Community Intervention for HIV Testing & Care Linkage Among Young Roma MSM in Bulgaria

HIV 检测的社区干预

基本信息

批准号：
9518131
负责人：
Yuri A Amirkhanian
金额：
$ 32.22万
依托单位：
MEDICAL COLLEGE OF WISCONSIN
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-08-10 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9518131
关键词：
20 year old AIDS prevention AIDS/HIV problem Address Age Alcohol or Other Drugs use Attitude Behavioral Bulgaria Caring Case Management Communities Counseling Country Data Democracy Diagnosis Disease Early Diagnosis Eastern Europe Effectiveness Enrollment Epidemic Ethnic Origin Europe Friends Friendships Fright Gays HIV HIV Infections HIV Seropositivity HIV risk Health Homosexuality Human immunodeficiency virus test Incidence Infection Influentials Intervention Intervention Trial Interview Link Measures Medical Methods Monitor Outcome Participant Patient Self-Report Perception Persons Phase Provider Public Health Randomized Recommendation Recording of previous events Recruitment Activity Research Risk Risk Reduction Seeds Services Sexual Transmission Site Social Network Stigmatization Testing Training Trust antiretroviral therapy base community intervention cost experience informant intervention effect low and middle-income countries member men men who have sex with men programs public health relevance same sex behavior social social stigma theories therapy design uptake young man young men who have sex with men

项目摘要

DESCRIPTION (provided by applicant): Throughout the world, young MSM are disproportionately burdened by HIV infection. Young MSM in low- and middle-income countries often do not seek out HIV testing, are unaware of their HIV-positive status, and do not receive early medical care, compromising their health and contributing to downstream disease incidence. This situation is of great concern in post-socialist countries of Eastern Europe, where stigma about HIV/AIDS and same-sex behavior are great, HIV epidemics are still increasing, and the health needs of young MSM are rarely acknowledged or addressed. The planned research will be conducted in Sofia, Bulgaria where MSM account for nearly half of HIV infections, MSM communities are very young, and a high proportion of persons living with HIV (PLH) are undiagnosed. This mixed-methods study will be conducted in two phases. In an initial qualitative phase, we will conduct in-depth interviews with young MSM ages 16 to 20 and other key informants to gain an understanding of factors related to HIV testing, as well as barriers and facilitators of testing and medical care. Results of the qualitative study will be shared with HIV test and care providers, and we will gain further input from a community advisory panel. The project's second phase is a trial of a network intervention to increase regular HIV testing and care linkage among young MSM. Our prior studies in Bulgaria have shown that young MSM are clustered with other young MSM in their social or friendship networks. The intervention trial will recruit 54 small social networks of MSM, each consisting of a young MSM "seed" between age 16 and 20 and also all close MSM friends surrounding the seed (expected n=54 networks x 5 members/network=270 participants). All participants will complete baseline measures assessing recent HIV testing practices and testing history; attitudes, intentions, perceived norms, barriers, and understanding about HIV testing and medical care; sexual risk practices; and substance use. All participants will receive HIV risk reduction counseling. Networks will then be randomized in equal numbers to comparison and intervention conditions. The influence leader of each experimental condition network will be empirically identified, and network leaders will together attend a 5-session intervention. Sessions will train, guide, and engage the cadre of leaders to deliver theory-based, personally-tailored advice and counseling to their network members to correct misconceptions about HIV testing and care; strengthen friends' norms, attitudes, intentions, and perceived benefits of regular testing; and address barriers to testing. All members of intervention and comparison condition networks will be re-assessed at 6- and 12-month followup to determine the intervention's effects on HIV testing, regular testing, and testing- and care-related scale measures. Data obtained from Sofia VCT providers will be used to corroborate testing uptake. Participants diagnosed with HIV infection at any point will be linked to medical care. If successful, this research will identify a new strategy for reaching and encouraging regular HIV testing in world regions where young MSM are often hidden in the community.

描述（由适用提供）：在世界范围内，年轻的MSM因艾滋病毒感染而过分燃烧。低收入和中等收入国家的年轻MSM通常不会寻求艾滋病毒测试，没有意识到其HIV阳性状况，并且不接受早期的医疗护理，损害其健康并为下游疾病事件做出贡献。在东欧的后社会主义国家，这种情况非常关注，在那里，关于艾滋病毒/艾滋病和同性行为的污名很大，艾滋病毒发作仍在增加，年轻MSM的健康需求很少得到承认或解决。计划的研究将在保加利亚的索非亚进行，其中MSM几乎占HIV感染的一半，MSM社区非常年轻，并且很大一部分患有艾滋病毒（PLH）（PLH）的人都没有诊断。这项混合方法研究将分为两个阶段。在最初的定性阶段，我们将对16至20岁的年轻MSM和其他关键信息进行深入的访谈，以了解与HIV测试有关的因素，以及测试和医疗护理的障碍和促进者。定性研究的结果将与HIV测试和护理提供者共享，我们将从社区咨询小组中获得进一步的意见。该项目的第二阶段是对网络干预的试验，以增加年轻MSM之间的常规HIV测试和护理联系。我们在保加利亚的先前研究表明，年轻的MSM与其他年轻的MSM聚集在其社交或友谊网络中。干预试验将招募54个MSM的小型社交网络，每个网络由16至20岁之间的年轻MSM“种子”组成，以及周围种子周围的所有亲密MSM朋友（预期n = 54个网络x 5成员/网络= 270名参与者）。所有参与者将完成评估最近的HIV测试实践和测试历史的基线措施；参加者，意图，感知规范，障碍，并了解艾滋病毒测试和医疗保健；性风险实践；和物质使用。所有参与者将获得降低艾滋病毒风险咨询。然后，网络将以相等的数量与比较和干预条件进行随机分配。每个实验条件网络的影响力领导者将得到经验确定，网络负责人将共同参加5条课程的干预措施。会议将培训，指导和吸引领导者干部，向其网络成员提供基于理论的，个人限制的建议和咨询，以纠正有关HIV测试和关怀的失误；更强大的朋友的规范，参与者，意图和定期测试的感知好处；并解决测试的障碍。所有干预和比较状况网络的所有成员将在6个月和12个月的随访中重新评估，以确定干预对HIV测试，常规测试以及与测试相关的量表测量的影响。从索非亚VCT提供商获得的数据将用于证实测试吸收。在任何时候被诊断出患有艾滋病毒感染的参与者将与医疗相关。如果成功，这项研究将确定一种新的策略，以在社区中通常隐藏在年轻的MSM的世界区域中达成和鼓励定期的HIV测试。