An RCT to train Black MSM as peer health educator for HIV testing and prevention

一项随机对照试验，旨在培训黑人男男性接触者作为艾滋病毒检测和预防的同伴健康教育者

• 批准号: 8440924
• 负责人: CARL A LATKIN
• 金额: $ 2.92万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8440924
• 关键词: AIDS prevention; Address; Advocacy; Affect; Alcohol or Other Drugs use; Area; Attention; Baltimore; Behavior; Behavior Therapy; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Clinic; Clinical Trials Design; Cocaine Users; Communities; Counseling; Crack Cocaine; Data; Diffuse; Diffusion; Drug usage; Effectiveness; Enrollment; Evaluation; Experimental Designs; Funding; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Health Educators; Health Promotion; Health education; Human immunodeficiency virus test; Illicit Drugs; Incidence; Individual; Intervention; Longitudinal Studies; Mediating; Medical; Mental Depression; Methamphetamine; Network-based; Opiates; Outcome; Participant; Prevalence; Prevention program; Preventive; Preventive Intervention; Process; Randomized; Randomized Clinical Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Sample Size; Sampling; Sexual Partners; Social Environment; Social Network; Surveys; System; Testing; Time; Training; Work; base; cost; design; flexibility; follow-up; improved; indexing; member; men; men who have sex with men; metropolitan; non-drug; novel; peer; programs; public health emergency; public health relevance; sex risk; social

DESCRIPTION (provided by applicant): In the US, the highest rates of HIV infection are among Black men who have sex with men (MSM). According to the CDC National HIV Behavioral Surveillance system (NHBS) in 2004-5, Baltimore had the highest HIV rates among Black MSM with prevalence of 51% and an incidence rates estimated to be 8% per year. In the 2008 NHBS survey of Black MSM, 45% were positive. There is also an alarmingly high rate of seropositive Black MSM who are not aware of their positive HIV status. The percent of positive Black MSM in the Baltimore NHBS survey who reported that they were unaware of their serostatus was 64% in 2004-5 and 77% in 2008. There is a dearth of Interventions that have demonstrated efficacy or effectiveness in reducing HIV risk behaviors among Black MSM. Many researchers have documented the importance of developing and tailoring HIV prevention programs to issues unique to Black MSM. Based on the process evaluation findings from our recent pilot HIV prevention intervention for Black MSM and using a randomized clinical trial design, we plan to randomize 360 Black MSM to either a 6-session Peer Health Educator intervention condition or an equal attention control condition. We have designed the experimental intervention to provide Black MSM an opportunity to perform a positive social role of peer health educator. This role allows for HIV preventive advocacy and practices without focusing on stigmatizing identities or behaviors, such as HIV seropositive or current drug use status. The primary goal of the proposed intervention is to increase HIV risk reduction among Black MSM and increase VCT, risk reduction, and access to HIV medical care among their risk network members. Peer Health Educators will be encouraged to recruit up to 5 sex partners and other Black MSM for VCT. The first 2 network members who receive VCT will be invited to the longitudinal study. It is anticipated that on average 1.5 risk network members will enroll in the longitudinal study. Thus, the sample will be 360 Index participants and 540 network members. We will follow-up both index and network participants' in six- month intervals for 18 months. The main outcomes will be HIV sexual risk behaviors and number of network members recruited for VCT. Mediating social environmental and individual level factors will also be assessed. As illicit drug use among Black MSM is a risk factor for HIV and there are high rates of drug use among MSM in Baltimore, we propose stratifying recruitment by drug use, with half of the index participants being current users of cocaine, crack, methamphetamines or non-prescription opiates. PUBLIC HEALTH RELEVANCE: There is an urgent need for effective behavioral interventions for HIV prevention, testing, and medical care for Black MSM. The proposed intervention is designed to promote and diffuse HIV risk reduction and VCT and reach a diverse group of Black MSM and their risk partners. This intervention has been designed to be low cost, sustainable, and feasible for health departments and community-based organizations to implement. It is also designed to be culturally appropriate for Black urban MSM and their network members.

描述（由申请人提供）：在美国，与男性发生性关系的黑人感染率最高。根据2004 - 5年度CDC国家艾滋病毒行为监测系统（NHB）的数据，巴尔的摩在黑色MSM中的艾滋病毒率最高，患病率为51％，发病率估计为每年8％。在2008年NHBS对黑色MSM的调查中，有45％为正。还没有意识到其阳性艾滋病毒状况的血清阳性黑色MSM的速度令人震惊。巴尔的摩NHBS调查中的黑色正MSM百分比表示，他们不知道自己的血清塔图斯在2004 - 5年为64％，在2008年为77％。缺乏干预措施，这些干预措施证明了在降低黑色MSM中降低HIV风险行为的功效或有效性。许多研究人员已经记录了开发和调整预防艾滋病毒预防计划对黑人MSM独特的重要性的重要性。基于我们最近针对黑色MSM的试点艾滋病毒预防干预措施的过程评估结果，并使用随机临床试验设计，我们计划将360黑色MSM随机化为6条经验的同伴健康教育者干预条件或同样的注意力控制条件。我们设计了实验干预措施，为黑人MSM提供了一个与同伴健康教育者一起发挥积极社会作用的机会。这种角色允许艾滋病毒预防性的倡导和实践，而无需集中精力使身份或行为（例如HIV血清阳性或当前的药物使用状态）。拟议的干预措施的主要目标是增加黑人MSM的艾滋病毒风险降低，并增加VCT，降低风险以及在其风险网络成员中获得艾滋病毒医疗服务。将鼓励同伴健康教育者为VCT招募多达5个性伴侣和其他黑色MSM。接收VCT的前两个网络成员将被邀请参加纵向研究。预计平均1.5风险网络成员将参加纵向研究。因此，样本将为360个索引参与者和540个网络成员。我们将在18个月的时间间隔六个月内在六个月内跟进指数和网络参与者。主要结果将是HIV性风险行为和VCT招募的网络成员数量。还将评估调解社会环境和个人层面因素。由于黑色MSM中非法药物使用是HIV的危险因素，巴尔的摩的MSM中有较高的药物使用率，我们建议通过吸毒进行分层招募，其中一半的指数参与者是可卡因，裂缝，甲基苯丙胺或非预订鸦片的现任使用者。 公共卫生相关性：迫切需要对黑人MSM进行预防，测试和医疗护理的有效行为干预措施。拟议的干预措施旨在促进和扩散艾滋病毒风险的降低和VCT，并与一组不同的黑色MSM及其风险伴侣融合。该干预措施旨在供卫生部门和社区组织实施低成本，可持续性和可行。它也旨在在文化上适合黑人城市MSM及其网络成员。