CBPR for Sexual Health & Reduction of HIV Health Disparities Among MSM in PR

性健康 CBPR

基本信息

批准号：
8500777
负责人：
Michael C. Clatts
金额：
$ 36.34万
依托单位：
UNIVERSITY OF PUERTO RICO MED SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-13 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8500777
关键词：
Accounting Address Attention Awareness Behavioral Caribbean region Caring Centers for Disease Control and Prevention (U.S.)Clinic Clinical Collaborations Communities Consensus Counseling Coupled Disclosure Disease Early Diagnosis Early treatment Effectiveness Enrollment Environment Epidemic Epidemiologic Studies Face Feedback Fostering Foundations Frequencies Funding Gays Generic Drugs Goals Grant HIV HIV Infections HIV/STD Health Health Promotion Health Services Homosexuality Human immunodeficiency virus test Incidence Infection Injection of therapeutic agent Instruction Intervention Knowledge Latin America Light Mental Depression Methodology Minority Groups Monitor Monoclonal Antibody R24 Newly Diagnosed Outcome Pattern Positioning Attribute Pre-Post Tests Premature Mortality Prevalence Prevention Prevention Research Process Process Assessment Prophylactic treatment Provider Public Health Puerto Rico Recommendation Recruitment Activity Research Risk Risk Reduction Role Series Services Sexual Health Societies Sorting - Cell Movement Source Staging Substance abuse problem Suicide Technology Testing Ursidae Family Virus Vulnerable Populations base community planning comparative effectiveness evidence base health disparity improved intervention program meetings men who have sex with men mortality programs response screening secondary infection skills social stigma therapy development transmission process treatment center uptake

项目摘要

DESCRIPTION (provided by applicant): While the overall rate of new HIV infections In the U.S. has remained relatively steady since 2006, rates among men who have sex with men (MSM) have significantly increased, particularly in ethnic/racial minority MSM. Similar patterns are seen among MSM in Puerto Rico where high levels of social stigma and bias contribute to poor use of HIV screening and late engagement in HIV care, resulting in high rates of premature mortality and high levels of circulating virus-thereby fueling secondary infections and thus sustaining the epidemic. In response to the longstanding absence of evidence-based HIV interventions for MSM in PR, and using a CBPR approach, we will adapt existing Sexual Health Promotion intervention technology for use among MSM who are HIV-/status unknown/or who are HIV+ but not enrolled in HIV care monitoring/treatment. In Year 1, we will conduct an ethnographically-oriented Community Assessment Process to develop a detailed understanding of sources of alienation and delay in care among MSM and to elicit direct feedback from MSM about their services needs and priorities. A parallel elicitation will be undertaken among service providers. This elicitation process will support identification of key stakeholders from both groups who will serve on the Community Advisory Board which will guide adaptation and implementation of the intervention. In Years 2 and 3, and building on an existing "Core" study within a local community STI/HIV services clinic (CLETS), we will recruit 240 MSM to participate in a preliminary assessment of the impact of the intervention. Using a "Comparative Effectiveness" approach, we will compare conventional, 2-session pre and post-test counseling with the adapted 2-session Sexual Health Promotion intervention on key outcomes, including sexual risk reduction, frequency of UAI, understanding the role of untreated STIs in facilitating HIV transmission, awareness of the role of early initiation of ARV care in effective management of HIV disease, health-seeking skills (including improved stigma management skills), routinization of non-symptom-driven HIV screening at 6 month intervals, and rapid uptake in HIV monitoring/ARV treatment services among newly-diagnosed HIV+ MSM.

描述（由申请人提供）：虽然自2006年以来，美国新艾滋病毒感染的总体率一直保持稳定，但与男性发生性关系的男性（MSM）的发生率显着增加，尤其是在种族/种族少数民族中。在波多黎各的MSM中也看到了类似的模式，高水平的社会污名和偏见导致对HIV筛查和较晚参与艾滋病毒护理的使用不良，导致高死亡率高和高水平的循环病毒 - 替代次生感染，从而维持该流行病。为了回应长期缺乏PR中MSM的循证HIV干预措施，并使用CBPR方法，我们将适应现有的性健康促进干预技术，以在HIV-/状态未知/或不接受HIV护理监测/治疗的MSM中使用。在第1年，我们将进行以人种学为导向的社区评估过程，以详细了解MSM之间的疏远和延迟护理的来源，并从MSM发出有关其服务需求和优先事项的直接反馈。服务提供商将进行并行启发。这种启发过程将支持将在社区顾问委员会任职的两个小组的主要利益相关者的识别，这些委员会将指导和实施干预措施。在第2和3年度，并在当地社区性传播疾病/艾滋病毒服务诊所（CLETS）中进行现有的“核心”研究，我们将招募240 MSM，以参与对干预影响的初步评估。使用“比较有效性”方法，我们将比较传统的2次结论前和测试后的咨询与适应的2份性健康促进促进干预措施对关键结果，包括降低性风险，UAI的频率，了解未经治疗的性传播感染的作用以6个月的间隔进行非检查者驱动的HIV筛查，并在新诊断的HIV+ MSM中快速吸收HIV监测/ARV治疗服务。