Men of Asia Testing for HIV (MATH)

描述（由申请人提供）：许多美国亚裔和太平洋岛民（AAPI）男性HIV高危人群从未接受过血清学检测。在最近的一项研究中，62%的艾滋病毒阳性的亚太裔男性在检测时不知道自己的艾滋病毒状况。此外，根据最近的另一项研究，45.6%的亚太裔艾滋病患者将疾病作为进行艾滋病毒检测的主要原因，与白人相比，这一比例要高得多。然而，对影响亚太裔男性检测的因素知之甚少。由于延迟检测通常与疾病晚期的初始表现、较高的医疗费用和疾病发病率有关，因此对检测行为的研究至关重要。在亚太地区累积的艾滋病病例中，男性在性行为中感染艾滋病毒的风险比例更高（71%），而所有男性在性行为中感染艾滋病毒的风险占美国男性累计艾滋病病例的56%，这一事实强调了了解亚太地区男性艾滋病毒相关风险的重要性。据估计，在美国的1090万亚太裔中，670万（61.4%）是在外国出生的，700万（63.7%）的5岁及以上的人在家里说亚太裔语言。在亚洲和太平洋地区，估计有720万人感染了艾滋病毒或艾滋病。有证据表明，人口和社会文化，包括种族认同，是艾滋病相关风险行为的主要决定因素——在亚洲、在美国出生的外国亚太裔男性和在美国出生的亚太裔男性。鉴于艾滋病在亚洲和太平洋地区的流行，了解新出现的风险模式（包括移徙、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，社会网络和规范的影响仍未得到充分研究。据我们所知，只有一项关于亚太裔男性向社交网络成员披露艾滋病毒状况的已发表研究。由于文化的限制，亚太裔在信息披露方面可能面临更大的挑战，尽管对社交网络的更大开放程度与艾滋病毒状况的了解呈正相关。更大的结构和网络层面因素的增加有助于个体心理和风险行为，最终决定是否寻求HIV检测的决定。因此，乔治城大学护理与健康研究学院联合美国一家全国性的AAPI健康倡导组织和八家美国AAPI社区组织（cbo）提出了一项为期五年的全国性研究：(1)估计AAPI MSM中HIV感染的患病率和发病率；(2)分析亚太地区男男性接触者HIV检测与HIV感染状况认知的社会文化和个人层面相关性；(3)探讨亚太地区男男性接触者中HIV风险的社会文化和个人层面的相关因素；(4)评估开展以社区为基础的艾滋病科学研究的联合体模式框架。

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.