CBPR for Sexual Health & Reduction of HIV Health Disparities Among MSM in PR

性健康 CBPR

基本信息

批准号：
8500777
负责人：
Michael C. Clatts
金额：
$ 36.34万
依托单位：
UNIVERSITY OF PUERTO RICO MED SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-13 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8500777
关键词：
Accounting Address Attention Awareness Behavioral Caribbean region Caring Centers for Disease Control and Prevention (U.S.)Clinic Clinical Collaborations Communities Consensus Counseling Coupled Disclosure Disease Early Diagnosis Early treatment Effectiveness Enrollment Environment Epidemic Epidemiologic Studies Face Feedback Fostering Foundations Frequencies Funding Gays Generic Drugs Goals Grant HIV HIV Infections HIV/STD Health Health Promotion Health Services Homosexuality Human immunodeficiency virus test Incidence Infection Injection of therapeutic agent Instruction Intervention Knowledge Latin America Light Mental Depression Methodology Minority Groups Monitor Monoclonal Antibody R24 Newly Diagnosed Outcome Pattern Positioning Attribute Pre-Post Tests Premature Mortality Prevalence Prevention Prevention Research Process Process Assessment Prophylactic treatment Provider Public Health Puerto Rico Recommendation Recruitment Activity Research Risk Risk Reduction Role Series Services Sexual Health Societies Sorting - Cell Movement Source Staging Substance abuse problem Suicide Technology Testing Ursidae Family Virus Vulnerable Populations base community planning comparative effectiveness evidence base health disparity improved intervention program meetings men who have sex with men mortality programs response screening secondary infection skills social stigma therapy development transmission process treatment center uptake

项目摘要

DESCRIPTION (provided by applicant): While the overall rate of new HIV infections In the U.S. has remained relatively steady since 2006, rates among men who have sex with men (MSM) have significantly increased, particularly in ethnic/racial minority MSM. Similar patterns are seen among MSM in Puerto Rico where high levels of social stigma and bias contribute to poor use of HIV screening and late engagement in HIV care, resulting in high rates of premature mortality and high levels of circulating virus-thereby fueling secondary infections and thus sustaining the epidemic. In response to the longstanding absence of evidence-based HIV interventions for MSM in PR, and using a CBPR approach, we will adapt existing Sexual Health Promotion intervention technology for use among MSM who are HIV-/status unknown/or who are HIV+ but not enrolled in HIV care monitoring/treatment. In Year 1, we will conduct an ethnographically-oriented Community Assessment Process to develop a detailed understanding of sources of alienation and delay in care among MSM and to elicit direct feedback from MSM about their services needs and priorities. A parallel elicitation will be undertaken among service providers. This elicitation process will support identification of key stakeholders from both groups who will serve on the Community Advisory Board which will guide adaptation and implementation of the intervention. In Years 2 and 3, and building on an existing "Core" study within a local community STI/HIV services clinic (CLETS), we will recruit 240 MSM to participate in a preliminary assessment of the impact of the intervention. Using a "Comparative Effectiveness" approach, we will compare conventional, 2-session pre and post-test counseling with the adapted 2-session Sexual Health Promotion intervention on key outcomes, including sexual risk reduction, frequency of UAI, understanding the role of untreated STIs in facilitating HIV transmission, awareness of the role of early initiation of ARV care in effective management of HIV disease, health-seeking skills (including improved stigma management skills), routinization of non-symptom-driven HIV screening at 6 month intervals, and rapid uptake in HIV monitoring/ARV treatment services among newly-diagnosed HIV+ MSM.

描述（由申请人提供）：虽然自 2006 年以来，美国新发 HIV 感染率总体保持相对稳定，但男男性行为者 (MSM) 的感染率却显着上升，特别是少数族裔/种族的 MSM。波多黎各的男男性行为者也存在类似的模式，那里高度的社会耻辱和偏见导致艾滋病毒筛查使用不当和艾滋病毒护理参与较晚，导致过早死亡率高和病毒传播水平高，从而助长继发感染和从而维持疫情。针对 PR 中长期缺乏针对 MSM 的循证 HIV 干预措施的问题，我们将采用 CBPR 方法，调整现有的性健康促进干预技术，以供 HIV 感染/状况未知/或 HIV 阳性但未感染的 MSM 使用。参加艾滋病毒护理监测/治疗。在第一年，我们将开展一个以人种学为导向的社区评估流程，以详细了解 MSM 中疏远和延迟护理的根源，并从 MSM 那里获取有关其服务需求和优先事项的直接反馈。服务提供商之间将进行并行启发。这一启发过程将支持从两个群体中确定关键利益相关者，他们将在社区咨询委员会中任职，该委员会将指导干预措施的调整和实施。在第 2 年和第 3 年，在当地社区 STI/HIV 服务诊所 (CLETS) 内现有的“核心”研究的基础上，我们将招募 240 名 MSM 参与干预措施影响的初步评估。使用“比较有效性”方法，我们将比较传统的 2 次测试前和测试后咨询与经过调整的 2 次性健康促进干预对关键结果的影响，包括性风险降低、UAI 频率、了解未经治疗的作用性传播感染促进艾滋病毒传播、认识到早期开始抗逆转录病毒治疗在有效管理艾滋病毒疾病中的作用、寻求健康的技能（包括改进耻辱管理技能）、非症状驱动的艾滋病毒筛查的常规化间隔 6 个月，新诊断的 HIV+ MSM 迅速接受 HIV 监测/ARV 治疗服务。