Risk Reduction for Urban Substance Using MSM

使用 MSM 降低城市物质风险

• 批准号: 8215856
• 负责人: Steven P Kurtz
• 金额: $ 30.57万
• 依托单位: NOVA SOUTHEASTERN 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 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8215856
• 关键词: AIDS prevention; Achievement; Acquired Immunodeficiency Syndrome; Adult; Alcohol or Other Drugs use; Area; Awareness; Behavior; Behavior Therapy; Behavioral; Caring; Characteristics; Cities; Communities; Coping Behavior; Counseling; Development; Drug usage; Economics; Effectiveness; Effectiveness of Interventions; Environment; Esthesia; Ethnic Origin; Exercise; Family; Florida; Funding; Gays; Goals; Group Processes; HIV; HIV Infections; Health; Health behavior; Home environment; Incidence; Individual; Intervention; Intervention Studies; Life; Link; Literature; Living Wills; Measures; Mediating; Mental Depression; Mental Health; Meta-Analysis; Minority; Modeling; National Institute of Drug Abuse; Nature; Outcome Measure; Participant; Pilot Projects; Population; Prevalence; Preventive Intervention; Public Health; Race; Randomized Clinical Trials; Recording of previous events; Relative (related person); Reliance; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Risk-Taking; Role; Sampling; Self Efficacy; Social Controls; Social isolation; Social status; Societies; Structure; Subgroup; Substance abuse problem; Surveys; System; Testing; authority; base; coping; demographics; empowerment; follow-up; high risk; improved; innovation; meetings; men; men who have sex with men; metropolitan; migration; prevention service; psychologic; racial and ethnic; sex; sex risk; sexually active; skills; social; stress management; theories; transmission process; urban area; AIDS prevention; Achievement; Acquired Immunodeficiency Syndrome; Adult; Alcohol or Other Drugs use; Area; Awareness; Behavior; Behavior Therapy; Behavioral; Caring; Characteristics; Cities; Communities; Coping Behavior; Counseling; Development; Drug usage; Economics; Effectiveness; Effectiveness of Interventions; Environment; Esthesia; Ethnic Origin; Exercise; Family; Florida; Funding; Gays; Goals; Group Processes; HIV; HIV Infections; Health; Health behavior; Home environment; Incidence; Individual; Intervention; Intervention Studies; Life; Link; Literature; Living Wills; Measures; Mediating; Mental Depression; Mental Health; Meta-Analysis; Minority; Modeling; National Institute of Drug Abuse; Nature; Outcome Measure; Participant; Pilot Projects; Population; Prevalence; Preventive Intervention; Public Health; Race; Randomized Clinical Trials; Recording of previous events; Relative (related person); Reliance; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Risk-Taking; Role; Sampling; Self Efficacy; Social Controls; Social isolation; Social status; Societies; Structure; Subgroup; Substance abuse problem; Surveys; System; Testing; authority; base; coping; demographics; empowerment; follow-up; high risk; improved; innovation; meetings; men; men who have sex with men; metropolitan; migration; prevention service; psychologic; racial and ethnic; sex; sex risk; sexually active; skills; social; stress management; theories; transmission process; urban area

