Examining community-based effectiveness of a substance use and HIV risk reduction intervention for young men of color

检查基于社区的针对有色人种年轻男性的药物滥用和艾滋病毒风险降低干预措施的有效性

• 批准号: 9920523
• 负责人: Tyrel J Starks
• 金额: $ 7.23万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-15 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9920523
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Affect; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Anal Sex; Area; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Client; Clinical effectiveness; Collaborations; Color; Communities; Cost Analysis; Counseling; Development; Diagnosis; Drug usage; Economically Deprived Population; Effectiveness; Effectiveness of Interventions; Enrollment; Environment; Evidence based intervention; Exclusion Criteria; Feedback; Focus Groups; Gap Junctions; Goals; HIV; HIV Infections; HIV Seronegativity; HIV diagnosis; HIV risk; HIV/STD; Health; Hispanics; Incidence; Individual; Infection; Intervention; Intervention Studies; Latino; Link; Measures; Minority; Neighborhoods; New York City; Newly Diagnosed; Outcome; Participant; Patient Self-Report; Phase; Population; Professional counselor; Publishing; Qualitative Research; Randomized; Reporting; Research; Risk; Risk Reduction; Science; Service provision; Sexual Health; Sexual Partners; Site; System; Testing; Urine; base; black men who have sex with men; comparative effectiveness; condoms; cost effective; cost effectiveness; design; effectiveness trial; efficacy trial; ethnic diversity; ethnic minority population; experience; high risk; inclusion criteria; male health; men; men who have sex with men; motivational enhancement therapy; novel strategies; peer; portability; pragmatic trial; pre-exposure prophylaxis; prevention service; programs; public health relevance; racial diversity; racial minority; recruit; reduced substance use; relative effectiveness; sex; sexual encounter; sexual risk behavior; surveillance data; testing services; theories; treatment as usual; trend; uptake; young man; young men who have sex with men

 DESCRIPTION (provided by applicant): Ethnic and racial minority young men who have sex with men (MYMSM) remain a critical population at the nexus of substance use and HIV/AIDS: a 132% increase in new infections concentrated among African American and Hispanic YMSM has been observed since 2002. The Young Men's Health Project (YMHP), a 4- session intervention utilizing motivational interviewing designed for HIV-negative or untested YMSM ages 18- 29 was found to be efficacious in significantly reducing substance use and condomless anal sex (CAS). To date, this is the first and only RCT of any published trial or CDC DEBI with YMSM to show significant reductions in both substance use and sexual risk. The CDC recently rated YMHP as "Best Evidence" and placed it on the compendium of Evidence Based Interventions and Best Practices for HIV Prevention. YMHP was tested through an efficacy trial in a research center environment with numerous inclusion and exclusion criteria, and thus, a community-based replication is the crucial next step in studying the intervention's effectiveness in the real world when delivered by staff to their clients. We will conduct a comparative effectiveness trial (CET) with two intensities of treatment offered following field-based HIV counseling and testing (C&T) - the YMHP intervention and enhanced "treatment as usual" (eTAU) HIV prevention services - in two real-world community based organizations (CBOs) to test their relative effectiveness in reducing substance use and CAS among HIV-negative MYMSM. The Specific Aims are to: 1) adapt the YMHP intervention for delivery in CBOs by peer counselors; 2) test the effectiveness of the YMHP intervention when delivered by peer counselors at two CBOs situated in high HIV incidence neighborhoods in New York City; and 3) assess the cost-effectiveness of YMHP relative to TAU. The proposed study will be implemented over two phases. In Phase 1 we will conduct qualitative research with staff at our collaborating agencies to adapt the efficacious YMHP intervention to the unique needs of MYMSM and incorporate existing systems and approaches utilized by site collaborators to facilitate for delivery by peer counselors. In Phase 2 we will randomize 260 HIV-negative substance using MYMSM into the YMHP intervention or eTAU. Assessments will include behavioral self-report measures, urine testing for substance use, and HIV and STI testing for sexual health outcomes. Working together with our CBO collaborators will help to address practical problems at the frontline of service provision to pave the way for a comprehensive program to reduce substance use and HIV infection among MYMSM. If effective, our program has the potential to exert a sustained and powerful influence on the effectiveness of behavioral interventions for economically disadvantaged, substance using MYMSM who are most at risk for HIV infection.

 描述（由应用程序提供）：与男性发生性关系（MYMSM）的种族和种族少数年轻人在药物使用和艾滋病毒/艾滋病的联系中仍然是关键人群：自2002年以来，已经观察到非裔美国人和西班牙裔YMMM的新感染增加了132％，自2002年以来，已经观察到了年轻人的健康项目（YMHP）。发现18-29岁的YMSM在显着减少药物使用和无避孕套肛交（CAS）方面有效。迄今为止，这是与YMSM的任何已发表试验或CDC Debi的第一个也是唯一的RCT，可以显示出物质使用和性风险的大幅降低。 CDC最近将YMHP评为“最佳证据”，并将其置于基于证据的干预措施和预防艾滋病毒的最佳实践上。 YMHP通过在研究中心环境中进行的有效试验进行了测试，其包含和排除标准很多，因此，基于社区的复制是研究员工向客户交付干预措施在现实世界中在现实世界中的有效性的关键一步。我们将进行一项比较有效性试验（CET），以下两种治疗实例（以下基于现场的HIV咨询和测试（C＆T））（C＆T） - YMHP干预和增强的“照常治疗”（ETAU）HIV预防服务 - 在两个现实世界社区的组织（CBOS）中，以测试其在降低HIV和Casecative casesm中的相对有效性。具体目的是：1）调整YMHP干预措施通过同伴硬币在CBO中的交付； 2）测试由同伴硬币在纽约市高艾滋病毒发病率社区的两个CBO交付时，测试YMHP干预的有效性； 3）评估YMHP相对于TAU的成本效益。拟议的研究将在两个阶段实施。在第1阶段，我们将与我们的合作机构的员工进行定性研究，以使有效的YMHP干预适应MYMSM的独特需求，并结合现有的系统和网站合作者使用的现有系统和方法，以促进Peer Coins交付。在第2阶段，我们将使用MYMSM随机将260个HIV阴性物质随机化为YMHP干预或ETAU。评估将包括行为自我报告措施，用于吸毒的尿液测试以及性健康结果的HIV和STI测试。与我们的CBO合作者合作将有助于解决服务提供的前线实际问题，为一项综合计划铺平道路，以减少MYMSM中的药物使用和HIV感染。如果有效，我们的计划有可能对行为干预措施的有效性产生持续而强大的影响，以实现经济困扰的，使用MYMSM最有可能感染HIV风险的MYMSM。

项目成果

Comparing the Efficiency of Online and Field-Based Outreach for the Recruitment of Black and Latino Sexual Minority Men into an HIV Prevention Implementation Trial.

• DOI: 10.1007/s11121-022-01367-3
• 发表时间: 2022-08
• 期刊: PREVENTION SCIENCE
• 影响因子: 3.5
• 作者: Bradford-Rogers, Jesse;Lopez-Matos, Jonathan;Cain, Demetria;Lopez, David;Starks, Tyrel J
• 通讯作者: Starks, Tyrel J