A Randomized Trial to Prevent HIV Among Gay Couples

一项预防同性恋夫妇感染艾滋病毒的随机试验

• 批准号: 9482537
• 负责人: LYNAE A DARBES
• 金额: $ 17.26万
• 依托单位: SAN FRANCISCO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9482537
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Agreement; Anal Sex; Attention; Baseline Surveys; Behavior Therapy; Cessation of life; Cost Effectiveness Analysis; Couples; Foundations; Gays; Goals; Gold; HIV; HIV Infections; HIV Seropositivity; HIV risk; Incidence; Individual; Internet; Intervention; Investments; Knowledge; Longitudinal Studies; Mediating; Mediation; Mediator of activation protein; Modeling; Persons; Population; Prevention; Preventive Intervention; Process; Randomized; Randomized Controlled Trials; Research; Risk Factors; Risk Reduction; Science; Social support; Surveys; Testing; Time; Viral Load result; base; cost effective; cost effectiveness; efficacy testing; epidemiology study; follow-up; high risk; high risk population; male; men; men who have sex with men; pre-exposure prophylaxis; prevent; programs; randomized trial; satisfaction; scale up; sex; sex risk; skills; theories; trend; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Agreement; Anal Sex; Attention; Baseline Surveys; Behavior Therapy; Cessation of life; Cost Effectiveness Analysis; Couples; Foundations; Gays; Goals; Gold; HIV; HIV Infections; HIV Seropositivity; HIV risk; Incidence; Individual; Internet; Intervention; Investments; Knowledge; Longitudinal Studies; Mediating; Mediation; Mediator of activation protein; Modeling; Persons; Population; Prevention; Preventive Intervention; Process; Randomized; Randomized Controlled Trials; Research; Risk Factors; Risk Reduction; Science; Social support; Surveys; Testing; Time; Viral Load result; base; cost effective; cost effectiveness; efficacy testing; epidemiology study; follow-up; high risk; high risk population; male; men; men who have sex with men; pre-exposure prophylaxis; prevent; programs; randomized trial; satisfaction; scale up; sex; sex risk; skills; theories; trend

In the US, men who have sex with men (MSM) represent the largest proportion of AIDS deaths, people living with AIDS, and HIV incidence. While numerous prevention efforts targeting MSM have successfully reduced HIV incidence in the US, many men are not reached, including gay couples. Several epidemiological studies attribute high rates of new HIV infections to condomless anal sex within male primary partnerships, but few prevention interventions are available to address and reverse this trend. Several factors have recently changed the HIV prevention landscape, including advancements in biomedical strategies, an increased desire to develop interventions that can be scaled up efficiently and a need to develop cost-effective programing due to decreases in prevention dollars. Multi-session individual- and group-level in-person sexual risk reduction interventions for MSM were the gold standard for many years. Behavioral interventions have also been delivered via the internet, since they are convenient, able to reach large numbers of individuals and less labor intensive to implement, compared to interventions delivered via multiple in- person sessions. It is important to examine the optimal modes of providing prevention interventions in the context of this changing prevention landscape. The majority of prevention interventions targeting MSM are individual-focused. However, over the years, our research has identified unique prevention needs for gay couples that have not been sufficiently addressed in individual-focused interventions. For example, while most gay couples have agreements about sex with partners outside the relationship, many couples have difficulty negotiating their agreements, some have difficulty adhering to their agreements and those who break their agreements have difficulty disclosing the break to their partner; all of which could pose potential HIV risk for the couple. Our study team has led the field in examining relationship dynamics among gay couples. With a goal to develop a theory driven yet empirically-informed intervention, we have been studying the nuances of relationships and determining the HIV risk factors that either persist or change over time. Several years of longitudinal quantitative and qualitative studies, have yielded the evidence for an empirically- driven model that provides a foundational framework for the proposed intervention. Additionally, due to a dearth of prevention interventions for gay couples, there is little documented knowledge about the best modes of intervention delivery. Specifically, we do not know if it is efficacious for couples to participate in an intervention in-person or online. We also do not know if particular topics are best addressed using one of these modes or the other. To address these questions, we propose in an R01 application, to test the efficacy of our theory-based and empirically-driven HIV risk reduction intervention for gay male couples using a randomized controlled trial.

在美国，与男人发生性关系的男人（MSM）是艾滋病死亡中最大的人， 患有艾滋病和艾滋病毒发病率的人。而针对MSM的许多预防努力 在美国成功降低了艾滋病毒的发病率，许多男人没有达到包括同性恋 夫妻。几项流行病学研究将新的HIV感染率归因于 男性主要伙伴关系内的无避孕套肛交，但预防干预措施很少 可用于解决并扭转这一趋势。 最近有几个因素改变了艾滋病毒预防景观，包括进步 在生物医学策略中，越来越多地开发可以扩展干预措施的愿望 有效，并且需要由于预防减少而开发具有成本效益的编程 美元。多会个人 - 个人和团体内部性风险减少干预措施 对于MSM，是多年来的黄金标准。行为干预也已经 通过互联网交付，因为它们很方便，能够吸引大量个人 与通过多个In-提供的干预措施相比 人会议。检查提供预防的最佳模式很重要 在这种不断变化的预防格局的情况下进行干预。 针对MSM的大多数预防干预措施是个人针对的。但是，结束了 这些年来，我们的研究已经确定了没有的同性恋夫妇的独特预防需求 在以个人为中心的干预措施中得到了足够的解决。例如，大多数同性恋 夫妻就与恋爱关系以外的伴侣发生性关系达成协议，许多夫妻有 难以谈判他们的协议，有些很难遵守他们的协议，并且 那些违反协议的人很难透露给伴侣的突破；所有人 这可能对这对夫妇构成潜在的艾滋病毒风险。我们的学习团队领导了研究 同性恋夫妇之间的关系动态。以发展为驱动理论的目标 经验明确的干预措施，我们一直在研究关系的细微差别和 确定持续时间或随时间变化的艾滋病毒危险因素。几年 纵向定量和定性研究已经提供了经验上的证据 驱动模型，为拟议的干预提供了基础框架。此外， 由于缺乏对同性恋夫妇的预防干预措施，很少有记录的知识 关于干预交付的最佳方式。具体来说，我们不知道它是否有效 夫妻参加面对面或在线干预。我们也不知道是否特别 最好使用这些模式之一或另一种模式来解决主题。要解决这些问题， 我们在R01应用程序中提议，以测试基于理论和经验驱动的理论的功效 同性恋男性夫妇使用随机对照试验的艾滋病毒风险降低干预措施。