Technology for HIV Prevention Among Vulnerable Men in India

印度弱势男性艾滋病毒预防技术

• 批准号: 8334488
• 负责人: Matthew James Mimiaga
• 金额: $ 23.19万
• 依托单位: FENWAY COMMUNITY HEALTH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8334488
• 关键词: AIDS prevention; AIDS/HIV problem; Alcohol or Other Drugs use; Behavior; Behavioral; Bilateral; Boston; Car Phone; Caring; Cities; Client; Communication; Communities; Community Health Centers; Comorbidity; Counseling; Cues; Data; Enrollment; Environment; Epidemic; Exploratory/Developmental Grant; Female; Focus Groups; Goals; HIV; HIV Infections; HIV/STD; Harm Reduction; Health; Health Status; Health behavior; High Prevalence; India; Individual; Intervention; Interview; Location; Mediator of activation protein; Medical Research; Modeling; Participant; Pattern; Persons; Phase; Philosophy; Play; Population; Prevalence; Prevention; Preventive Intervention; Problem Solving; Procedures; Professional counselor; Randomized; Randomized Controlled Trials; Readiness; Research; Research Institute; Risk; Risk Reduction; Risk-Taking; Schedule; Sexually Transmitted Diseases; Site; Spouses; Structure; Techniques; Technology; Testing; Text; Trust; Tuberculosis; Unsafe Sex; Work; base; brief intervention; condoms; evidence base; experience; innovation; intervention effect; intravenous drug user; male; male sex worker; men; men who have sex with men; minority health; motivational enhancement therapy; primary outcome; sex; sex risk; sexual minority; standard of care; therapy development; transmission process

DESCRIPTION (provided by applicant): Background. Male sex workers (MSWs) are at particularly elevated risk for HIV infection and represent an important bridge population potentiating the HIV/AIDS epidemic in India. Most (~60%) MSWs in Chennai and Mumbai have a steady male or female partner/spouse (Humsafar, 2007; Mimiaga 2010), thus the risk for HIV-infection/transmission is not only to/from their sex work clients but also to/from their primary partners. Our team's experience with the population suggests that MSWs are networked with each other and with their clients through the use of mobile phones. Overview of project. This proposal is to develop and pilot test a new intervention that will use mobile phone technologies to reduce sexual risk taking in MSWs in Chennai and Mumbai. Following initial formative work, we anticipate that the intervention will incorporate standard of care HIV and STI testing (during in person assessments) with behavioral risk reduction counseling approaches using problem-solving/motivational interviewing, as well as text messaging of motivational reminders and for risk reduction cues delivered by study staff via participant's mobile phones. Phase 1: The first six months will be an intervention development and refinement phase. We will first conduct qualitative interviews (N = ~20 at both the Chennai and Mumbai study sites) and focus groups to inform the content of the intervention. We will then conduct an open pilot of the intervention with up to 10 MSWs (5 per study site) and assess initial feasibility and acceptability. We will then revise the intervention based on these data and work out any remaining methodological or intervention-development details. Phase 2: The next 18 months will be a RCT pilot of the intervention. One hundred (80 completers: 40 per study site) MSWs at risk for transmitting or acquiring HIV will be randomized to either 1) the mobile phone delivered counseling intervention and standard of care HIV/STI counseling and testing or 2) the control condition-standard of care HIV/STI counseling and testing alone. To maximize generalizability and feasibility, we will include both HIV-infected and HIV-uninfected participants. Accordingly, following the U.S.-India Bilateral Collaborative Research Partnerships on the Prevention of HIV/AIDS and Co-morbidities (R21) mechanism, one of the goals of the project will be to determine whether the structure and content of an intervention can be similar across two heavily populated cities in India. Innovation. To our knowledge, despite the rapid increase in mobile phone usage globally, no study has been conducted using counselors to deliver an HIV prevention intervention via mobile phone technologies in India among MSWs. This will be the first study to assess the acceptability and feasibility of using this technology, with a largely underserved, marginalized, and at risk subpopulation who are already networked through mobile phones. Environment. This proposal grew from ongoing work between Fenway Health, a non-profit community health center and research institute specializing in sexual minority health including HIV/AIDS care and research in Boston, the Tuberculosis Research Centre/ICMR in Chennai, and Gaurav/Humsafar Trust, the largest NGO providing care for sexual minorities, as well as MSWs, in Mumbai.

