Multilevel HIV Prevention Intervention for Young African American Men

针对年轻非洲裔美国男性的多层次艾滋病毒预防干预

• 批准号: 8700538
• 负责人: Susan M. KEGELES
• 金额: $ 60.42万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700538
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adopted; Affect; African American; Age; Anal Sex; Anus; Behavior; Behavioral; Beryllium; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Contracts; Cross-Sectional Studies; Data; Development; Diffuse; Diffusion; Diffusion of Innovation; Elements; Epidemic; Ethnography; Frequencies; Funding; Goals; Grant; HIV; HIV Seropositivity; HIV risk; HIV/STD; Health; Human immunodeficiency virus test; Incidence; Indium; Individual; Intervention; Interview; Latino; Mediating; Mental Health; Methods; Personal Satisfaction; Prevalence; Prevention approach; Preventive Intervention; Process; Psychosocial Factor; Public Health; Race; Randomized; Research; Research Personnel; Research Project Grants; Resources; Risk Behaviors; Risk Reduction; Sampling; Services; Social Environment; Social Network; Surveys; Testing; Texas; Time; Translating; Unsafe Sex; Work; aged; base; behavior test; cohort; cost; cost effective; efficacy testing; empowered; evidence base; help-seeking behavior; improved; innovation; men; men who have sex with men; programs; psychosocial; safer sex; sex risk; social; social norm; socioeconomics; theories; urban area

DESCRIPTION (provided by applicant): HIV prevalence and incidence rates have reached catastrophic levels among young black men who have sex with men (YBMSM), ages 18-29. The goal of this project is to determine the efficacy of a multilevel, theory- based intervention, calld United Black Element (UBE), in reducing YBMSM's sexual risk behavior and increasing the frequency of HIV testing. Although based on the Mpowerment Project, a cost-effective HIV prevention intervention that has been shown to be efficacious in reducing the rate of unprotected sex among young MSM, UBE has been extensively adapted to the socioeconomic, cultural, and social context of YBMSM's lives. Through the development of an empowered, mobilized YBMSM community, UBE creates positive social norms around HIV prevention that are diffused throughout diverse social networks. We began work to launch and begin testing the efficacy of UBE in Dallas and Houston, TX with CDC funding; Dallas was randomized to the intervention condition. Large cities were chosen since that is where the majority of YBMSM reside, and testing a community mobilization approach in such a setting is critical in considering how to translate it to practice. It took longer than anticipated to fully implement UBE because of community capacity issues, but UBE is now fully implemented and is reaching into diverse social networks of Dallas YBMSM. The CDC funding that supported the intervention and baseline assessments has ended, and the Texas State Health Department is now funding UBE at a local organization with which we are collaborating. In the proposed mixed methods project, we have an extraordinary opportunity to study the impact of this intervention without having to start up or cover the costs of the intervention. Thus, the aims of this mixed methods project are to: 1) Analyze public health data and conduct 3 additional annual cross-sectional surveys of YBMSM in Dallas and Houston using venue-based sampling to determine the efficacy of UBE in: (a) reducing unprotected anal sex; (b) increasing recent HIV testing; (c) modifying psychosocial mediating variables that may be causally related to HIV risk reduction; and (d) changing psychosocial factors related to positive mental health and well-being; 2) Determine how community changes occur during implementation of UBE by examining when changes in the psychosocial mediating variables, sexual risk behavior and HIV testing take place and if changes in sexual risk behavior and testing continue to improve, remain the same, or decrease over time; 3) Explore how UBE penetrates diverse YBMSM subcommunities in Dallas, and how this multilevel intervention impacts individual, interpersonal, and social level factors related t risk behavior and testing. Using ethnography, we will follow a longitudinal cohort while the intervention is being fully implemented. 4) Examine the potential integration of biomedical HIV prevention methods into UBE through administering and analyzing quantitative data from the survey and qualitative data from the interviews.

描述（由申请人提供）：与男性发生性关系的年轻黑人（YBMSM），年龄在18-29岁之间的艾滋病毒患病率和发病率已经达到灾难性水平。该项目的目的是确定基于理论的干预措施Calld United Black Element（UBE）在减少YBMSM的性风险行为并增加HIV测试频率方面的功效。尽管基于MAPEPORMENT项目，但已证明具有成本效益的HIV预防干预措施可以有效地降低年轻MSM的无保护性别率，但UBE已广泛适应了YBMMSM生活的社会经济，文化和社会背景。通过开发有能力的，动员的YBMSM社区，UBE围绕艾滋病毒预防创造积极的社会规范，这些规范在各种社交网络中被扩散。我们开始启动并开始通过CDC资金来测试UBE在达拉斯和休斯敦的功效。达拉斯被随机分配到干预条件。选择了大型城市，因为这是大多数YBMSM居住的地方，并且在这种环境中测试社区动员方法对于考虑如何将其翻译成练习至关重要。由于社区能力问题，它花费的时间比预期的要长得多，但是UBE现在已经完全实施，并且正在进入达拉斯YBMSM的各种社交网络。支持干预措施和基线评估的CDC资金已经结束，德克萨斯州卫生部门现在正在为我们合作的当地组织提供资金。在拟议的混合方法项目中，我们有一个非凡的机会来研究这种干预措施的影响，而无需启动或支付干预成本。因此，该混合方法项目的目的是：1）分析公共卫生数据并使用基于场地的采样来确定UBE在：（a）降低未受保护的肛交中的YBMSM年度YBMSM年度YBMSM年度横断面调查； （b）增加最近的HIV检测； （c）修改可能与艾滋病毒风险降低有关的社会心理介导变量； （d）改变与积极心理健康和福祉有关的社会心理因素； 2）通过检查何时会发生社会社会介导变量的变化，性风险行为和艾滋病毒测试以及性风险行为和测试的变化继续改善，保持相同或随着时间的流逝而减少，确定社区变化如何发生在UBE期间发生变化； 3）探索UBE如何渗透到达拉斯的YBMSM子社区，以及这种多层次干预如何影响个人，人际关系和社会水平因素与T风险行为和测试相关的个人，人际关系和社会水平。 使用民族志，我们将在完全实施干预时遵循纵向队列。 4）通过管理和分析调查中的定量数据以及访谈中的定性数据，研究生物医学HIV预防方法的潜在整合到UBE中。