HIV PREVALENCE, SEXUAL BEHAVIOR, AND ATTITUDES TOWARD CIRCUMCISION AMONG COLOMBIA

哥伦比亚的艾滋病毒感染率、性行为和对包皮环切术的态度

• 批准号: 7810559
• 负责人: Maria Cecilia Zea
• 金额: $ 66.06万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7810559
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adult; Affect; Africa; Age; American; Area; Attention; Attitude; Behavior; Behavioral; Belief; Caribbean region; Characteristics; Cities; Colombia; Communities; Computer Assisted; Conflict (Psychology); Counseling; Country; Data; Demographic Factors; Development; Epidemic; Female; Focus Groups; Future; Gays; Gray unit of radiation dose; HIV; Health Knowledge, Attitudes, Practice; Heterosexuals; High Prevalence; Homosexuality; Human immunodeficiency virus test; Incidence; Individual; Internal Migrations; Intervention; Interview; Knowledge; Label; Latin America; Laws; Lead; Legal; Life; Link; Male Circumcision; Methods; Modeling; Outcome; Participant; Pattern; Perception; Persons; Phase; Plague; Policies; Population; Population Characteristics; Poverty; Prevalence; Prevention; Prostitution; Public Health; Public Policy; Qualitative Research; Reaction; Recommendation; Recording of previous events; Research; Research Methodology; Respondent; Rights; Risk; Risk Behaviors; Sample Size; Sampling; Sex Behavior; Sexual Partners; Shapes; Social Class; Social Conditions; Social Environment; Social Network; Stigmata; Surveys; Testing; Time; UNHCR; Urbanization; Violence; War; aged; demographics; design; displaced person; epidemiological model; experience; high risk; informant; information gathering; innovation; life history; male; men; men who have sex with men; migration; oral HIV; programs; protective effect; psychologic; public health relevance; residence; sex risk; social; social stigma; stem; surveillance data

DESCRIPTION (provided by applicant): This application describes a five-year research program that investigates individual, social, and structural influences on HIV risk and serostatus among men who have sex with men (MSM) in Bogota, Colombia. This study is of public health significance because it will contribute to knowledge concerning HIV prevalence and risk behavior in an understudied group at high risk for HIV. Moreover, it will evaluate the protection against HIV afforded by circumcision among MSM in Colombia. This application is innovative in its use of a conceptual framework that addresses HIV risk within the social and structural context. In Colombia, there are legal protections of the rights of all individuals, including gay men, while at the same time, there is ongoing civil unrest, forced displacement of large numbers of people, and homonegativity. This study investigates how such societal characteristics, as well as individuals' characteristics, influence vulnerability to HIV. The aims of the proposed study are 1) to examine structural, social, and individual factors relevant to HIV risk among MSM in Bogota; 2) to estimate prevalence of HIV among MSM in Bogota; 3) to explore the association between circumcision status and HIV serostatus and to investigate beliefs, knowledge, and attitudes concerning circumcision among Colombian MSM; and 4) to integrate information gained from the various research methods used and to draw conclusions that will guide the design of policies and interventions addressing HIV risk among MSM in Colombia. The research consists of three phases. Phase I involves qualitative research (12 key informant interviews, 10 focus groups, and 28 life history interviews) to explore the context of life for MSM in Bogota, including sexual behavior patterns, social networks, stigma associated with homosexuality and HIV, violence, migration, and displacement. Life history interviews will be conducted with MSM who have experienced displacement. Phase II involves quantitative research. Rapid oral HIV testing and a quantitative survey instrument will be administered with A-CASI to samples of MSM, aged 15 to 49. Social and structural data will reflect conditions in Bogota's19 localidades (localities) where participants live. Data will be used to test a model of HIV risk with both individual-level analyses and multi-level analyses (incorporating characteristics of the person and the locality of residence); to obtain estimates of HIV prevalence among MSM in the city; to examine protective effects of circumcision; and to describe attitudes and knowledge of circumcision. The pilot test includes 100 participants, and the full administration of the revised survey includes 1000 participants, all obtained through respondent-driven sampling. Phase III consists of triangulation of data and dissemination of findings. The contextualized information gained from this research will be useful in HIV prevention efforts for Colombian MSM at the societal, city, community, and individual levels. PUBLIC HEALTH RELEVANCE The proposed study will examine individual, social, and structural factors influencing HIV risk among Colombian MSM, and findings will be useful in designing targeted interventions. Elucidation of societal conditions that increase individuals' HIV vulnerability; identification of susceptible groups of people; and explication of the link between individual experiences, social/structural characteristics, and HIV risk will inform prevention efforts at multiple levels, including legal or policy changes and interventions aimed at the community or individuals.

描述（由申请人提供）：本申请描述了一项为期五年的研究计划，该计划研究了与男性发生性关系的男性（MSM）（MSM）的个人，社会和结构性影响。这项研究具有公共卫生的意义，因为它将有助于有关艾滋病毒高风险的研究群体中有关HIV患病率和风险行为的知识。此外，它将评估哥伦比亚MSM对包皮环切术提供的艾滋病毒的保护。该应用程序在使用概念框架中具有创新性，该概念框架在社会和结构背景下解决艾滋病毒风险。在哥伦比亚，对包括同性恋者在内的所有个人的权利都有法律保护，而同时，内乱正在进行，强迫流离失所的人以及同性恋。这项研究调查了这种社会特征以及个人的特征如何影响艾滋病毒的脆弱性。拟议的研究的目的是1）检查波哥大MSM中与HIV风险有关的结构，社会和个人因素； 2）估计波哥大MSM中艾滋病毒的患病率； 3）探索包皮环切术与艾滋病毒血清的关联，并调查哥伦比亚MSM中关于包皮环切术的信念，知识和态度； 4）整合从所使用的各种研究方法中获得的信息，并得出结论，以指导哥伦比亚MSM中艾滋病毒风险的政策和干预措施的设计。该研究包括三个阶段。第一阶段涉及定性研究（12项关键的线人访谈，10个焦点小组和28个生活史访谈），以探索波哥大MSM的生活背景，包括性行为模式，社交网络，与同性恋和艾滋病毒，暴力，迁移和移民相关的污名。人生历史访谈将与经历流离失所的MSM进行。第二阶段涉及定量研究。快速口服HIV测试和定量调查工具将用A-CASI对MSM的样本进行15至49岁的样本。社会和结构数据将反映参与者居住的波哥大S19 Localidades（地区）的条件。数据将用于通过个人级别的分析和多层次分析（结合了人的特征和居住地点）来测试HIV风险模型；为了获得城市中MSM中艾滋病毒患病率的估计；检查包皮环切术的保护作用；并描述包皮环切术的态度和知识。试点测试包括100名参与者，修订的调查的完整管理包括1000名参与者，所有参与者都是通过受访者驱动的抽样获得的。第三阶段由数据进行三角剖分和发现的传播。从这项研究中获得的上下文化信息将在哥伦比亚MSM的艾滋病毒预防工作中有用，在社会，城市，社区和个人层面上。 公共卫生相关性拟议的研究将检查影响哥伦比亚MSM艾滋病毒风险的个体，社会和结构性因素，发现对设计有针对性的干预措施将很有用。阐明增加个人艾滋病毒脆弱性的社会条件；识别易感人群；并阐明个人经验，社会/结构特征和艾滋病毒风险之间的联系将为预防工作提供多个级别的预防工作，包括法律或政策变化以及针对社区或个人的干预措施。