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)：男男性行为者(MSM)的HIV和细菌性性传播感染(STI)的发病率是美国异性恋者的数倍。尽管性行为在定义HIV/STI传播动力学方面的重要性得到了广泛的认可，但人们对MSM如何形成性行为模式，哪些因素预测这些模式，以及这些行为模式在一个人的一生中如何变化知之甚少。我们建议对100名MSM进行一项队列研究：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。该队列将被跟踪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的自我访谈(CASI)；每3个月回顾一次在线跟踪调查问卷；基于网络的性生活日记；以及基线、6个月和12个月的艾滋病毒/性传播感染检测。这项研究的第一个目标是确定在同性性行为首次出现时招募不同样本的MSM的可行性，跟踪队列1年，收集频繁的性行为数据，并对这些男性进行HIV/STI连续检测。成功的定义将基于登记和完成研究的男性人数，以及完成所有问卷和艾滋病毒/性传播感染检测的比例。这项研究的第二个目的是评估使用基于网络的性生活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报告的行为频率，并与回溯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育和与同性恋社区开始接触的背景之间的联系。其次，我们将调查同性首次性行为的背景和在整个一年的随访中观察到的危险行为之间的联系。第三，调查人员将进行探索性分析，以确定性行为模式，如使用避孕套、艾滋病毒状况披露以及性角色和剧目。这些分析将评估个人之间和个人内部的风险差异(例如，按伙伴关系类型)，并将寻求建立可在未来、更大和更长的队列研究中纵向衡量的风险类型。拟议研究的结果，以及对MSM性行为的更大和更明确的队列研究的结果，可能有助于定义HIV/STI传播动力学；识别早期同性恋经历中预测后续风险的因素；为预防MSM中艾滋病毒的干预措施的发展提供洞察力；并为未来的前瞻性干预研究提供平台。与公共卫生相关：2005年，MSM(包括MSM/IDU)占美国新增艾滋病毒/艾滋病病例的53%(CDC，2005)。由于缺乏关于早期同性恋经历如何影响随后的风险，以及MSM的性行为如何在一个人的一生中发生变化的知识，目前MSM的科学和预防工作受到了阻碍。我们建议对缺乏性经验的年轻MSM进行一项试点队列研究，以确定对年轻MSM进行大规模、前瞻性队列研究的可行性，这可能定义男性同性恋的自然历史。除了为这项更大规模研究的设计提供信息外，这项拟议研究的结果还可以为数学模型提供经验性的衍生参数，帮助设计MSM预防计划，并确定未来干预措施中风险最高的年轻MSM。