Prevention of HIV Infection in High-Risk Social Networks of African American MSM

非裔美国男男性接触者高风险社交网络中艾滋病毒感染的预防

基本信息

批准号：
8725232
负责人：
Jeffrey A Kelly
金额：
$ 130.04万
依托单位：
MEDICAL COLLEGE OF WISCONSIN
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-28 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8725232
关键词：
AIDS prevention AIDS/HIV problem Accounting Acquired Immunodeficiency Syndrome Address Advocate Affect African American Alcohol or Other Drugs use American Anus Behavior Therapy Biological Bisexual Caring Centers for Disease Control and Prevention (U.S.)Characteristics Cities Collaborations Color Communities Community Participation Contracts Counseling Country Data Development Diagnosis Diffuse Disease Drug usage Eastern Europe Economics Employee Strikes Enrollment Epidemic Ethnic Origin Foundations Frequencies Friends Gays HIV HIV Infections HIV/STD Health Health Personnel Homophobia Human immunodeficiency virus test Incidence Individual Infection International Intervention Intervention Trial Interview Laboratories Language Life Style Measures Methods Minority Modality Modeling Outcome Participant Persons Phase Pilot Projects Play Population Preparation Prevalence Prevention Prevention approach Preventive Intervention Procedures Provider Public Health Publishing Race Randomized Recommendation Recording of previous events Recruitment Activity Reporting Research Risk Risk Behaviors Risk Reduction Risk Reduction Behavior Sampling Services Sex Orientation Shock Site Social Network Specimen Structure Testing Training Treatment Efficacy United States United States Public Health Service Visit Vulnerable Populations Work arm base behavior change comparative effectiveness condoms contextual factors cost cost effectiveness directed attention ethnic minority population falls group counseling health disparity high risk high risk sexual behavior indexing informant man member men men who have sex with men novel oral communication prevent primary outcome programs prospective public health relevance public health research randomized trial same sex behavior sex sex risk social social norm social stigma theories therapy design uptake

项目摘要

DESCRIPTION (provided by applicant): Risk for HIV infection in the United States falls along sharp lines of disparity related to sexual orientation and race/ethnicity. HIV infection has always taken a heavy toll on men who have sex with men (MSM) and also on African Americans. However, HIV incidence disparity is most striking of all for MSM who are also African American, a segment that probably accounts for less than one percent of the American population but fully 25% of all new HIV infections in the United States. Surprisingly, very few HIV prevention interventions designed for African American MSM have been undertaken, and most existing approaches have relied on individual or small-group risk reduction counseling. These existing models have limited cultural and practical suitability for reaching high-risk African American MSM who are hidden in the community and unlikely to seek out sexual risk reduction counseling. Interventions directed to individuals alone also do not attend sufficiently to the important influence played by social norms and social network factors on risk behavior. In contrast to individual counseling models, HIV prevention interventions that are directed to social networks of Black MSM in the community and that work through natural influence channels within these networks hold the potential for reaching deeply into hidden and vulnerable populations of African American MSM. Network-level HIV prevention interventions rely on oral communication traditions and cultural models appropriate in minority communities, and can strengthen social network normative support for risk reduction. Following a 1-year formative research phase that will provide data needed to contextualize the study's recruitment, assessment, and intervention content and delivery methods, we will undertake a social network-level intervention outcome trial in 3 cities: Milwaukee, Cleveland, and Miami. Project-wide, 24 sociocentric networks of African American MSM-each expected to be composed of approximately 40 people (total n=960 participants)-will be recruited. 12 of the networks (n=480 participants) will be randomized to a comparison condition and receive HIV/STD testing, treatment, and individual counseling. The other 12 networks (n=480) will receive the same counseling and testing and also a social network intervention that identifies, trains, and engages empirically-identified influence leaders of each network to deliver ongoing, theory-based, and culturally tailored HIV prevention advice, recommendations, and support to other network members. The study will determine the comparative effectiveness of the social network intervention to the counseling, testing, and treatment comparison condition on measures of sexual risk, substance use associated with sexual risk behavior, and STD/HIV incidence assessed with laboratory measures at 6- and 18-month followup points. The study aim is to develop and determine the efficacy of an intervention modality capable of reaching and preventing HIV among high-risk African American MSM in the community.

描述（由申请人提供）：美国艾滋病毒感染的风险属于与性取向和种族/种族有关的急剧差异。艾滋病毒感染一直对与男性发生性关系的男性以及非裔美国人造成了巨大的损失。但是，对于也是非裔美国人的MSM，艾滋病毒的发病率差异最为惊人。令人惊讶的是，已经进行了为非裔美国人MSM设计的预防艾滋病毒预防干预措施，大多数现有方法都依赖于个人或小组风险咨询。这些现有的模型对于藏在社区中的高风险的非裔美国人MSM方面的文化和实用性有限，并且不太可能寻求减少性风险的咨询。仅针对个人的干预措施也不能充分参加社会规范和社交网络因素对风险行为的重要影响。与个别咨询模型相反，针对社区中黑人MSM社交网络的艾滋病毒预防干预措施以及通过这些网络内的自然影响渠道运作的潜力有可能深入到非裔美国人MSM的隐藏和脆弱的人群中。网络级的艾滋病毒预防干预措施依赖于适合少数民族社区的口头交流传统和文化模式，并可以加强社交网络规范性的支持，以降低风险。在一个为期1年的形成性研究阶段，该阶段将提供所需的数据，以将研究的招聘，评估和干预内容和交付方法背景下，我们将在3个城市进行社交网络级干预结果试验：密尔沃基，克利夫兰和迈阿密。在项目范围内，非裔美国人MSM EAP的24个社会中心网络预计将由约40人组成（总n = 960名参与者） - 将被招募。 12个网络（n = 480名参与者）将被随机分为比较条件，并接受HIV/STD测试，治疗和个人咨询。其他12个网络（n = 480）将获得相同的咨询和测试，以及确定每个网络的经验识别影响力领导者的社交网络干预措施，以向其他网络成员提供持续，基于理论和文化量身定制的HIV预防艾滋病毒预防建议，建议和支持。该研究将确定社交网络干预对性风险，与性风险行为相关的药物使用以及在6个月和18个月的随访点评估的性风险，与性风险行为相关的药物使用以及性病/HIV发病率的咨询，测试和治疗比较条件的比较有效性。该研究的目的是开发和确定能够达到和预防社区中非裔美国人MSM中艾滋病毒的干预方式的功效。