Couples-Based HIV/STI Prevention for Drug-Involved, African American MSM

针对吸毒、非裔美国男男性接触者的基于夫妻的艾滋病毒/性传播感染预防

• 批准号: 8138790
• 负责人: Elwin Wu
• 金额: $ 63.96万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8138790
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adult; Affect; African American; Alcohols; Anus; Attention; Behavioral; Biological; Biological Assay; Bisexual; Categories; Centers for Disease Control and Prevention (U.S.); Chlamydia; Communities; Couples; Data; Drug usage; Drug user; Epidemiology; Evidence based intervention; Funding; Gap Junctions; Gays; Goals; Gonorrhea; HIV; HIV Infections; Harm Reduction; Health; Heterosexuals; Incidence; Infection prevention; Intervention; Lead; Lesbian; Letters; Life; Mediator of activation protein; Mental Health; Methamphetamine; Minority; Outcome; Participant; Pharmaceutical Preparations; Pilot Projects; Population Heterogeneity; Pre-Post Tests; Prevention Research; Prevention program; Preventive Intervention; Provider; Public Health; Qualifying; Randomized Clinical Trials; Recording of previous events; Relative (related person); Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Services; Sexual Partners; Sexually Transmitted Diseases; Shapes; Shoulder; Staging; Subgroup; Target Populations; Testing; Vaccines; base; clinically significant; design; efficacy testing; evidence base; follow-up; health disparity; high risk; innovation; intervention effect; men; men who have sex with men; primary outcome; racial and ethnic; research study; scale up; sex; sex risk; social; tool; transgender; transmission process

DESCRIPTION (provided by applicant): The purpose of this study is to rigorously test the efficacy of a couples-based HIV and sexually transmitted infection (HIV/STI) preventive intervention for African American/Black men who have sex with men (MSM) in same sex intimate relationships in which at least one partner is using stimulants (herein referred to as "stimulant-using, African American MSM couples"). The proposed study is a logical progression from the investigative team's prior formative research to take an existing couples based intervention originally for heterosexual couples ("Connect") and revise/tailor it for methamphetamine-using, African American MSM couples. The adapted intervention was pilot tested using a pre-/post-test design. Findings revealed statistically and clinically significant reductions in sexual and drug risk behaviors. In addition, this formative research informs the proposed study in several additional ways: (1) the importance of addressing stimulants beyond methamphetamine with African American MSM; (2) qualitative data on how a couples-based intervention can interrupt relationship dynamics more unique to drug-involved, African American MSM couples that lead to risk behavior; and (3) couples-based HIV prevention research is feasible, promising, and safe for stimulant using, African American MSM. This earlier research has culminated with a 7-session, manualized intervention entitled "Connect 'n Unite" (or CNU-pronounced "seein' you"-for short) as a candidate couples-based HIV preventive intervention for stimulant-using, African American MSM couples. The proposed study is a randomized clinical trial with 270 stimulant-using, African American MSM couples to test the impact of CNU versus a wellness promotion (WP) attention control condition on behavioral and biologically assayed outcomes over a 12-month follow-up period. The study has the following primary aims: (1) to test whether participants assigned to CNU engage in lower HIV/STI behavioral risk-fewer number of unprotected acts of anal intercourse, greater proportion of protected acts of anal intercourse, and fewer number of sexual partners-compared to participants assigned to WP; (2) to test whether participants assigned to CNU have lower cumulative incidence of STIs-chlamydia and gonorrhea-confirmed via biological assay compared to participants assigned to WP; and (3) to test whether participants assigned to CNU engage in less drug use and drug-related HIV risk (i.e., sex under the influence of drugs/alcohol) compared to participants assigned to WP. If successful, this study will advance the field by providing an evidence-based, innovative intervention that can be delivered in drug treatment and other service settings to reduce the spread of HIV among stimulant-using, African American MSM. PUBLIC HEALTH RELEVANCE: This study addresses the overrepresentation of the African American/Black community among those living with HIV/AIDS in the U.S. as well as men who have sex with men (MSM), the transmission category that accounts for the majority of HIV infections. In the absence of a vaccine or cure for HIV infection, behavioral risk reduction represents the best public health tool for prevention of HIV transmission. The proposed randomized clinical trial will rigorously test an innovative, couples-based intervention targeting the intersection of stimulant use and sexual risk behavior among racial/ethnic and sexual minorities, with the ultimate goal providing an evidence-based intervention that can be delivered in drug treatment and other service settings to reduce the spread of HIV among stimulant-using, African American/Black MSM.

