Men of Asia Testing for HIV (MATH)

描述(由申请人提供)：在美国，许多感染艾滋病毒的高危亚裔美国人和太平洋岛民(AAPI)男性从未接受过血清学检测。在最近的一项研究中，62%的艾滋病毒阳性的AAPI男性在检测时并不知道他们的艾滋病毒状况。此外，根据最近的另一项研究，在被诊断为艾滋病的AAPIs中，45.6%的人将疾病作为接受艾滋病毒检测的主要原因，这一比例明显高于高加索人。然而，人们对影响AAPI男性检测的因素知之甚少。由于延迟检测通常与晚期疾病的初始表现、更高的医疗保健费用和疾病发病率有关，因此对检测行为的研究至关重要。在AAPIs的累计艾滋病病例中，艾滋病毒的性风险男性比例更高(71%)，而所有艾滋病毒性风险男性占美国男性累计艾滋病病例的56%，这一事实突显了了解AAPI男性艾滋病毒相关风险的重要性。据估计，在美国的1090万AAPI中，670万(61.4%)是在外国出生的，700万(63.7%)5岁及以上的AAPI在家里说AAPI语言。在亚太地区，估计有720万人感染艾滋病毒或艾滋病。有证据表明，人口和社会文化，包括种族认同，是艾滋病毒相关风险行为的主要决定因素--在亚洲，在美国出生的AAPI男子，以及在美国出生的AAPI男子。鉴于艾滋病在亚太地区的爆发，了解新出现的风险模式(包括移民、文化污名化和性旅游)变得比以往任何时候都更加重要。此外，社交网络和规范的影响仍未得到充分研究。据我们所知，在AAPI男性中只发表了一项关于向社交网络成员披露艾滋病毒状况的研究。由于文化限制，AAPIs可能面临更大的披露挑战，尽管对社交网络的更大开放与对艾滋病毒状况的了解正相关。更大的结构和网络层面的因素的积累有助于个人心理和危险行为，最终决定是否寻求艾滋病毒检测的决定。因此，乔治城大学护理和健康研究学院与美国一个全国性的AAPI健康倡导组织和八个AAPI社区组织(CBO)一起提出了一项全国性的五年研究：(1)估计AAPI男男性接触者中HIV感染的流行率和发病率；(2)描述AAPI男男性接触者中HIV检测和对HIV感染状况的了解的社会文化和个人水平的相关性；(3)研究AAPI MSM中HIV风险的社会文化和个人水平的相关性；以及(4)评估进行科学的、以社区为基础的艾滋病毒研究的联盟模式框架。

DESCRIPTION (provided by applicant): Many Asian American and Pacific Islander (AAPI) men in the U.S. at high risk for HIV have never undergone serological testing. In one recent study, 62% of HIV-positive AAPI men were unaware of their HIV status at the time of testing. Moreover, according to another recent study 45.6% of AAPIs with an AIDS diagnosis cite illness as the primary reason for being tested for HIV, a significantly higher proportion in comparison to their Caucasian counterparts. However, little is known about factors that influence testing among AAPI men. Because delayed testing is often associated with an initial presentation of advanced disease, higher health care costs, and disease morbidity, studies of testing behaviors are vital. Among cumulative AIDS cases in AAPIs, proportionately more are men at sexual risk for HIV (71%) whereas all men at sexual risk for HIV make up 56% of cumulative AIDS cases among men in the U.S., a fact that underscores the significance of understanding the HIV-related risks of AAPI men. It is estimated that of the 10.9 million AAPIs in the U.S., 6.7 million (61.4%) are foreign-born and 7 million (63.7%) ages 5 and above speak an AAPI language at home. In the Asia and Pacific region, it is estimated that 7.2 million people are living with HIV or AIDS. Evidence suggests that demographic and socio-cultural, including ethnic identification, are major determinants of HIV-related risk behavior -- in Asia, in foreign-born AAPI men in the U.S., and in U.S.-born AAPI men. Given the explosion of the AIDS epidemic in the Asia and Pacific region, understanding emerging patterns of risk (including migration, cultural stigmatization, and sex tourism) become more important than ever. Furthermore, the impact of social networks and norms remains understudied. To our knowledge there is only one published study among AAPI men on the disclosure of HIV status to social network members. AAPIs may face greater challenges to disclosure due to cultural constraints, despite the fact that greater openness to social networks is positively associated with knowledge of HIV status. The accretion of larger structural and network level factors contributes to individual psychology and risk behaviors that ultimately determine the decision of whether or not to seek HIV testing. Therefore, the Georgetown University's School of Nursing and Health Studies, together with one national AAPI health advocacy organization and eight (8)AAPI community-based organizations (CBOs) in the U.S. propose a national five-year study: (1) to estimate the prevalence and incidence of HIV infection among AAPI MSM; (2) to describe the socio-cultural and individual-level correlates of HIV testing and knowledge of HIV infection status among AAPI MSM; (3) to examine the socio-cultural and individual level correlates of HIV risk among AAPI MSM; and (4) to evaluate a consortium model framework for conducting scientific, community-based HIV research.