Family influences on HIV-related sexual risk of young men who have sex with men

家庭对男男性接触者的艾滋病毒相关性风险的影响

• 批准号: 8711560
• 负责人: Brian Thoma
• 金额: $ 4.07万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-16 至 2015-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8711560
• 关键词: AIDS prevention; Adolescent; Affect; Age; Area; Bisexual; Categories; Child; Clinical; Communication; Data; Environment; Epidemic; Faculty; Family; Frequencies; Future; Gays; Goals; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Heterosexuals; Incidence; Individual; Interdisciplinary Study; Intervention; Interview; Knowledge; Light; Longitudinal Studies; Mentors; Modeling; Monitor; Parents; Population; Prevalence; Prevention; Preventive Intervention; Qualitative Methods; Relative (related person); Research; Research Training; Resources; Risk; Risk Behaviors; Risk Reduction; Sampling; Science; Sex Behavior; Sex Orientation; Sexual Partners; Statistical Methods; Supervision; Surveys; Teenagers; Testing; Training; Work; Writing; condoms; cost; effective intervention; experience; family influence; health care service utilization; improved; male; member; men who have sex with men; parent-child communication; parental influence; parental monitoring; peer; sex; sex risk; sexual debut; transmission process; young man

DESCRIPTION (provided by applicant): Young men who have sex with men (YMSM) are severely affected by the current HIV epidemic. While incidence via all other HIV transmission categories has recently remained stable or decreased, male-to-male sexual contact resulting in HIV infection continues to increase, particularly among young men. HIV prevalence is alarmingly high within the YMSM population (previously estimated at 7% for YMSM ages 15 - 22), but no effective interventions to reduce risk behaviors have been developed for MSM under 23. Parents of YMSM have been identified as an underutilized resource for future risk-reduction interventions within this population, but we know virtually nothing about parental influences on sexual behavior among YMSM. Studies of general adolescent samples reveal that parents have a significant influence on the sexual behaviors of their adolescents. Parental monitoring, parent disapproval of teen sex, family connectedness, and parent-child communication are associated with adolescents' sexual behaviors, including condom use, sex frequency, number of sex partners, and sexual debut. Whether these findings generalize to HIV-related sexual risk behaviors of YMSM is unclear. Limited previous evidence suggests that family connectedness may be protective against sexual risk behaviors among YMSM, but the influences of monitoring, disapproval, or communication have not been examined among YMSM. Moreover, the unique parent-adolescent dynamics that occur when a child is gay, including coming out and parent rejection of sexual orientation, could alter the ways in which previously established family factors influence risk among YMSM. Given the importance of family factors in determining HIV-related sexual risk behaviors, the aims of the current study are threefold: 1) to use data from a large national study to determine which well-established family predictors of adolescent sexual risk also predict risk among YMSM and gay or bisexual young men; 2) to identify through qualitative methods the unique family factors that could predict risk within a family environment where a child is gay or bisexual and 3) to test new family-focused models of YMSM sexual risk behaviors that combine both previously established and newly identified family-relevant predictors. The results of the proposed study could significantly improve future HIV prevention interventions targeting YMSM by advancing knowledge of how to most effectively incorporate parents into prevention efforts. These goals aim to be accomplished within the context of a research training plan focused on developing expertise in the areas of HIV prevention science, advanced mixed-method statistical approaches, and family factors and adolescent health. The training plan proposed includes completion of a number of specific courses, close supervision and individualized mentoring, multidisciplinary collaborations with faculty members, scientific writing and presentation experience, and hands-on clinical work with families and HIV positive individuals.

描述（由申请人提供）：与男性发生性关系的年轻人受到当前的艾滋病毒流行的严重影响。尽管通过所有其他HIV传播类别的发病率最近一直保持稳定或减少，但男性到男性的性接触导致HIV感染持续增加，尤其是在年轻男性中。在YMSM人群中，HIV患病率令人震惊（先前估计为15-22岁的YMSM为7％），但没有为23岁以下的MSM制定有效的干预措施以减少风险行为。 YMSM的父母已被确定为该人群中未来降低风险干预措施的未充分利用的资源，但我们几乎对父母对YMSM性行为的影响一无所知。一般青少年样本的研究表明，父母对青少年的性行为有重大影响。父母的监测，对青少年性别的父母不赞成，家庭联系和亲子沟通与青少年的性行为有关，包括使用避孕套，性频率，性伴侣的数量和性伴侣的性行为。这些发现是否概括为YMSM与HIV相关的性风险行为尚不清楚。以前的有限证据表明，家庭联系可能可以保护YMSM之间的性风险行为，但是在YMSM中尚未检查监测，不赞成或交流的影响。此外，当孩子是同性恋（包括出来和父母拒绝性取向）时发生的独特父母 - 成年动态可能会改变以前建立的家庭因素影响YMSM风险的方式。 鉴于家庭因素在确定与HIV相关的性风险行为方面的重要性，本研究的目的是三重：1）使用大型国家研究中的数据来确定哪些成熟的青少年性风险家庭预测指标也可以预测风险YMSM和同性恋或双性恋年轻人； 2）通过定性方法识别可以预测儿童是同性恋或双性恋的家庭环境中风险的独特家庭因素和3）测试新的以家庭为中心的YMMSM性风险行为模型，这些模型结合了以前建立和新确定的家庭 - 预测指标。拟议研究的结果可以通过推进如何最有效地将父母纳入预防工作的知识来显着改善针对YMSM的未来HIV预防干预措施。 这些目标的目的是在研究培训计划的背景下完成，重点是在艾滋病毒预防科学，高级混合方法统计方法以及家庭因素和青少年健康方面发展专业知识。拟议的培训计划包括完成许多特定课程，密切监督和个性化指导，与教师的多学科合作，科学写作和演示经验以及与家人和艾滋病毒积极个人的动手临床工作。