描述（由申请人提供）：背景。男性性工作者（MSW）感染艾滋病毒的风险特别高，是加剧印度艾滋病毒/艾滋病流行的重要桥梁人群。金奈和孟买的大多数（约 60%）MSW 都有稳定的男性或女性伴侣/配偶（Humsafar，2007 年；Mimiaga，2010 年），因此艾滋病毒感染/传播的风险不仅来自于他们的性工作客户，还来自于他们的性工作客户。与他们的主要合作伙伴之间。我们团队与民众打交道的经验表明，城市生活工作者通过使用移动电话相互之间以及与客户之间建立了联系。项目概况。该提案旨在开发并试点测试一种新的干预措施，该干预措施将使用移动电话技术来减少金奈和孟买城市生活工人的性风险。在初步形成工作之后，我们预计干预措施将结合艾滋病毒和性传播感染护理标准（在个人评估期间）与使用问题解决/动机访谈以及动机提醒和风险短信的行为风险降低咨询方法相结合。研究人员通过参与者的手机提供减少线索。第一阶段：前六个月将是干预措施的制定和完善阶段。我们将首先进行定性访谈（钦奈和孟买研究中心的 N = ~20）和焦点小组，以告知干预内容。然后，我们将与最多 10 名 MSW（每个研究地点 5 名）进行干预的公开试点，并评估初步可行性和可接受性。然后，我们将根据这些数据修改干预措施，并制定任何剩余的方法或干预措施开发细节。第 2 阶段：接下来的 18 个月将是干预措施的 RCT 试点。一百名（80 名完成者：每个研究中心 40 名）有传播或感染 HIV 风险的 MSW 将被随机分配到 1）手机提供的咨询干预和护理标准 HIV/STI 咨询和检测或 2）控制条件标准仅提供艾滋病毒/性传播感染咨询和检测服务。为了最大限度地提高普遍性和可行性，我们将包括感染艾滋病毒和未感染艾滋病毒的参与者。因此，根据美印预防艾滋病毒/艾滋病及合并症双边合作研究伙伴关系（R21）机制，该项目的目标之一将是确定干预措施的结构和内容是否可以在不同国家之间保持相似。印度的两个人口稠密的城市。创新。据我们所知，尽管全球移动电话使用量迅速增加，但在印度，尚未开展过利用咨询员通过移动电话技术向城市生活工作者提供艾滋病毒预防干预的研究。这将是第一项评估使用该技术的可接受性和可行性的研究，该技术主要针对已经通过手机联网的服务不足、边缘化和面临风险的亚人群。环境。该提案源于 Fenway Health 和 Gaurav/Humsafar Trust 之间正在进行的工作，Fenway Health 是一家非营利性社区健康中心和专门研究性少数群体健康（包括波士顿的艾滋病毒/艾滋病护理和研究）的研究机构、钦奈的结核病研究中心/ICMR 和 Gaurav/Humsafar Trust，孟买最大的为性少数群体和社会工作者提供护理的非政府组织。

项目成果

A Pilot Randomized Controlled Trial of an Integrated In-person and Mobile Phone Delivered Counseling and Text Messaging Intervention to Reduce HIV Transmission Risk among Male Sex Workers in Chennai, India.

• DOI: 10.1007/s10461-017-1884-5
• 发表时间: 2017-11
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Mimiaga MJ;Thomas B;Biello K;Johnson BE;Swaminathan S;Navakodi P;Balaguru S;Dhanalakshmi A;Closson EF;Menon S;O'Cleirigh C;Mayer KH;Safren SA
• 通讯作者: Safren SA

Development and Open Pilot Trial of an HIV-Prevention Intervention Integrating Mobile-Phone Technology for Male Sex Workers in Chennai, India.

• DOI: 10.1007/s10508-015-0665-3
• 发表时间: 2017-05
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Thomas B;Closson EF;Biello K;Menon S;Navakodi P;Dhanalakshmi A;Mayer KH;Safren SA;Mimiaga MJ
• 通讯作者: Mimiaga MJ

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India.

• DOI: 10.1080/09540121.2016.1204421
• 发表时间: 2017-03
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: Biello KB;Thomas BE;Johnson BE;Closson EF;Navakodi P;Dhanalakshmi A;Menon S;Mayer KH;Safren SA;Mimiaga MJ
• 通讯作者: Mimiaga MJ