The importance of Early Sexual Experiences Among Men Who Have Sex With Men

男男性行为者早期性经历的重要性

• 批准号: 7554515
• 负责人: Matthew R Golden
• 金额: $ 6.3万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-10 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7554515
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adolescent; Affect; Age; Agreement; Alcohol or Other Drugs use; Anus; Area; Asses; Behavior; Behavioral; Biological; Centers for Disease Control and Prevention (U.S.); Characteristics; Cohort Studies; Communities; Computers; County; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Disclosure; Enrollment; Epidemic; Epidemiology; Foundations; Frequencies; Future; Gays; Genetic; HIV; Heterosexuals; Homosexuals; Immunologic Factors; Incidence; Individual; Intervention; Intervention Studies; Interview; Knowledge; Lead; Life; Male Homosexuality; Measures; Methods; Morbidity - disease rate; Natural History; Numbers; Online Systems; Participant; Pattern; Persons; Pilot Projects; Population; Prevention; Prevention intervention; Prevention program; Prospective Studies; Public Health; Questionnaires; Randomized; Rate; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Retrospective Studies; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Schedule; Self-Administered; Sex Behavior; Sexual Development; Sexual Partners; Sexually Transmitted Diseases; Specimen; Testing; Theoretical model; Time; Typology; base; cohort; condoms; design; diaries; experience; follow-up; insight; interest; lifetime risk; male; mathematical model; men; men who have sex with men; novel strategies; prevent; prospective; psychosocial; sex; sound; success; therapy development; transmission process

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) experience rates of HIV and bacterial sexually transmitted infections (STI) that are many times those experienced by heterosexuals in the U.S. Despite the widely acknowledged importance of sexual behavior in defining HIV/STI transmission dynamics, little is known about how MSM form patterns of sexual behavior, what factors predict these patterns, and how those behavioral patterns change over a person's life. We propose to conduct a cohort study of 100 MSM who are: 1) age 16-20 with 1-3 lifetime male sex partners, or 2) age 16-30 within 3 years of their same-sex sexual debut. This cohort will be followed for 1 year during which participants will complete a baseline computer administered self-interview (CASI) regarding early homosexual experiences and sexual behavior; retrospective online follow-up questionnaires every 3 months; web-based sex diaries; and HIV/STI testing at baseline, 6, and 12 months. The study's first aim is to define the feasibility of enrolling a diverse sample of MSM near the time of same-sex sexual debut, following the cohort for 1 year, collecting frequent sexual behavioral data, and serially testing these men for HIV/STI. Success will be defined based on the number of men who enroll and complete the study, and the proportion who complete all questionnaires and HIV/STI testing. The study's second aim is to assess the feasibility of using web-based sex diaries to collect sexual behavior data and to identify the appropriate diary schedule. MSM will be randomly assigned diary schedules and we will compare the frequency of reported behaviors across diary schedules and against the retrospective questionnaire data. Finally, for the third aim we will conduct three analyses. First, we will asses the association between early sexual development and the context of initiation of contact with the gay community. Second, we will investigate the association between the context of same-sex sexual debut and risk behavior observed throughout the one year of follow-up. Third, investigators will conduct exploratory analyses to define patterns of sexual behaviors such as condom use, HIV status disclosure, and sexual role and repertoire. These analyses will assess how risk varies between individuals and within individuals (e.g., by partnership type), and will seek to establish typologies of risk that can be longitudinally measured in a future, larger and longer cohort study. Findings from the proposed study, as well as those from a larger and more definitive cohort study of MSM sexual behavior, could help define HIV/STI transmission dynamics; identify factors in early homosexual experiences that predict subsequent risk; provide insights into the development of interventions to prevent HIV in MSM; and provide a platform for future prospective intervention studies. PUBLIC HEALTH RELEVANCE: In 2005, MSM (including MSM/IDU) comprised 53% of new HIV/AIDS cases in the U.S (CDC, 2005). Current scientific and prevention efforts among MSM are hampered by the paucity of knowledge about how early homosexual experiences affect subsequent risk, and how the sexual behavior of MSM changes over a person's lifetime. We propose a pilot cohort study of young, sexually inexperienced MSM to define the feasibility of conducting a large, prospective cohort study of young MSM that might define the natural history of male homosexuality. In addition to informing the design of this larger study, findings from the proposed research could provide empirically derived parameters for mathematical models, assist in the design of prevention programs for MSM, and identify the highest risk young MSM for future interventions.

描述（由申请人提供）：与男性发生性关系的男性（MSM）的艾滋病毒和细菌性传播感染（STI）的经验率，这些人在美国经历了很多次，尽管在定义HIV/STI传播方面，在定义性行为的情况下，鲜为人知的是，这些模式的模式是对这些模式的模式，并且这些模式的改变了这些行为，并且如何逐渐逐渐构成这些模式，并且对某种情况进行了一种范围，并且如何逐渐地构成了这些模式，并且如何逐渐地逐渐地，这些行为在美国经历了这些行为的重要性。我们建议对100个MSM进行一项队列研究：1）年龄16-20岁，有1-3岁的男性性伴侣，或2）年龄在同性性行为的同性性行为后3年内16-30岁。该队列将在1年内遵循，在此期间，参与者将完成有关早期同性恋经历和性行为的基线计算机管理的自我面试（CASI）；回顾性在线后续调查问卷每3个月；基于网络的性爱日记；基线，6个和12个月时的HIV/STI测试。该研究的第一个目的是定义在同性性行为1年之后，在同性性行为首次亮相的时间附近招募各种MSM样本的可行性，收集了频繁的性行为数据，并串行对这些男性进行HIV/STI的序列测试。成功将根据入学和完成研究的男性数量以及完成所有问卷和HIV/STI测试的比例来定义成功。该研究的第二个目的是评估使用基于Web的性日记收集性行为数据并确定适当日记时间表的可行性。 MSM将是随机分配的日记时间表，我们将比较跨日记时间表的报告行为的频率，并与回顾性问卷数据进行比较。最后，对于第三个目标，我们将进行三个分析。首先，我们将评估早期性发展与与同性恋社区接触的背景之间的关联。其次，我们将调查在随访的一年中观察到的同性性行为和风险行为的背景之间的关联。第三，研究人员将进行探索性分析，以定义性行为的模式，例如使用安全套，艾滋病毒状况披露以及性作用和曲目。这些分析将评估个人和个人内部（例如，通过合作伙伴类型）的风险如何变化，并将寻求建立风险类型，这些风险类型可以在未来的，更大，更长的队列研究中纵向衡量。拟议的研究的发现，以及更大，更确切的同类对MSM性行为的研究结果，可以帮助定义HIV/STI传播动力学。在早期的同性恋经历中确定因素，以预测随后的风险；提供有关预防MSM中HIV的干预措施发展的见解；并为未来的前瞻性干预研究提供平台。公共卫生相关性：2005年，MSM（包括MSM/IDU）占美国新艾滋病毒/艾滋病案件的53％（CDC，2005年）。关于早期的同性恋经历如何影响后续风险以及MSM的性行为在一个人的一生中如何变化，因此在MSM中目前的科学和预防工作受到了阻碍。我们提出了一项针对年轻，性不足的MSM的试点队列研究，以定义对年轻MSM进行大型，前瞻性队列研究的可行性，这可能定义了男性同性恋的自然历史。除了告知这项较大研究的设计外，拟议的研究的发现还可以为数学模型提供经验衍生的参数，帮助为MSM设计预防计划，并确定未来干预措施的最高风险。