描述（由申请人提供）：本研究的目的是严格测试基于夫妻的艾滋病毒和性传播感染（HIV/STI）的预防性干预（HIV/STI）的预防性干预措施，他们与男性发生性关系（MSM）在相同的性别亲密关系中至少一种伴侣使用兴奋剂（以下是一种兴奋剂）（在此提到了“刺激性刺激性”，“刺激性的MSS MSS MSS MSS COUN AMSSEMANS MSS C”）COUN''''拟议的研究是调查团队先前的形成性研究的逻辑进展，以最初针对异性恋夫妇（“ Connect”）进行基于夫妻的干预措施，并为使用甲基苯丙胺的非裔美国人MSM夫妇进行修订/量身定制。使用前/后测试设计对改编的干预进行了试点测试。发现在统计和临床上显着减少了性和药物风险行为。此外，这项形成性研究以其他方式为拟议的研究提供了信息：（1）与非裔美国人MSM一起解决甲基苯丙胺以外的兴奋剂的重要性； （2）关于基于夫妻干预的定性数据如何中断涉及药物涉及的非裔美国人MSM夫妇更独特的关系动态，从而导致风险行为； （3）基于夫妻的艾滋病毒预防研究是可行的，有前途的，并且可以安全使用非裔美国人MSM。这项较早的研究以7条经验的手动干预措施为题为“ Connect'N Unite”（或简称为“ Seein'Y You”），作为基于候选夫妇的HIV预防性干预兴奋的非裔美国人MSM夫妇。拟议的研究是一项随机临床试验，其中有270种刺激性的非裔美国人MSM夫妇在12个月的随访期内测试CNU与健康促进（WP）注意控制条件对行为和生物学测定结果的影响。该研究具有以下主要目的：（1）测试分配给CNU的参与者是否参与了较低的艾滋病毒/STI行为风险 - 肛门交流的不受保护的行为的数量，较大的肛门性交行为比例更大，较少的性伴侣数量较少，使分配给WP的参与者的性伴侣数量更少； （2）与分配给WP的参与者相比，通过生物测定法确认了分配给CNU的参与者是否具有较低的Stis-Chlamydia和Gonorrhea-condea的累积发生率； （3）与分配给WP的参与者相比，要测试分配给CNU的参与者是否从事较少的药物使用和与药物有关的HIV风险（即在药物/酒精的影响下的性别）。如果成功的话，这项研究将通过提供基于证据的创新干预措施来推进该领域，该干预措施可以在药物治疗和其他服务环境中进行，以减少艾滋病毒在使用刺激性的非裔美国人MSM中的传播。 公共卫生相关性：这项研究涉及在美国患艾滋病毒/艾滋病的人和与男性发生性关系的男性（MSM）的非裔美国人/黑人社区（MSM）的过度代表性，这是大多数艾滋病毒感染的传播类别。在没有疫苗或治疗艾滋病毒感染的情况下，行为风险的降低代表了预防艾滋病毒传播的最佳公共卫生工具。拟议的随机临床试验将严格测试针对种族/族裔和性少数群体中刺激性使用和性风险行为相交的创新的，基于夫妻的干预措施，其最终目标最终可以提供基于证据的干预措施，可提供在药物治疗和其他服务环境中，以减少刺激性艾滋病毒的兴奋性，以减少刺激性的艾滋病毒范围，利用刺激性，使用非洲人，使用非洲人，非洲黑人黑人/黑人黑人/黑人。