HIV-Prevention Intervention Targets in High-risk Alcohol Venues in Argentina

阿根廷高风险酒精场所的艾滋病毒预防干预目标

• 批准号: 7620532
• 负责人: Ivan C Balan
• 金额: $ 19.88万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7620532
• 关键词: AIDS prevention; Address; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcoholism; Alcohols; Area; Argentina; Behavior; Behavioral; Beverages; Characteristics; Cities; Clinical; Cognitive; Collaborations; Country; Data; Data Analyses; Depth; Educational workshop; Environment; Focus Groups; Funding; Future; Gatekeeping; Gays; General Population; Goals; Government Programs; HIV; HIV Infections; High Prevalence; Human Activities; Human Resources; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Interview; Knowledge; Lighting; Literature; Locales; Location; Maps; Measures; Modeling; Multiple Partners; Music; Numbers; Pattern; Persons; Phase; Play; Population; Prevalence; Prevention intervention; Prevention program; Prostitution; Public Health; Rate; Recruitment Activity; Relative (related person); Research; Research Personnel; Resources; Respondent; Risk; Risk Behaviors; Risk Reduction; Rosa; Sampling; Sex Behavior; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Site; Socioeconomic Status; South America; Specialist; System; Testing; Time; Treatment Cost; Universities; Work; alcohol availability; base; concept; day; design; high risk sexual behavior; lens; men; men who have sex with men; sex; social; theories; transmission process; willingness

DESCRIPTION (provided by applicant): The HIV prevalence rate in Argentina is 0.6 percent in the general population, with much higher rates in high risk segments of the population. While the cost of treatment for HIV is covered by the government, programs in HIV prevention are limited. Venue based interventions have the potential to reach segments of the population at high risk for HIV infection. Given the associations between alcohol use and sexual risk behavior, venues where alcohol is sold and sexual behavior occurs could be particularly effective settings for HIV prevention efforts. However, although there has been much research on venues, alcohol use, and sexual risk behavior, no studies have sought to understand the interaction between these three factors, an essential step in developing interventions that target HIV risk behavior in these settings. Targeting public venues in Buenos Aires where men meet, alcohol is consumed, and sexual behavior occurs, the goal of this 2-year exploratory study is to understand the various factors that contribute to the creation of a high risk sexual space. To that end, the study seeks to describe the relative contribution of physical characteristics of the place, patron characteristics, type and level of alcohol consumption, and social dynamics that are at play and potentiate each other to result in sexual risk behavior. The specific aims of this study are to 1) describe 6 public venues in terms of their physical characteristics, alcohol availability, patron characteristics, and sexual behavior that occurs in the venue; 2) identify factors that contribute to alcohol use and high-risk sexual behavior in the venues; 3) identify HIV risk reduction possibilities in the venues and how they can be targeted by interventions; 4) assess willingness of venue owners/personnel to partner with HIV prevention organizations in reducing HIV risk in these settings and the types of prevention programs they find acceptable or unacceptable; and 5) assess ways to measure the efficacy of future interventions in these settings. This qualitative study consists of site observations of 6 venues frequented by men where alcohol is consumed and sexual behavior occurs, as well as in-depth interviews with 48 patrons of those venues, 18 owners/personnel from the venues, and 10 HIV prevention and alcoholism specialists. Venue patrons will also undergo a brief quantitative assessment to gather descriptive data on sexual behavior and substance use among this sample. Grounded theory will guide the qualitative data analysis, with the venue patron data undergoing a second level of analysis to develop cross-case causal models of HIV risk behavior in the context of alcohol use in these venues. We expect findings from this study to provide a blueprint for developing a venue-based HIV prevention intervention for these settings, which could be more fully developed and tested in a subsequent study. PUBLIC HEALTH RELEVANCE: Venue-based HIV-prevention interventions target places versus individuals, thereby tapping into high risk sexual networks and disrupting channels of sexual transmission (Weir, Pailman, Mahlalela, Coetzee, Meidany, & Boerma, 2003; Wohlfeiler & Potterat, 2005). Given the limited HIV-prevention programs in Argentina and high rates of HIV infection among high risk populations, intervening in these settings can be particularly useful in reaching large segments of the population, especially those at high risk of infection. Although this study will be conducted through the lens of Argentine culture (which affects norms of alcohol use and sexual behavior), we expect findings to be useful in informing venue-based interventions for these types of venues in other countries.

描述（由申请人提供）：阿根廷普通人群的艾滋病毒感染率为 0.6%，高危人群的感染率要高得多。虽然艾滋病毒的治疗费用由政府承担，但艾滋病毒预防项目却很有限。基于场所的干预措施有可能惠及艾滋病毒感染高危人群。鉴于饮酒与危险性行为之间的关联，出售酒精和发生性行为的场所可能是艾滋病毒预防工作特别有效的场所。然而，尽管对场所、饮酒和性危险行为进行了大量研究，但没有研究试图了解这三个因素之间的相互作用，而这是制定针对这些环境中艾滋病毒危险行为的干预措施的重要一步。这项为期两年的探索性研究以布宜诺斯艾利斯男性聚会、饮酒和性行为发生的公共场所为目标，旨在了解导致高风险性空间形成的各种因素。为此，该研究试图描述该地点的物理特征、顾客特征、饮酒类型和水平以及社会动态的相对贡献，这些因素相互作用并相互促进，导致危险性行为。本研究的具体目的是 1) 描述 6 个公共场所的物理特征、酒精供应情况、顾客特征以及场所内发生的性行为； 2) 确定导致场所内饮酒和高风险性行为的因素； 3) 确定场所内降低艾滋病毒风险的可能性以及如何通过干预措施来瞄准这些风险； 4) 评估场地所有者/人员与艾滋病毒预防组织合作降低这些场所的艾滋病毒风险的意愿，以及他们认为可接受或不可接受的预防计划类型； 5) 评估衡量未来干预措施在这些环境中的有效性的方法。这项定性研究包括对 6 个男性经常光顾的饮酒和性行为场所的现场观察，以及对这些场所的 48 名顾客、18 名场所业主/工作人员以及 10 名艾滋病毒预防和酗酒情况的深入访谈。专家。场所顾客还将接受简短的定量评估，以收集该样本中性行为和药物使用的描述性数据。扎根理论将指导定性数据分析，对场所顾客数据进行第二级分析，以开发这些场所饮酒背景下艾滋病毒风险行为的跨案例因果模型。我们期望这项研究的结果能够为针对这些环境制定基于场所的艾滋病毒预防干预措施提供蓝图，该蓝图可以在后续研究中得到更全面的开发和测试。 公共卫生相关性：基于场所的艾滋病毒预防干预措施针对的是场所而非个人，从而利用高风险性网络并扰乱性传播渠道（Weir、Pailman、Mahlalela、Coetzee、Meidany 和 Boerma，2003 年；Wohlfeiler & Potterat，2005 年） ）。鉴于阿根廷的艾滋病毒预防计划有限，而且高危人群的艾滋病毒感染率很高，对这些环境进行干预对于覆盖大部分人群，特别是感染高危人群特别有用。尽管这项研究将通过阿根廷文化（影响饮酒和性行为规范）的视角进行，但我们希望研究结果有助于为其他国家此类场所的基于场所的干预措施提供信息。