POSSE Project: A Community-Level Intervention for Black YMSM

POSSE 项目：针对黑人 YMSM 的社区级干预

• 批准号: 9037710
• 负责人: Sybil Hosek
• 金额: $ 66.68万
• 依托单位: HEKTOEN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9037710
• 关键词: AIDS prevention; AIDS/HIV problem; Affect; Age; Anus; Area; Beauty; Behavior; Behavioral; Biological; Characteristics; Chicago; Cities; Communities; Contracts; Coupled; Data; Discrimination; Education; Education Projects; Educational Intervention; Effectiveness; Epidemic; Evaluation; Event; Family; Gays; Gender Identity; HIV; HIV Infections; HIV risk; HIV/STD; Health; House Call; Housing; Hybrids; Intervention; Intervention Studies; Interview; Knowledge; Leadership; Methods; Modeling; Participant; Performance; Philadelphia; Population; Prevalence; Prevention; Preventive Intervention; Process; Public Health; Recruitment Activity; Reporting; Research; Research Project Grants; Risk; Risk Behaviors; Risk Reduction; Safe Sex; Schools; Sexual Partners; Social Network; Structure; Testing; TimeLine; Training; United States; Use Effectiveness; Work; base; behavior change; community based participatory research; design; effective intervention; experience; follow-up; high risk men; improved; innovation; metropolitan; peer; pilot trial; post intervention; programs; research to practice; sex; sex risk; social norm; social stigma; success; theories; transmission process; trend; trial design; young men who have sex with men

 DESCRIPTION (provided by applicant): Black young men who have sex with men (BYMSM) are at high risk for contracting and transmitting HIV, and represent a priority population for developing effective interventions. Within the House Ball community (HBC), a clandestine subculture of the Black gay community, HIV is highly stigmatized. This stigma, coupled with high HIV prevalence rates and elevated levels of undiagnosed/untreated HIV infection, places BYMSM in HBCs at incredible risk for HIV infection. Community-level interventions that target social norms, behavior, and stigma in the HBC are sorely needed in order to make a broader impact among BYMSM. Building on prior work in the community, this study proposes to launch an innovative Effectiveness-Implementation Hybrid Type 2 trial to examine the effectiveness and implementation of a community-level HIV prevention intervention (called POSSE) based on popular opinion leader (POL) models across two cities with similar HBCs, Chicago and Philadelphia. The proposed study has two specific aims: 1) To determine the effectiveness of a POL intervention, POSSE, to decrease sexual risk behavior (UAI), STIs and HIV stigma among BYMSM in the HBC; and 2) To evaluate the processes, strategies, barriers and facilitators for the implementation of POSSE delivered across two distinct metropolitan areas with high HIV prevalence among BYMSM and similar House Ball Communities. To examine these aims, we will first use social network strategies to identify, screen, and recruit POLs (n=75) from the Philadelphia HBC. We will then gather baseline behavioral and biological (HIV/STI testing) data in both Chicago and Philadelphia (n=100 BYMSM per city) and train the Philadelphia POLs to implement the POSSE intervention. We will conduct an implementation-focused process evaluation to assess fidelity to the POSSE intervention; number, content, spread, and acceptability of risk reduction messages; age appropriateness of the messages; acceptability of the overall intervention; and barriers/facilitators to implementation. Next, we will complete follo-up assessments every 6 months post- intervention in both cities (n=100 BYMSM per city at each assessment point). We will also assess behavior change in those delivering the intervention (POLs) at each assessment point. We will conduct implementation- focused qualitative interviews with POLs (n=15) and community participants (n=30) from Philadelphia. Last, we will implement POSSE in Chicago by repeating the steps outlined above, continuing assessments in both cities, and conducting qualitative interviews in Chicago. This study is significant and innovative in that it proposes to simultaneously evaluate the effectiveness and implementation of a community-level intervention for BYMSM, a group disproportionately impacted by the HIV epidemic, in order to expeditiously move effective public health programming into the community.

 描述（由申请人提供）：男男性行为者 (BYMSM) 感染和传播艾滋病毒的风险很高，是秘密亚文化 House Ball 社区 (HBC) 中制定有效干预措施的重点人群。在黑人同性恋群体中，艾滋病毒受到高度污名，再加上艾滋病毒感染率高以及未诊断/未治疗的艾滋病毒感染率升高，使得 HBC 中的 BYMSM 面临极高的艾滋病毒感染风险。为了在 BYMSM 中产生更广泛的影响，迫切需要针对 HBC 中的社会规范、行为和耻辱进行社区层面的干预。在社区先前工作的基础上，本研究建议推出一种创新的有效性-实施混合类型 2。一项试验旨在检验社区级艾滋病毒预防干预措施（称为 POSSE）的有效性和实施情况，该干预措施基于芝加哥和费城这两个具有类似 HBC 的城市的民意领袖 (POL) 模型。拟议的研究有两个具体目标：1)决定POL 干预措施 POSSE 在减少 HBC 的 BYMSM 中的性危险行为 (UAI)、性传播感染和艾滋病毒耻辱方面的有效性；以及 2) 评估在两个不同的地区实施 POSSE 的流程、策略、障碍和促进因素； BYMSM 和类似 House Ball 社区中 HIV 流行率较高的大都市地区 为了检验这些目标，我们将首先使用社交网络策略从费城 HBC 中识别、筛选和招募 POL（n=75）。然后，我们将在芝加哥和费城收集基线行为和生物学（HIV/STI 检测）数据（每个城市 n=100 BYMSM），并培训费城 POL 实施 POSSE 干预措施。我们将进行以实施为重点的流程评估以进行评估。对 POSSE 干预措施的忠诚度；风险降低信息的数量、内容、传播和可接受性；总体干预措施的可接受性；以及实施的障碍/促进因素。两个城市干预后 6 个月（每个评估点每个城市 100 名 BYMSM）我们还将评估每个评估点实施干预措施的人员 (POL) 的行为变化。我们将与 POL 进行以实施为重点的定性访谈。 (n=15) 和来自费城的社区参与者 (n=30) 最后，我们将通过重复上述步骤、在两个城市继续进行评估并在芝加哥进行定性访谈来实施 POSSE。这项研究意义重大且具有创新性。在那它建议同时评估 BYMSM（受艾滋病毒流行影响尤为严重的群体）社区一级干预措施的有效性和实施情况，以便迅速将有效的公共卫生规划转移到社区。