Developing an HIV Prevention Intervention for HIV-Positive Men in China

为中国艾滋病毒阳性男性制定艾滋病毒预防干预措施

• 批准号: 8250379
• 负责人: KYUNG HEE CHOI
• 金额: $ 18.25万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8250379
• 关键词: AIDS prevention; Acceleration; Accounting; Address; Advocate; Applications Grants; Area; Behavior Therapy; China; Chinese People; Clinical Trials; Communities; Data; Elements; Epidemic; Equilibrium; Evaluation; Funding; HIV; HIV Infections; HIV Seropositivity; Health Professional; Incidence; Individual; Intervention; Interview; Life; Medical; Modeling; Outcome; Phase; Prevalence; Prevention Research; Prevention program; Preventive Intervention; Process; Provider; Public Health; Review Literature; Risk; Risk Behaviors; Risk Reduction; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Surveys; Syphilis; Testing; Work; contextual factors; driving force; evidence base; experience; informant; innovation; men; men who have sex with men; prevent; psychosocial; public health relevance; sex; sex risk; transmission process; working group

DESCRIPTION (provided by applicant): In China, sexual transmission has become the major driving force behind the HIV epidemic, accounting for more than half (52%) of the estimated 700,000 people currently living with HIV. Men who have sex with men (MSM) may contribute to the rapid acceleration of the epidemic throughout China. Studies with Chinese MSM have documented an increasing HIV prevalence, a high HIV incidence, and high rates of unprotected intercourse and sexually transmitted infections (e.g., syphilis) known to facilitate sexual transmission of HIV. Moreover, our work found that HIV-transmission risk behavior is highly prevalent among HIV-positive MSM in China. Nonetheless, no HIV prevention interventions have targeted HIV-positive Chinese MSM. Several interventions have demonstrated efficacy in reducing sexual risk behaviors among HIV- positive MSM in the U.S. Adapting such interventions for HIV-positive MSM in China would help accelerate the process of developing an efficacious intervention for this risk group. The proposed three-year study (R34) will adapt and pilot-test currently available evidence-based behavioral interventions to reduce HIV-transmission risk behavior among HIV-positive MSM in Chongqing, China. This study will be implemented in five phases, guided by Wainberg et al.'s intervention adaptation model. In Step 1, we will identify core components of efficacious interventions (e.g., key theoretical constructs, intervention messages, delivery modes) through the review of the literature. In Step 2, we will explore cultural, psychosocial, and contextual factors associated with sexual risk behaviors and generate ideas for intervention strategies for HIV-positive MSM by conducting 15 key informant interviews with individuals knowledgeable about HIV-positive MSM and 30 in-depth interviews with HIV-positive MSM. In Step 3, we will adapt efficacious interventions through reviewing the core elements of efficacious interventions identified in Step 1 and collating those elements with qualitative data collected in Step 2 with an intervention adaptation working group of 10 health professionals and MSM lay workers who serve HIV-positive MSM. In Step 4, we will pilot-test the adapted intervention with 16 HIV- positive MSM and refine the intervention if necessary. In Step 5, we will test the feasibility of implementing and assessing the intervention refined in Step 4 by conducting the intervention with 50 HIV-positive MSM and having these 50 men complete baseline and 3-month surveys. The proposed intervention is innovative because we are not aware of any efficacious interventions targeting HIV-positive MSM in China. This study will also expand the field of HIV prevention research by developing a risk reduction intervention critically needed because of the rapidly increasing numbers of HIV-positive MSM throughout China. PUBLIC HEALTH RELEVANCE: The proposed study addresses a critical public health issue facing MSM communities throughout China. The study has the potential to create a prevention program that could prevent sexual HIV transmission from HIV- positive MSM to their sexual partners and that, in turn, could facilitate curbing the rapidly rising number of HIV infection among Chinese MSM and their sexual partners.

描述（申请人提供）：在中国，性传播已成为艾滋病毒流行的主要驱动力，目前估计有 70 万艾滋病毒感染者，其中性传播者占一半以上（52%）。男男性行为者（MSM）可能会导致中国各地疫情的迅速加速。对中国男男性行为者的研究表明，艾滋病毒感染率不断上升，艾滋病毒发病率很高，无保护性交和性传播感染（例如梅毒）的发生率也很高，而已知这些感染会促进艾滋病毒的性传播。此外，我们的研究发现，中国艾滋病毒阳性男男性行为者中艾滋病毒传播风险行为非常普遍。尽管如此，还没有针对艾滋病毒阳性的中国男男性行为者的艾滋病毒预防干预措施。一些干预措施已被证明可以有效减少美国 HIV 阳性 MSM 的性危险行为。在中国针对 HIV 阳性 MSM 采用此类干预措施将有助于加快为该风险群体制定有效干预措施的进程。拟议的为期三年的研究（R34）将调整和试点测试目前可用的循证行为干预措施，以减少中国重庆艾滋病毒阳性男男性行为者的艾滋病毒传播风险行为。这项研究将在 Wainberg 等人的干预适应模型的指导下分五个阶段实施。在第一步中，我们将通过文献回顾来确定有效干预措施的核心组成部分（例如关键理论构建、干预信息、实施模式）。在第 2 步中，我们将通过对了解 HIV 阳性 MSM 的人士进行 15 次关键信息访谈和 30 次深度访谈，探讨与性危险行为相关的文化、社会心理和背景因素，并为 HIV 阳性 MSM 的干预策略提出想法。患有 HIV 阳性 MSM。在第 3 步中，我们将通过审查第 1 步中确定的有效干预措施的核心要素，并将这些要素与第 2 步中收集的定性数据进行整理，从而调整有效的干预措施，并由 10 名卫生专业人员和服务于 HIV 的 MSM 外行工作人员组成的干预调整工作组积极的男男性行为者。在第 4 步中，我们将针对 16 名 HIV 阳性 MSM 试点调整后的干预措施，并在必要时完善干预措施。在第 5 步中，我们将测试实施和评估第 4 步中细化的干预措施的可行性，方法是对 50 名 HIV 阳性 MSM 进行干预，并让这 50 名男性完成基线调查和 3 个月的调查。拟议的干预措施具有创新性，因为我们不知道中国有任何针对艾滋病毒阳性男男性行为者的有效干预措施。由于中国艾滋病毒阳性男男性接触者数量迅速增加，这项研究还将通过开发急需的降低风险干预措施来扩大艾滋病毒预防研究领域。 公共卫生相关性：拟议的研究解决了中国各地 MSM 社区面临的一个关键公共卫生问题。这项研究有可能制定一项预防计划，防止艾滋病毒阳性男男性行为者将艾滋病毒传播给其性伴侣，进而有助于遏制中国男男性行为者及其性伴侣中艾滋病毒感染人数的迅速上升。