A Partnership Approach to Reducing HIV Disparities Among Latino Men

描述（由申请人提供）：美国东南部拥有该国增长最快的拉丁裔人口，并承担着不成比例的艾滋病毒/艾滋病疾病负担。我们提出了一项为期5年的研究（R24），以充分实施和严格评估试点奠定健康顾问（LHA）干预，旨在降低艾滋病毒感染的风险，最近抵达，单语，较少的文化适应拉丁美洲男子谁是在东南部定居。干预措施是基于社会认知理论和赋权教育理论，并利用基于社区的参与性研究（CBPR）开发的。这项研究是长期社区-大学合作的结果，该合作伙伴关系已经并将继续在研究过程的所有阶段使用CBPR。 在北卡罗来纳州农村地区，共有20支拉丁美洲足球队将被随机分配到LHA领导的艾滋病毒预防干预组或延迟干预对照组。每个干预团队（n=10）的一名男性将由其队友提名，并在第2年被选为LHA。延迟干预团队（n=10）将在第3年接受相同的干预。定量评估数据将从每个LHA及其来自20个团队中的每个团队的12名队友中收集：（1）基线，（2）干预后立即，和（3）12个月随访。 与延迟干预对照组的同龄人相比，HIV预防干预的参与者预计将证明（1）在性交期间增加自我报告的避孕套使用率，（2）增加自我报告的HIV和性传播疾病（STD）咨询，检测和治疗服务的利用率。 为了进一步评估和探索干预措施，将通过与LHA及其队友的个人深入访谈收集定性数据。我们还将通过直接观察合作伙伴会议、与合作伙伴进行深入访谈以及审查合作伙伴文件来评估CBPR流程。 这项研究的成果将包括：（1）一项西班牙语干预措施，可随时传播和调整，具有文化相关性和性别特异性，旨在降低新近抵达、文化适应程度较低的拉丁美洲男子的艾滋病毒风险;（2）更深入地了解拉丁美洲男子的艾滋病毒风险和干预措施，将通过简报、报纸文章、地方和国家介绍和手稿进行报道;以及（3）深入了解研究伙伴关系过程，包括非专业社区成员、拉丁美洲足球联盟和球队、艾滋病服务组织、社区组织、3所大学和广泛的其他合作伙伴。

DESCRIPTION (provided by applicant): The Southeastern United States has the fastest growing Latino population in the country and carries a disproportionate HIV/AIDS disease burden. We propose a 5-year study (R24) to fully implement and rigorously evaluate a piloted lay health advisor (LHA) intervention designed to reduce risk of HIV infection among recently arrived, monolingual, less-acculturated Latino men who are settling in the Southeast. The intervention is based on social cognitive theory and the theory of empowerment education and was developed using community-based participatory research (CBPR). This study is a result of a long-term community-university partnership that has used and will continue to use CBPR throughout all phases of the research process. A total of 20 Latino soccer teams in rural NC will be randomized to an LHA-led HIV prevention intervention or a delayed-intervention comparison group. One man from each of the intervention teams (n=10) will be nominated by his teammates and selected as an LHA in Year 2. The delayed-intervention teams (n=10) will receive the same intervention in Year 3. Quantitative assessment data will be collected from each LHA and 12 of his teammates from each of the 20 teams at: (1) baseline, (2) immediate postintervention, and (3) 12-month follow-up. Participants in the HIV prevention intervention, relative to their peers in the delayed-intervention comparison group, are anticipated to demonstrate (1) increased self-reported use of condoms during sexual intercourse and (2) increased self-reported utilization of HIV and sexually transmitted disease (STD) counseling, testing, and treatment services. To further evaluate and explore the intervention, qualitative data will be collected using individual in-depth interviews with LHAs and their teammates. We also will evaluate the CBPR process, using direct observation of partnership meetings, in-depth interviews with partners, and partnership document review. Products from this study will include (1) a Spanish-language intervention that is ready for dissemination and adaptation, culturally relevant and gender-specific, and designed to reduce HIV risk among recently arrived, less-acculturated Latino men; (2) a deeper understanding of HIV risk and intervention among Latino men that will be reported through briefs, newspaper articles, local and national presentations, and manuscripts; and (3) insight into a research partnership process that includes lay community members, Latino soccer leagues and teams, AIDS service organizations, community-based organizations, 3 universities, and a broad spectrum of other partners.