Safer sex intervention for male clients of female sex workers in Tijuana, Mexico

对墨西哥蒂华纳女性性工作者的男性客户进行安全性行为干预

• 批准号: 8634323
• 负责人: Thomas L. Patterson
• 金额: $ 9.61万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-03-01 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8634323
• 关键词: AIDS prevention; Address; Age; Alcohol consumption; Alcohol or Other Drugs use; Anal Sex; Attitude; Behavior; Behavior Therapy; Behavioral; Belief; Biological Markers; Border Crossings; California; Characteristics; Chlamydia; Cities; Client; Cognitive; Cognitive Therapy; Counseling; Country; County; Data; Drug usage; Effectiveness; Enrollment; Epidemic; Equation; Esthesia; Expectancy; Female; Funding; General Population; Goals; Gonorrhea; HIV; HIV Infections; HIV risk; Hour; Human immunodeficiency virus test; Incidence; Infection; International; Intervention; Intervention Studies; Interview; Knowledge; Life; Manuals; Measures; Men' s Role; Methamphetamine; Mexican; Mexico; Modeling; NIH Office of AIDS Research; Outcome; Outcome Measure; Participant; Policy Making; Population; Pre-Post Tests; Prevalence; Prevention; Prevention Research; Prevention strategy; Preventive Intervention; Problem Solving; Psychosocial Factor; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Resources; Risk; Risk Reduction; Self Efficacy; Services; Sexuality; Sexually Transmitted Diseases; Sister; Site; Social Network; Socioeconomic Status; Subgroup; Surveys; Syphilis; Testing; Time; Translating; Treatment Efficacy; Unsafe Sex; Vagina; Work; base; behavior change; behavioral/social science; brief intervention; condoms; contextual factors; cooking; cost effectiveness; depressive symptoms; drug abuse education; effective intervention; efficacy testing; follow-up; high risk; high risk sexual behavior; male; men; motivational enhancement therapy; primary outcome; programs; public health relevance; safer sex; sex; sexual encounter; social; social cognitive theory; theories; therapy design; transmission process

DESCRIPTION (provided by applicant): Interventions designed to reduce STI/HIV risk have mostly failed to consider clients of FSWs, who may act as a 'bridge' to the general population. Our recent survey of U.S and Mexican clients seeking FSWs in Tijuana revealed a startling HIV prevalence rate of 4.1%. Based on qualitative and quantitative interviews with clients from Tijuana Mexico and the U.S. we developed a theory-based intervention (Hombre Seguro) that uses Motivational Interviewing, active participation, and problem solving to increase clients' use of condoms with FSWs. We now propose an RCT to test the efficacy of this one- hour intervention in Tijuana which will enroll 400 HIV-negative men (200 residents of San Diego County; 200 Tijuana residents) who report having unprotected sex with FSWs in the past 4 months. Our theory-based participatory intervention will be evaluated in comparison with a time and information equivalent didactic control condition. Participants will be recruited in Tijuana where they will undergo a baseline CAPI-administered interview, STI testing (HIV, syphilis, gonorrhea, Chlamydia), and intervention counseling with follow-up interviews at 4, 8, and 12 months post-baseline conducted in either Tijuana or San Diego. Our study aims are to: 1) evaluate the efficacy of Hombre Seguro to increase condom use of clients with FSWs; 2) determine if the intervention is as efficacious among U.S. versus Mexican clients; 3) determine the extent to which theoretically-based components of our intervention (e.g., self-efficacy) represent underlying mechanisms of change in primary outcomes (e.g., lower HIV/STI incidence); and 4) explore subgroup differences in efficacy of the intervention based on background characteristics (e.g., age), contextual factors (e.g., substance use before/during sex), psychosexual factors (e.g., social-sexual effectiveness), and psychosocial factors (e.g., social network influence). Our primary analytic approach will utilize a generalized linear mixed models (GLMM) approach to repeated measures analysis. This bi-national study will contribute significantly to HIV prevention research by addressing the role of male clients in the escalating HIV epidemics in Tijuana and San Diego, and could have application to other settings where HIV prevalence is high among FSWs and their clients.

描述（由申请人提供）：旨在减少STI/HIV风险的干预措施大多未能考虑FSW的客户，他们可能充当一般人群的“桥梁”。我们最近对蒂华纳（Tijuana）寻求FSW的美国和墨西哥客户的调查显示，令人震惊的HIV患病率为4.1％。基于对墨西哥蒂华纳和美国客户的定性和定量访谈，我们开发了一种基于理论的干预措施（Hombre Seguro），该干预措施使用动机访谈，积极参与和解决问题的方法来增加客户使用FSW的避孕套。现在，我们提出了一项RCT来测试这一单小时干预蒂华纳的功效，该干预措施将招募400名HIV阴性男性（圣地亚哥县的200名居民； 200位蒂华纳居民），他们报告了过去4个月在过去4个月中与FSW的性行为未经保护的性行为。我们将基于理论的参与式干预与时间和信息等效的教学控制条件进行评估。参与者将在蒂华纳招募，在那里他们将接受一项基线Capi Adminester访谈，STI测试（HIV，梅毒，淋病，淋病，衣原体），并在蒂华纳或圣地亚哥进行了4、8和12个月的后续访谈。我们的研究目的是：1）评估Hombre Seguro的功效，以增加对FSW客户使用的避孕套的使用； 2）确定在美国与墨西哥客户中的干预措施是否有效； 3）确定我们干预理论上基于理论上的组成部分（例如，自我效能感）代表主要结果变化的潜在机制（例如，HIV/STI较低的发病率）；和4）探索基于背景特征（例如年龄），上下文因素（例如，性别之前/期间的物质使用），心理因素（例如社会性性能效率）和心理社会因素（例如社交网络影响），探索干预效率的亚组差异。我们的主要分析方法将利用广义线性混合模型（GLMM）方法进行重复测量分析。这项双国研究将通过解决蒂华纳和圣​​地亚哥艾滋病毒流行病的作用，从而为艾滋病毒预防研究做出重大贡献，并可以应用于FSW及其客户中HIV较高的其他环境。

项目成果

Place of Residence Moderates the Relationship Between Emotional Closeness and Syringe Sharing Among Injection Drug Using Clients of Sex Workers in the US-Mexico Border Region.

居住地调节了美墨边境地区性工作者注射毒品客户的情感亲密程度和注射器共享之间的关系。

• DOI: 10.1007/s10461-015-1001-6
• 发表时间: 2015
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Wagner,KarlaD;Pitpitan,EileenV;Valente,ThomasW;Strathdee,SteffanieA;Rusch,Melanie;Magis-Rodriguez,Carlos;Chavarin,ClaudiaV;Patterson,ThomasL
• 通讯作者: Patterson,ThomasL

Behavioral and psychosocial correlates of anal sex among male clients of female sex workers in Tijuana, Mexico.

墨西哥蒂华纳女性性工作者的男性客户与肛交的行为和社会心理相关性。

• DOI: 10.1007/s10508-015-0514-4
• 发表时间: 2015
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Semple,ShirleyJ;Strathdee,SteffanieA;Pitpitan,EileenV;Chavarin,Claudia;Patterson,ThomasL
• 通讯作者: Patterson,ThomasL