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

• 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
• 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

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）：在美国，艾滋病毒感染风险因性取向和种族/民族而异。艾滋病毒感染一直给男男性行为者（MSM）和非裔美国人带来沉重负担。然而，艾滋病毒感染率差异在非裔美国人的 MSM 中最为显着，这一群体可能只占美国人口的不到 1%，但占美国所有新发艾滋病毒感染者的 25%。令人惊讶的是，针对非裔美国男男性接触者设计的艾滋病毒预防干预措施很少，大多数现有方法都依赖于个人或小组风险降低咨询。这些现有模式对于接触隐藏在社区中且不太可能寻求降低性风险咨询的高风险非裔美国男男性接触者来说，在文化和实践上的适用性有限。仅针对个人的干预措施也没有充分考虑社会规范和社交网络因素对危险行为的重要影响。与个人咨询模式相比，针对社区中黑人 MSM 的社交网络并通过这些网络内的自然影响渠道进行的艾滋病毒预防干预措施有可能深入接触非裔美国 MSM 中隐藏的弱势群体。网络层面的艾滋病毒预防干预措施依赖于适合少数群体社区的口头交流传统和文化模式，并且可以加强社会网络对降低风险的规范支持。经过为期 1 年的形成性研究阶段，该阶段将提供研究招募、评估、干预内容和实施方法的背景所需的数据，我们将在密尔沃基、克利夫兰和迈阿密这 3 个城市进行社交网络级别的干预结果试验。在整个项目范围内，将招募 24 个以社会为中心的非裔美国 MSM 网络，每个网络预计由大约 40 人组成（总共 n = 960 名参与者）。其中 12 个网络（n = 480 名参与者）将被随机分配到比较条件，并接受 HIV/STD 检测、治疗和个人咨询。其他 12 个网络 (n=480) 将接受相同的咨询和测试以及社交网络干预，以识别、培训和吸引每个网络中根据经验确定的影响力领导者，以提供持续的、基于理论和文化定制的艾滋病毒预防向其他网络成员提供建议、建议和支持。该研究将确定社交网络干预对咨询、测试和治疗比较条件的比较有效性，包括性风险测量、与性风险行为相关的物质使用以及通过实验室测量在 6 岁和 18 岁评估的 STD/HIV 发病率。 - 月随访点。该研究的目的是开发并确定一种干预方式的有效性，该方式能够在社区高危非裔美国男男性接触者中接触和预防艾滋病毒。