工作组紧密合作，以开发一种在文化上相关的艾滋病毒预防方法，并创建一种可行的干预方法，可以实施并可能在研究后可持续。我们将试用秘鲁社区中的干预措施，并检查干预措施是否显示出改变性风险行为的潜在功效，MSM可以接受，以及干预方法是否可行。如果在这些方面证明了干预措施有望，我们将撰写一份赠款建议，以进行实验试验。