DESCRIPTION (provided by applicant): Although recent meta-analyses of the HIV prevention intervention literature have demonstrated that behavioral interventions reduce sexual risk-taking among men who have sex with men (MSM), interventions for not-in-treatment substance using MSM are lacking. Consequently, and based upon overwhelming evidence that substance use is a primary driver of HIV infection among urban MSM, public health authorities have identified the development of efficacious interventions for substance using MSM as a concern of the highest priority. The proposed study aims to test a new intervention based upon psychological empowerment theory that, in preliminary field tests, produced high levels of acceptability and participation, as well as large reductions in sexual risks and substance use, among a sample of ethnically-diverse, high risk, substance using, HIV+ and -negative MSM. The intervention to be tested is based upon a theory of MSM health risk behaviors that posits that urban gay "fast lane" subcultures present risk environments - including lack of integration with the larger society, normative hypersexuality and substance use, homophobia, sexual competitiveness, and an emphasis on entertainment and escapism - that become problematic for a sizable minority of MSM who live in them. Within this context, the specific aims of the proposed 5-year study are to: 1) describe the nature and extent of substance use and sexual risk behaviors in a sample of 500 sexually active, substance using, not-in- treatment MSM in urban South Florida (Miami/Ft. Lauderdale); 2) identify the independent covariates of baseline substance abuse and sexual risks; 3) evaluate, through random assignment of participants, the relative effectiveness of two intervention conditions in reducing sexual risks and substance use, as measured at 3-, 6-, and 12-month follow-up assessments: a) an innovative five-session risk reduction intervention derived from psychological empowerment theory titled Project GOAL; and, b) a community standard-of-care HIV counseling and testing Comparison Condition. The proposed project responds directly to the calls by public health authorities for the development of efficacious risk reduction interventions for substance using MSM. South Florida consistently ranks in the top three MSAs nationwide in HIV and AIDS incidence and prevalence. South Florida is also a well-known migration point for MSM of extraordinarily diverse backgrounds with high rates of non-injection drug use. This setting provides an excellent context for testing an innovative intervention among high risk substance using MSM who are in need of HIV prevention services. Men who have sex with men (MSM) continue to be at high risk for acquisition and transmission of HIV, and substance use is associated with higher risk. Public health authorities have identified the development of efficacious interventions for substance using MSM as a concern of the highest priority. The proposed randomized clinical trial research aims to test a new intervention based upon psychological empowerment theory that demonstrated large reductions in sexual risks and substance use among a sample of diverse, high risk, heavy substance using MSM in preliminary field tests.

描述（由申请人提供）：尽管最近对HIV预防干预文献的荟萃分析表明，行为干预措施减少了与男性发生性关系的男性（MSM）的性冒险，但缺乏对使用MSM进行非疗法物质的干预措施。因此，基于大量证据表明，使用物质是城市MSM中艾滋病毒感染的主要驱动力，公共卫生当局已经确定了使用MSM的有效干预措施的发展，以此作为最高优先级的关注。拟议的研究旨在基于心理授权理论来测试新的干预措施，在初步现场测试中，在种族多样性，高风险的样本中，使用HIV++和 - 维度的MSM产生了高水平的可接受性和参与度以及性风险和药物使用的大量降低。要测试的干预措施基于MSM健康风险行为的理论，该理论认为，城市同性恋“快车”亚文化具有风险环境，包括与较大的社会缺乏融合，相互性的超情感和毒品，同性恋恐惧症，性竞争力，以及对娱乐和环保的强调 - 对MSM的生活变得不合时宜。在这种情况下，拟议的5年研究的具体目的是：1）描述500个性活跃的，在南佛罗里达州城市（Miami/Ft。Lauderdale）中使用500个性活跃，使用，不接受MSM的物质风险行为的性质和程度； 2）确定基线药物滥用和性风险的独立协变量； 3）通过随机分配参与者评估两种干预条件在减少性风险和毒品使用方面的相对有效性，如3，6和12个月的随访评估：a）创新的五次经营风险降低干预措施从心理授权理论的标题为项目目标中得出； b）社区保健艾滋病毒咨询和测试比较条件。拟议的项目直接响应了公共卫生当局使用MSM开发有效风险干预措施的呼吁。南佛罗里达州始终在全国艾滋病毒和艾滋病发病率和患病率的全国三名MSA中排名前三。南佛罗里达州也是众所周知的迁移点，具有多种多样背景的MSM，不注射药物使用率很高。该设置为使用需要艾滋病毒预防服务的MSM在高风险物质中进行创新干预提供了一个良好的背景。与男性发生性关系的男性（MSM）继续处于收购和传播艾滋病毒的高风险中，并且使用物质与较高的风险有关。公共卫生当局已经确定了使用MSM的有效干预措施的发展，以此作为最高优先事项的关注。拟议的随机临床试验研究旨在基于心理授权理论测试新的干预措施，该理论表明，在初步现场测试中使用MSM的多样化，高风险，重型物质样本中的性风险和物质使用大量降低。