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

基本信息

批准号：
9296114
负责人：
JEFFREY T PARSONS
金额：
$ 60.75万
依托单位：
HUNTER COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-06-15 至 2020-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9296114
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 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 Recruitment Activity Reporting Research Risk Risk Reduction Science Services 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 reduced substance use relative effectiveness sex sex risk sexual encounter surveillance data theories treatment as usual trend uptake young man young men who have sex with men

项目摘要

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（由申请人提供）：少数族裔和少数族裔男男性行为者 (MYMSM) 仍然是药物滥用和艾滋病毒/艾滋病关系中的关键人群：非洲裔美国人和西班牙裔 YMSM 中的新感染浓度增加了 132%自 2002 年以来一直在观察。青年男性健康项目 (YMHP)，这是一项针对 HIV 阴性或未经测试的 18 岁以下 YMSM 设计的利用动机访谈的 4 期干预措施29 被发现可有效显着减少物质使用和无套肛交 (CAS) 迄今为止，这是任何已发表的试验或 CDC DEBI 与 YMSM 中第一个也是唯一一个显示物质使用和性风险显着减少的随机对照试验。 CDC 最近将 YMHP 评为“最佳证据”，并将其纳入艾滋病毒预防循证干预措施和最佳实践纲要中。YMHP 通过在研究中心环境中进行的功效试验进行了测试，并进行了多次纳入和排除。因此，基于社区的复制是研究工作人员向客户提供的干预措施在现实世界中的有效性的关键下一步，我们将在现场提供两种治疗强度的比较有效性试验（CET）。基于 HIV 咨询和检测 (C&T) - YMHP 干预和强化“照常治疗”(eTAU) HIV 预防服务 - 在两个现实世界的社区组织 (CBO) 中测试其在减少药物使用和 CAS 方面的相对有效性HIV 阴性MYMSM。具体目标是：1) 调整 YMHP 干预措施，以便由同伴辅导员在 CBO 中实施；2) 测试由位于纽约市艾滋病毒高发区的两个 CBO 的同伴辅导员实施的 YMHP 干预措施的有效性； 3) 评估 YMHP 相对于 TAU 的成本效益拟议的研究将分两个阶段实施。在第一阶段，我们将与合作机构的工作人员进行定性研究，以适应该研究。针对 MYMSM 的独特需求进行有效的 YMHP 干预，并结合现场合作者使用的现有系统和方法，以促进同伴辅导员的交付。在第 2 阶段，我们将使用 MYMSM 将 260 种 HIV 阴性物质随机纳入 YMHP 干预或 eTAU 评估中。行为自我报告措施、药物使用尿液检测以及性健康结果的艾滋病毒和性传播感染检测与我们的 CBO 合作者合作将有助于解决服务提供第一线的实际问题。为减少 MYMSM 中的物质使用和艾滋病毒感染的综合计划铺平道路。如果有效，我们的计划有可能对经济上处于不利地位、物质使用 MYMSM 的行为干预的有效性产生持续而强大的影响。用于艾滋病毒感染。