HIV PREVALENCE, SEXUAL BEHAVIOR, AND ATTITUDES TOWARD CIRCUMCISION AMONG COLOMBIA

哥伦比亚的艾滋病毒感染率、性行为和对包皮环切术的态度

• 批准号: 7495232
• 负责人: Maria Cecilia Zea
• 金额: $ 46.51万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7495232
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adult; Affect; Africa; Age; American; Attention; Attitude; Beds; Behavior; Behavioral; Belief; Blood Tests; Capital; Caribbean natives; Caribbean region; Characteristics; Cities; Colombia; Communities; Computer Assisted; Condition; Conflict (Psychology); Country; Data; Demographic Factors; Depth; Development; Disruption; Enzyme-Linked Immunosorbent Assay; Epidemic; Female; Focus Groups; Future; Gays; Gray unit of radiation dose; HIV; Heterosexuals; High Prevalence; Homosexuality; Human immunodeficiency virus test; Immunoassay; Incidence; Individual; Internal Migrations; Intervention; Interview; Knowledge; Label; Latin America; Laws; Lead; Legal; Life; Link; Male Circumcision; Medical Surveillance; Methods; Modeling; Motivation; Multivariate Analysis; Numbers; Oral; Outcome; Participant; Pattern; Persons; Phase; Plague; Policies; Population; Poverty; Prevalence; Prevention; Prostitution; Public Health; Public Policy; Qualitative Research; Rate; Reaction; Recommendation; Recording of previous events; Research; Research Methodology; Respondent; Rights; Risk; Risk Behaviors; Sampling; Sex Behavior; Sexual Partners; Shapes; Social Class; Social Conditions; Social Environment; Social Network; Stigmata; Surveys; Techniques; Testing; Time; UNHCR; Urbanization; Violence; War; aged; base; demographics; design; displaced person; epidemiological model; experience; information gathering; innovation; life history; male; men; men who have sex with men; migration; oral HIV; programs; protective effect; psychologic; residence; response; social; social stigma; stem

DESCRIPTION (provided by applicant): This application describes a five-year research program that investigates individual, social, and structural influences on HIV risk and serostatus among men who have sex with men (MSM) in Bogota, Colombia. This study is of public health significance because it will contribute to knowledge concerning HIV prevalence and risk behavior in an understudied group at high risk for HIV. Moreover, it will evaluate the protection against HIV afforded by circumcision among MSM in Colombia. This application is innovative in its use of a conceptual framework that addresses HIV risk within the social and structural context. In Colombia, there are legal protections of the rights of all individuals, including gay men, while at the same time, there is ongoing civil unrest, forced displacement of large numbers of people, and homonegativity. This study investigates how such societal characteristics, as well as individuals' characteristics, influence vulnerability to HIV. The aims of the proposed study are 1) to examine structural, social, and individual factors relevant to HIV risk among MSM in Bogota; 2) to estimate prevalence of HIV among MSM in Bogota; 3) to explore the association between circumcision status and HIV serostatus and to investigate beliefs, knowledge, and attitudes concerning circumcision among Colombian MSM; and 4) to integrate information gained from the various research methods used and to draw conclusions that will guide the design of policies and interventions addressing HIV risk among MSM in Colombia. The research consists of three phases. Phase I involves qualitative research (12 key informant interviews, 10 focus groups, and 28 life history interviews) to explore the context of life for MSM in Bogota, including sexual behavior patterns, social networks, stigma associated with homosexuality and HIV, violence, migration, and displacement. Life history interviews will be conducted with MSM who have experienced displacement. Phase II involves quantitative research. Rapid oral HIV testing and a quantitative survey instrument will be administered with A-CASI to samples of MSM, aged 15 to 49. Social and structural data will reflect conditions in Bogota's19 localidades (localities) where participants live. Data will be used to test a model of HIV risk with both individual-level analyses and multi-level analyses (incorporating characteristics of the person and the locality of residence); to obtain estimates of HIV prevalence among MSM in the city; to examine protective effects of circumcision; and to describe attitudes and knowledge of circumcision. The pilot test includes 100 participants, and the full administration of the revised survey includes 1000 participants, all obtained through respondent-driven sampling. Phase III consists of triangulation of data and dissemination of findings. The contextualized information gained from this research will be useful in HIV prevention efforts for Colombian MSM at the societal, city, community, and individual levels. PUBLIC HEALTH RELEVANCE The proposed study will examine individual, social, and structural factors influencing HIV risk among Colombian MSM, and findings will be useful in designing targeted interventions. Elucidation of societal conditions that increase individuals' HIV vulnerability; identification of susceptible groups of people; and explication of the link between individual experiences, social/structural characteristics, and HIV risk will inform prevention efforts at multiple levels, including legal or policy changes and interventions aimed at the community or individuals.

