NIMH Collaborative HIV/STD Prevention Trial among young, low-income men in Peru

NIMH 在秘鲁低收入年轻男性中开展艾滋病毒/性病协作预防试验

• 批准号: 7771642
• 负责人: Kelika Anne Konda
• 金额: $ 2.31万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-06 至 2010-05-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7771642
• 关键词: Address; Alcohols; Behavior; Bisexual; Chlamydia; Cities; Communities; Computer software; Data; Diffusion of Innovation; Drug usage; Effectiveness of Interventions; Epidemic; Ethnography; Female; Gays; General Population; Goals; Gonorrhea; Government; Group Identifications; HIV; Human Herpesvirus 2; Institutes; International; Intervention; Laboratories; Lead; Low income; National Institute of Mental Health; National Research Service Awards; Parents; Peru; Pharmaceutical Preparations; Population; Prevalence; Prevalence Study; Preventive Intervention; Reporting; Research; Resources; Risk; Risk Behaviors; Role; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Site; Subgroup; Surveys; Syphilis; Testing; Training; Underemployment; Unemployment; Unsafe Sex; Woman; Work; aged; base; community intervention; condoms; disorder prevention; disorder risk; efficacy testing; efficacy trial; gang; high risk; high risk men; intervention effect; male; men; men who have sex with men; outreach; peer; public health relevance; response; sex; sex risk; statistical center; theories

DESCRIPTION (provided by applicant): In Peru, the HIV epidemic is primarily concentrated among men who have sex with men (MSM). The Peruvian government's response to the HIV epidemic has primarily focused on a subset of MSM who can be identified through peer outreach. This is an appropriate use of their limited resources; however, these efforts do not reach all MSM, especially men who have sex with men and women (MSMW). The recent increase of female cases of HIV, evidenced by the change in the male to female ratio from 10:1 in the early 1990's to 3:1 today and that HIV risk among women is influenced by the sexual behavior of their male partner, including bisexual behavior demonstrate the importance of understanding the behavior of MSMW in this setting. Our previous research in Peru identified a sub-population of young, un- or underemployed, high-risk men, referred to as "esquineros" (or 'Corner Men'), who are heterosexually-identified, but report much higher levels of bisexual behavior than the general population. This study proposes to further describe this sub-population in order to characterize their role in the HIV epidemic as well as determining the efficacy of the NIMH Collaborative HIV/STD Prevention Trial among them. The goal of this HIV/STD Prevention Trial was to test the efficacy of the Community Popular Opinion Leader (CPOL) intervention, which is based on the "Diffusion of Innovations" theory. The intervention worked to change community norms by training community popular opinion leaders to act as innovators of condom use behaviors to influence condom use increases among the peers. This trial was conducted between 2003 and 2007 among esquineros aged 18-40 years in three coastal Peruvian cities: Lima, Trujillo and Chiclayo. The proposed study is not part of the planned statistical analysis of the parent trial and will be the only in depth analysis of the effect of the CPOL trial on the esquinero sub-population. Aim 1: Identify subgroups among the esquineros based on differences in HIV/STI prevalence and sexual risk behavior as defined by partner selection (e.g. men only, women and men, or women only) and partner concurrency as well as alcohol/drug use prior to sex using baseline data. Aim 2: Demonstrate the effect of the CPOL intervention on sexual risk behavior. We hypothesize that unprotected sex with a non-primary partner in the past 3 months will decrease among esquineros in intervention communities versus control community. Aim 3: Demonstrate the effect of the CPOL intervention among subgroups of esquineros identified in Aim 1, sub-group identification is hypothesized to modify the effect of the intervention. PUBLIC HEALTH RELEVANCE: The proposed study will lead to further information on this newly identified high-risk, sub-population and to characterize their role in the HIV epidemic in Peru.

描述（由申请人提供）：在秘鲁，HIV流行主要集中在与男性发生性关系的男性中（MSM）。秘鲁政府对艾滋病毒流行的反应主要集中在可以通过同伴外展确定的MSM的一部分。这是对他们有限的资源的适当使用；但是，这些努力并没有达到所有MSM，尤其是与男人和女人发生性关系的男性（MSMW）。女性艾滋病毒病例的最近增加，这是由于男性与女性比率从1990年代初的10：1变化到今天的3：1，而女性的艾滋病毒风险受其男性伴侣的性行为的影响，包括双性恋行为，表明了在这种情况下了解MSMW行为的重要性。我们先前在秘鲁的研究确定了年轻，失业或不足的高风险男人的子人群，被称为“ Esquineros”（或“角落男人”），这些人是异性恋，但报告的双性恋行为水平比一般人群高得多。这项研究建议进一步描述这种子人群，以表征其在HIV流行中的作用，并确定NIMH协作HIV/STD预防试验的疗效。这项艾滋病毒/性病预防试验的目的是测试社区大众舆论领袖（CPOL）干预的功效，该干预基于“创新的扩散”理论。这项干预措施通过训练社区流行的意见领导者作为避孕套使用行为的创新者来改变社区规范，以影响同龄人之间的使用避孕套的使用。这项试验是在2003年至2007年之间在三个沿海秘鲁城市的18-40岁的Esquineros进行的：利马，特鲁吉洛和奇卡洛。拟议的研究不是父母试验计划的统计分析的一部分，并且将是CPOL试验对Esquinero子人群的影响的唯一深入分析。目标1：根据伴侣选择（例如，仅男性，只有男性或妇女）以及伴侣并发以及使用基线数据在性生活之前的饮酒/药物使用，基于HIV/STI患病率和性风险行为的差异来确定Esquineros之间的亚组。目标2：证明CPOL干预对性风险行为的影响。我们假设过去三个月中与非主要伙伴的无保护性在干预社区与控制社区中的性行为将减少。 AIM 3：证明在AIM 1中鉴定的Esquineros亚组中CPOL干预的影响，假设亚组鉴定以修改干预措施的效果。 公共卫生相关性：拟议的研究将导致有关这种新确定的高风险，子人群的进一步信息，并表征其在秘鲁的HIV流行中的作用。