AN INTERVENTION FOR MALE STD PATIENTS IN INDIA

印度男性性病患者的干预措施

• 批准号: 6078872
• 负责人: CHRISTINA P LINDAN
• 金额: $ 58.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-15 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6078872
• 关键词: AIDS /HIV test; HIV infections; India; behavior therapy; behavioral /social science research tag; clinical research; clinical trials; counseling; health behavior; human subject; human therapy evaluation; male; microorganism disease chemotherapy; sex behavior; sexually transmitted diseases

India now has the greatest number of HIV infections of any country in the world, with heterosexual transmission responsible for 75% of its reported HIV cases. In Mumbai, formerly Bombay, the prevalence of HIV among sex workers (CSWs) is 60-80%. Interventions targeting CSWs have met with limited success given these women's lack of power to negotiate condom use; concomittantly, HIV infection among male sexually transmitted disease (STD) patients, a majority of whom are regular clients Of CSWs, has risen to 36%. Targeting male STD patients can be an effective HIV prevention strategy, as these men represent a critical link in the transmission Of HW to the general population. The high prevalence of STDs, particularly genital ulcers, as well as lack of adequate diagnosis and timely treatment, also contribute to increased HIV transmission in this group. We have conducted a pilot study among male STD patients in a public clinic in Mumbai that has provided baseline information on sexual risk behavior and the feasibility of performing a behavioral intervention. We base our current proposal on this extensive pilot data. The goals of this proposal are to perform a randomized, controlled trial of a behavioral intervention when added to standard care (STD treatment, with HIV testing and counseling) compared with standard care alone, among male STD patients in two public clinics in Mumbai. We will determine the impact of the intervention using biological outcome measures, specifically, HIV incidence over a one-year follow-up period. We will also measure the program's effect on self-reported risk behaviors, including condom use, visits to sex workers, number of sexual partners and health seeking behavior. We will determine the incidence and prevalence of bacterial and viral STDs using nucleic acid amplification techniques to identify the etiology of genital ulcer disease, urethritis, and asymptomatic infections. There have been no controlled trials of behavioral interventions in India targeting male clients of sex workers or STD patients. There is an urgent need to test strategies that are feasible, effective, sustainable and applicable to similar settings in India and elsewhere in Asia. This study will provide valuable information on the added efficacy of a behavioral approach to HIV control.

印度现在是世界上艾滋病毒感染人数最多的国家，异性性传播占其报告的艾滋病毒病例的75%。在孟买，即以前的孟买，性工作者中艾滋病毒的流行率为60- 80%。针对性工作者的干预措施取得了有限的成功，因为这些妇女缺乏协商使用避孕套的权力;随之而来的是，男性性传播疾病（性病）患者中的艾滋病毒感染率上升到36%，其中大多数是性工作者的常客。针对男性性病患者可以是一种有效的艾滋病毒预防策略，因为这些男性代表了将性病传播给普通人群的关键环节。性传播疾病，特别是生殖器溃疡的高发病率，以及缺乏适当的诊断和及时的治疗，也是这一群体中艾滋病毒传播增加的原因。我们在孟买一家公共诊所的男性性病患者中进行了一项试点研究，该研究提供了有关性风险行为的基线信息和进行行为干预的可行性。我们目前的建议是基于这一广泛的试点数据。该提案的目标是在孟买两家公立诊所的男性性病患者中进行一项行为干预的随机对照试验，将其与标准治疗（性病治疗，艾滋病毒检测和咨询）相比较。我们将使用生物学结果指标（特别是一年随访期内的艾滋病毒发病率）来确定干预措施的影响。我们还将衡量该计划对自我报告的风险行为的影响，包括安全套的使用，访问性工作者，性伴侣的数量和寻求健康的行为。我们将使用核酸扩增技术确定细菌性和病毒性性病的发病率和流行率，以确定生殖器溃疡疾病、尿道炎和无症状感染的病因。印度没有针对性工作者的男性顾客或性病患者的行为干预对照试验。迫切需要在印度和亚洲其他地方测试可行、有效、可持续和适用于类似环境的战略。这项研究将提供有价值的信息，增加艾滋病毒控制的行为方法的效力。