Development of a HIV prevention toolkit for at-risk HIV-negative male couples

为高危艾滋病毒阴性男性夫妇开发艾滋病毒预防工具包

基本信息

批准号：
8912543
负责人：
Daniel J Feaster
金额：
$ 22.21万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8912543
关键词：
AIDS prevention Address Agreement Anal Sex Anus Attitude Behavior Cellular Phone Communities Computer software Control Groups Couples Data Data Set Development Enrollment Epidemic Esthetics Exercise Feedback Focus Groups HIV HIV risk HIV/STD Health Health Resources Health behavior Human immunodeficiency virus test Individual Infection Internet Intervention Interview Location Methods Modeling Nature Online Systems Phase Prevention Prevention Research Prevention approach Preventive Intervention Randomized Research Research Personnel Risk Risk Reduction Role Safe Sex Sampling Sex Behavior Sexual Health Structure Tablet Computer Technology Testing Time base behavior test condoms design efficacy testing expectation follow-up improved innovation male meetings men men who have sex with men novel novel strategies prevent prospective risk perception same-sex partnership sex sex risk tool web site

项目摘要

DESCRIPTION (provided by applicant): Current estimates indicate that between 58% and 78% of MSM in the US acquire HIV from their main partners within the context of a same-sex relationship (e.g., male couples). Studies with male couples have examined which factors, including sexual agreements, impact their risk for acquiring HIV. Many male couples in the US form a sexual agreement: an explicit agreement made between two partners about what sexual and other behaviors may occur within and outside of their relationship. By nature, couples' sexual agreements have direct implications toward their risk for HIV and other STIs. Because few HIV prevention interventions exist for male couples, new and novel approaches that consider the relational context of male couples are urgently needed to significantly improve HIV prevention. To help fulfill this critical gap, the proposed 3-year study aims to develop and pilot theoretically derived, web-based HIV prevention toolkit for at-risk HIV-negative male couples in the US. Through the completion of modules, the interactive HIV prevention toolkit will guide and assist at-risk HIV-negative male couples who currently practice unprotected anal intercourse (UAI) - the primary sexual risk behavior for HIV acquisition among MSM - form an explicit sexual agreement that integrates interval testing for HIV and STIs and prevention messaging while uniquely meeting the needs of their relationship. The web-based prevention toolkit will consist of two components: an interactive website that contains theoretically-based modules for couples to complete while forming their agreement, and a corresponding smartphone application (app) that will contain a copy of the agreement along with a list of GPS- enabled sexual health resources, such as where they can test for HIV and STIs, and access free safer sex supplies and biomedical approaches to prevention. Development of the prevention toolkit will occur through 3 phases. In Phase 1, we will conduct individual- and couple-level interviews in Detroit and Atlanta with 30 HIV- negative male couples who practice UAI and currently have a sexual agreement (15 open, 15 closed) to obtain feedback about the content in the prevention toolkit modules, derived from our extensive previous HIV prevention studies about male couples' sexual agreements and relationship dynamics. Feedback obtained from Phase 1 will be integrated to improve the content of the modules, and used by the software company to design the first version of prevention toolkit. Phase 2 will include conducting 2 focus groups, one in Detroit and one in Atlanta, with 7 HIV-negative male couples to pilot test the content of the modules, and obtain feedback about the appeal and ascetics of the interactive exercises and components of the prevention toolkit. By integrating findings from Phase 2, further refinements will be made to the prevention toolkit before beginning to pilot test the intervention. For Phase 3, a small prospective RCT with a 6-month follow-up period will be conducted via the Internet with a national convenience sample of 160 at-risk HIV-negative male couples to determine whether couples who receive the intervention (i.e., prevention toolkit) will form and adhere to their sexua agreement, increase their testing rates for HIV and STIs, and abstain from or decrease their occurrences of UAI with casual MSM partners when compared to couples in the control group. The proposed study is innovative because technology is appropriately used to maximize reach and impact while uniquely tailoring to the needs of each couple. We anticipate our pilot intervention will show promise for reducing male couples' HIV risk, which would then be further tested for efficacy through a larger RCT.

描述（由申请人提供）：目前估计表明，美国 58% 至 78% 的 MSM 从同性关系（例如男性伴侣）的主要伴侣处感染艾滋病毒。针对男性夫妇的研究调查了哪些因素（包括性协议）会影响他们感染艾滋病毒的风险。美国的许多男性夫妇都会签订性协议：两个伴侣之间就他们的关系内外可能发生的性行为和其他行为达成的明确协议。从本质上讲，夫妻的性协议对其感染艾滋病毒和其他性传播感染的风险有直接影响。由于针对男性夫妇的艾滋病毒预防干预措施很少，因此迫切需要考虑男性夫妇关系背景的新方法来显着改善艾滋病毒预防。为了帮助弥补这一关键差距，拟议的为期三年的研究旨在为美国高危艾滋病毒阴性男性夫妇开发和试点基于理论的基于网络的艾滋病毒预防工具包。通过完成模块，交互式艾滋病毒预防工具包将指导和帮助目前进行无保护肛交（UAI）（MSM 中感染艾滋病毒的主要性风险行为）的高危艾滋病毒阴性男性夫妇形成明确的性协议，整合了艾滋病毒和性传播感染的间隔检测和预防信息，同时独特地满足了他们的关系的需求。基于网络的预防工具包将由两个部分组成：一个交互式网站，其中包含基于理论的模块，供夫妻在达成协议时完成；以及一个相应的智能手机应用程序（应用程序），其中包含协议副本以及列表支持 GPS 的性健康资源，例如可以检测艾滋病毒和性传播感染，并获得免费的安全性行为用品和生物医学预防方法。预防工具包的开发将分三个阶段进行。在第一阶段，我们将在底特律和亚特兰大对 30 名实施 UAI 并目前达成性协议（15 公开，15 封闭）的 HIV 阴性男性夫妇进行个人和夫妇层面的访谈，以获取有关预防内容的反馈工具包模块，源自我们之前对男性夫妇的性协议和关系动态进行的广泛的艾滋病毒预防研究。从第一阶段获得的反馈将被整合以改进模块的内容，并由软件公司用来设计第一版预防工具包。第二阶段将包括举办 2 个焦点小组，一个在底特律，一个在亚特兰大，由 7 名 HIV 阴性男性夫妇进行试点测试模块的内容，并获得有关互动练习和预防组成部分的吸引力和禁欲性的反馈工具包。通过整合第二阶段的研究结果，在开始试点测试干预措施之前，将进一步完善预防工具包。对于第 3 阶段，将通过互联网进行一项为期 6 个月随访的小型前瞻性随机对照试验，对全国 160 名高危 HIV 阴性男性夫妇进行方便抽样，以确定接受干预（即预防）的夫妇是否工具包）将与对照组的夫妇相比，形成并遵守他们的性协议，提高艾滋病毒和性传播感染的检测率，并避免或减少与临时 MSM 伴侣发生 UAI 的发生率。拟议的研究具有创新性，因为技术得到了适当的利用，以最大限度地提高影响力和影响力，同时根据每对夫妇的需求进行独特的定制。我们预计我们的试点干预措施将有望降低男性夫妇的艾滋病毒风险，然后通过更大规模的随机对照试验进一步测试其有效性。