描述（由申请人提供）：本申请描述了一项为期五年的研究计划，该计划调查了哥伦比亚波哥大男男性行为者（MSM）对艾滋病毒风险和血清状态的个人，社会和结构影响。这项研究是公共卫生的意义，因为它将有助于了解艾滋病毒的流行和危险行为，在一个欠研究的群体在艾滋病毒的高风险。此外，它还将评估割礼在哥伦比亚男男性行为者中提供的艾滋病毒防护。这一应用在使用一个概念框架方面具有创新性，该框架在社会和结构背景下处理艾滋病毒风险。在哥伦比亚，所有个人的权利都受到法律的保护，包括男同性恋者，但与此同时，国内动乱仍在继续，大量人被迫流离失所，同性恋者也遭到否定。这项研究调查了这些社会特征以及个人特征如何影响对艾滋病毒的脆弱性。本研究的目的是：1）研究结构、社会和个人因素与波哥大男男性行为者艾滋病风险的关系; 2）估计波哥大男男性行为者艾滋病的流行率; 3）探讨哥伦比亚男男性行为者包皮环切状况与艾滋病血清状态之间的关系，并调查他们对包皮环切的信念、知识和态度;以及4）整合从所使用的各种研究方法中获得的信息，并得出结论，指导哥伦比亚男男性行为者中艾滋病毒风险的政策和干预措施的设计。研究分为三个阶段。第一阶段涉及定性研究（12个关键的知情人访谈，10个焦点小组，和28个生活史访谈），探讨在波哥大的男男性接触者的生活背景，包括性行为模式，社交网络，与同性恋和艾滋病毒，暴力，移民和流离失所相关的耻辱。将对经历过流离失所的男男性行为者进行生活史访谈。第二阶段涉及定量研究。艾滋病病毒快速口服测试和定量调查工具将使用A-CASI对15至49岁的男男性接触者进行样本检测。社会和结构数据将反映参与者居住的波哥大19个地方的情况。数据将被用来测试艾滋病毒的风险模型与个人层面的分析和多层次的分析（包括人的特征和居住地），以获得估计艾滋病毒的流行在城市男男性行为者之间，检查包皮环切术的保护作用，并描述包皮环切术的态度和知识。试点测试包括100名参与者，修订后的调查的全面管理包括1000名参与者，所有参与者都是通过受访者驱动的抽样获得的。第三阶段包括数据的三角测量和调查结果的传播。从这项研究中获得的背景信息将是有用的艾滋病毒预防工作，哥伦比亚男男性接触者在社会，城市，社区和个人层面。 公共卫生相关性拟议的研究将探讨影响哥伦比亚男男性行为者艾滋病毒风险的个人，社会和结构因素，研究结果将有助于设计有针对性的干预措施。阐明增加个人艾滋病毒易感性的社会条件;识别易感人群;以及解释个人经历、社会/结构特征和艾滋病毒风险之间的联系，将为多层面的预防工作提供信息，包括法律的或政策的变化以及针对社区或个人的干预措施。