Adaptation and feasibility of Many Men Many Voices (3MV), an HIV prevention intervention to reduce intersectional stigma and increase HIVST among YSMM residing in Ghanaian slums

多男多声 (3MV) 的适应和可行性，这是一种艾滋病毒预防干预措施，旨在减少居住在加纳贫民窟的 YSMM 中的交叉耻辱并增加艾滋病毒传播与传播

• 批准号: 10756009
• 负责人: Gamji Rabiu Abu-Ba'are
• 金额: $ 21.66万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10756009
• 关键词: AIDS prevention; Address; Africa; African ancestry; Age; Amendment; Behavior; Black race; Caring; Clinic; Communities; Diagnostic Reagent Kits; Discrimination; Economics; Ensure; Face; Feedback; Geography; Ghana; HIV; HIV Infections; Health; Health Care Visit; Health care facility; Home; Human immunodeficiency virus test; Intervention; Interview; Knowledge; Location; Longevity; Manuals; Measures; Modeling; Modification; Multiple Partners; Nurses; Outcome; Persons; Preparation; Prevalence; Privacy; Provider; Randomized, Controlled Trials; Recommendation; Research; Research Personnel; Resource-limited setting; Risk; Science; Scientific Advances and Accomplishments; Sexual and Gender Minorities; Slum; Stigmatization; Surveys; Testing; Training; Transact; Voice; Work; acceptability and feasibility; behavior influence; community organizations; evidence based guidelines; experience; gender expression; high risk population; implementation strategy; improved; marginalized community; men; post intervention; preventive intervention; primary outcome; scale up; secondary outcome; self testing; sex; sexual minority men; social; social stigma; socioeconomics; testing uptake; uptake; willingness; young adult

Project Summary Young sexual minority men (YSMM) make up 63% of the HIV prevalence (18%) among sexual minority men in Ghana, which has a 2% national prevalence rate. Our previous studies that included YSMM in Ghana show that internalized and interpersonal intersectional (HIV, sexual minority, gender expression) stigma and insufficient HIV knowledge impedes HIV testing among SMM. For those in slums, the social and economic barriers in slum communities can intertwine with intersectional stigma to exacerbate the risk of HIV infections and discourage HIV testing among YSMM. HIV self-testing (HIVST) has the efficacy of increasing testing, providing privacy and convenience. Yet its uptake among YSMM remains daunting due to insufficient expertise and intersectional stigma. We propose to adapt the Many Men, Many Voices (3MV) to a modified version dubbed LAFIYA (local word meaning wellness) to address intersectional stigma and increase HIVST among YSMM. Whereas 3MV has the efficacy to increase HIV testing among SMM, adaptation for YSMM in slums will show its applicability to young adults and YSMM in a different geographic and socioeconomic context in Ghana and SSA. LAFIYA will also extend 3MV’s utility for HIV prevention by utilizing scientific advancements around intersectional stigma and HIVST options, which came after the original version. Guided by the eight steps of the ADAPTT-IT model, we will implement the following aims. 1) Assess intersectional stigma and options for HIVST implementation among YSMM, 2) Adapt 3MV to LAFIYA to address intersectional stigma and HIVST among YSMM, and 3) Test acceptance, feasibility, appropriateness, and preliminary efficacy of LAFIYA to address intersectional stigma and increase HIVST uptake. In Aim 1, we will conduct in-depth interviews with YSMM (n= 20), providers (n=20); clinics=10, and community-based organizations (=10) that work with YSMM to evaluate experiences of intersectional stigma and options for implementing HIV self-testing among YSMM. In Aim 2, we will conduct a summative analysis to interpret findings from AIM1 to identify fit and modifications to tailor 3MV to the realities of YSMM in Ghanaian slums. In AIM 3, we will test the acceptability, feasibility, appropriateness, and preliminary efficacy of LAFIYA through a pilot pre-post intervention among YSMM (n=60). The YSMM will receive the LAFIYA intervention and have the option to pick up HIVST and contact of ART providers for support if they test positive. We will assess primary outcomes (acceptability, feasibility, appropriateness) and secondary outcomes (preliminary efficacy) using baseline, immediate, and 3-month post-intervention surveys. The study will inform the preparation of a clustered randomized control trial to measure LAFIYA’s efficacy in increasing HIVST among YSMM. The findings will inform intersectional stigma reduction and HIVST implementation strategies among YSMM, slums, SSA, and other high-risk populations in different settings.

项目概要 年轻性少数男性 (YSMM) 占性少数男性艾滋病毒感染率 (18%) 的 63% 加纳的全国患病率为 2%，我们之前对加纳 YSMM 进行的研究显示， 内化和人际交叉（艾滋病毒、性少数、性别表达）耻辱和不足 HIV 知识阻碍了 SMM 中的 HIV 检测 对于贫民窟中的人来说，贫民窟中的社会和经济障碍。 社区可能与交叉耻辱交织在一起，加剧艾滋病毒感染的风险和沮丧 YSMM 中的 HIV 自我检测（HIVST）具有增加检测、提供隐私和保护的功效。 然而，由于专业知识和交叉性不足，它在 YSMM 中的采用仍然令人畏惧。 我们建议将《Many Men, Many Voices》(3MV) 改编为名为 LAFIYA（本地）的修改版本。 一词（意思是健康）来解决 YSMM 中的交叉耻辱并增加 HIVST，但 3MV 除外。 提高 SMM 中艾滋病毒检测的功效，贫民窟 YSMM 的适应将显示其适用性 加纳和 SSA 的不同地理和社会经济背景的年轻人和 YSMM 将。 还利用围绕交叉耻辱和疾病的科学进步，扩展了 3MV 在艾滋病毒预防方面的效用 HIVST 选项是在原始版本之后出现的，我们以 ADAPTT-IT 模型的八个步骤为指导。 将实现以下目标 1) 评估交叉污名和实施 HIVST 的选择。 YSMM，2) 将 3MV 应用于 LAFIYA，以解决 YSMM 中的交叉耻辱和 HIVST，以及 3) 测试 LAFIYA 解决交叉污名和问题的接受度、可行性、适当性和初步功效 在目标 1 中，我们将与 YSMM（n=20）、提供者（n=20）进行深入访谈； 诊所=10，以及与 YSMM 合作评估患者经验的社区组织 (=10) 在 YSMM 中实施艾滋病毒自我检测的交叉耻辱和选择 在目标 2 中，我们将开展一项活动。 总结性分析，解释 AIM1 的结果，以确定适合性和修改，以根据现实情况定制 3MV 在 AIM 3 中，我们将测试 YSMM 在加纳贫民窟的可接受性、可行性、适当性和初步性。 通过在 YSMM 中进行试点前后干预来提高 LAFIYA 的疗效 YSMM 将接受 LAFIYA。 如果测试呈阳性，可以选择接受 HIVST 治疗并联系 ART 提供者寻求支持。 我们将评估主要结果（可接受性、可行性、适当性）和次要结果 （初步疗效）使用基线、立即和干预后 3 个月的调查来提供信息。 准备一项集群随机对照试验来衡量 LAFIYA 在增加 HIVST 人群中的功效 YSMM 的研究结果将为减少交叉耻辱和 HIVST 实施策略提供信息。 YSMM、贫民窟、SSA 和不同环境中的其他高风险人群。