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（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性传播感染（STI）率是美国异性恋者的许多倍。尽管性行为在定义艾滋病毒/STI传播动力学方面的重要性被广泛认可，但对MSM如何形成性行为模式知之甚少，什么因素预测这些模式，以及这些行为模式在人的一生中是如何变化的。我们建议对100名MSM进行队列研究，这些MSM是：1）年龄16-20岁，有1-3个终身男性性伴侣，或2）年龄16-30岁，首次同性性行为3年内。该队列将随访1年，在此期间，参与者将完成关于早期同性恋经历和性行为的基线计算机管理自我访谈（CASI）;每3个月一次的回顾性在线随访问卷;基于网络的性日记;以及基线、6个月和12个月的HIV/STI检测。该研究的第一个目的是确定在同性首次性行为的时间附近招募不同的MSM样本的可行性，跟踪队列1年，收集频繁的性行为数据，并连续检测这些男性的HIV/STI。成功将根据入组并完成研究的男性人数以及完成所有问卷和HIV/STI检测的比例来定义。这项研究的第二个目的是评估使用基于网络的性日记来收集性行为数据的可行性，并确定适当的日记时间表。MSM将被随机分配日记时间表，我们将比较不同日记时间表和回顾性问卷数据报告的行为频率。最后，为了第三个目标，我们将进行三个分析。首先，我们将评估早期性发育和与同性恋社区接触的背景之间的关联。其次，我们将调查在一年的随访中观察到的同性首次性行为和风险行为之间的关联。第三，研究人员将进行探索性分析，以确定性行为的模式，如避孕套的使用，艾滋病毒状况的披露，以及性角色和剧目。这些分析将评估个体之间和个体内部的风险变化（例如，伙伴关系类型），并将寻求建立风险类型学，以便在未来更大和更长的队列研究中进行纵向测量。这项研究的结果，以及一项更大、更明确的MSM性行为队列研究的结果，可以帮助定义HIV/STI传播动力学;确定早期同性恋经历中预测随后风险的因素;为MSM预防HIV的干预措施的发展提供见解;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，男男性行为者（包括男男性行为者/注射吸毒者）占美国新增艾滋病毒/艾滋病病例的53%（CDC，2005年）。目前的科学和预防工作中的男男性接触者是阻碍了知识的缺乏如何早期的同性恋经验影响随后的风险，以及如何改变的男男性接触者的性行为在一个人的一生。我们提出了一个试点队列研究的年轻，性经验不足的男男性接触者，以确定进行一个大型的，前瞻性的队列研究的年轻男男性接触者，可能会定义的自然历史的男性同性恋的可行性。除了为这项大型研究的设计提供信息外，拟议研究的结果还可以为数学模型提供经验推导的参数，帮助设计MSM预防方案，并确定未来干预措施的最高风险年轻MSM。