Computer-based HIV Prevention for Seropositive Men

基于计算机的血清阳性男性艾滋病毒预防

• 批准号: 8743298
• 负责人: DOUGLAS W BILLINGS
• 金额: $ 46.74万
• 依托单位: ISA ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-26 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8743298
• 关键词: AIDS prevention; Accounting; Address; Adopted; Advocate; African American; Alcohol or Other Drugs use; Behavior; Behavior Therapy; Benchmarking; Binding; Centers for Disease Control and Prevention (U.S.); Client; Clinic; Communities; Computers; Consultations; Data; Development; Diagnosis; Disclosure; Discrimination; Disease; Effectiveness; Epidemiology; Experimental Designs; Gender; Gender Role; HIV; HIV Infections; Health; Health behavior; Heterosexuals; Homophobia; Hour; Human immunodeficiency virus test; Incidence; Individual; Inequality; Infection; Intervention; Life; Marketing; Participant; Patients; Phase; Physicians; Population; Poverty; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Probability; Program Effectiveness; Questionnaires; Race; Randomized; Reporting; Research; Resources; Risk; Risk Behaviors; Route; Secondary Prevention; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Source; Surveys; Test Result; Testing; Time; Translating; United States; Virus; Woman; base; cost; design; health care quality; high risk sexual behavior; injection drug use; male; medication compliance; meetings; men; men who have sex with men; prevent; programs; prototype; public health relevance; sex; sex risk; sexual encounter; skills; social stigma; socioeconomics; transmission process; usability

DESCRIPTION (provided by applicant): Sexual transmission is the predominant route of HIV infection in the United States, and it is men who are primarily spreading the virus. Male-to-male sexual contact accounts for 72% of all new HIV infections in men while heterosexual contact accounts for 83% of all new HIV infections in women. Extrapolating this incidence data reveals that 75% of all new HIV cases result from high risk sexual activity by men. These new infections are also not evenly distributed throughout the population. African Americans comprise only 14% of the US population, but account for 44% of the new infections. Black men, in particular, are disproportionately burdened, accounting for 70% of new HIV cases among African Americans. In addition, African Americans tend to have sex with people of the same race. As the prevalence of HIV increases within this community, the risk of infection concomitantly increases with each new sexual encounter. Given this epidemiological reality, reducing sexual risk behaviors among African American HIV+ men who have sex with men (MSM), with women (MSW), and with both men and women (MSM/W) is a prevention imperative. To address this, we intend to develop and test Positively tHrIVing, an HIV behavioral intervention based on modules 2 and 3 of the Healthy Living Project (HLP; a "best evidence" CDC intervention), and then tailored it to fit the unique needs of HIV+ African American men (both MSM and MSW). This will include a focus on the distinctive challenges faced by all men independent of race (e.g., the influence of gender roles on sexual risk behaviors), faced by African-Americans living in the United States (e.g., discrimination, socioeconomic issues), and the intersection of these factors with the gender of sexual partners (e.g., managing power inequalities in heterosexual relationships v. facing homophobia and cultural issues). Additionally, Positively tHrIVing will adopt a pro-health point of view so that it will be perceived as supportive and nonstigmatizing. Finally, Positively tHrIVing will be computer-based to further increase acceptability among patients and physicians, reduce staff time, lower costs, increase fidelity of treatment delivery, and enhance the probability of widespread dissemination. The results of Phase I strongly support the feasibility and potential effectiveness of the program - far exceeding the three usability benchmarks established in the Phase I proposal. In Phase II we will complete development of the Positively tHrIVing program and test its effectiveness in a pretest-posttest experimental design. 240 HIV+ African American men will be randomly assigned to receive either the computer-based Positively tHrIVing program or flash-enabled STD CDC fact sheets. Before, and at two points after random assignment, participants' sexual transmission risk behavior, medication adherence, disclosure, health behaviors, and substance use will be assessed through an online survey-questionnaire.

描述（由申请人提供）：在美国，性传播是艾滋病毒感染的主要途径，而男性是病毒的主要传播者。男性与男性之间的性接触占男性新发艾滋病毒感染的 72%，而异性性接触占女性新发艾滋病毒感染的 83%。推断这一发病率数据表明，75% 的新艾滋病毒病例是由男性的高风险性活动引起的。这些新感染病例在人群中的分布也不均匀。非裔美国人仅占美国人口的 14%，但却占新增感染病例的 44%。尤其是黑人男性，他们所承受的负担尤其严重，占非洲裔美国人新增艾滋病毒病例的 70%。此外，非裔美国人倾向于与同一种族的人发生性关系。随着该社区内艾滋病毒流行率的增加，每次新的性接触感染的风险也会随之增加。鉴于这种流行病学现实，减少与男性发生性行为（MSM）、与女性发生性行为（MSW）以及与男性和女性发生性关系（MSM/W）的非裔美国艾滋病毒阳性男性的性危险行为是一项必要的预防工作。为了解决这个问题，我们打算开发和测试 Positively tHrIVing，这是一种基于健康生活项目（HLP；“最佳证据”CDC 干预措施）模块 2 和 3 的 HIV 行为干预措施，然后对其进行定制，以满足不同人群的独特需求。 HIV+ 非洲裔美国男性（MSM 和 MSW）。这将包括关注所有独立于种族的男性所面临的独特挑战（例如，性别角色对性风险行为的影响）、生活在美国的非裔美国人所面临的独特挑战（例如，歧视、社会经济问题），以及这些因素与性伴侣的性别的交叉（例如，管理异性关系中的权力不平等v.面临同性恋恐惧症和文化问题）。此外，Positively thrIVing 将采用以下有利于健康的观点： 观点，以便将其视为支持性且非侮辱性的。最后，Positively thrIVing 将基于计算机，以进一步提高患者和医生的可接受性，减少工作人员时间，降低成本，提高治疗交付的保真度，并提高广泛传播的可能性。第一阶段的结果有力地支持了该计划的可行性和潜在有效性——远远超过第一阶段提案中建立的三个可用性基准。在第二阶段，我们将完成 Positively tHrIVing 计划的开发，并在前测后测实验设计中测试其有效性。 240 名 HIV+ 非洲裔美国男性将被随机分配接受基于计算机的 Positively thrIVing 计划或启用 Flash 的 STD CDC 情况说明书。在随机分配之前和之后的两个时间点，参与者的性传播风险行为、药物依从性、披露、健康行为和物质使用将通过在线调查问卷进行评估。