An HIV Intervention Tailored for Black YMSM in the House Ball Community

为 House Ball 社区中的黑人 YMSM 量身定制的艾滋病毒干预措施

• 批准号: 8012312
• 负责人: Sybil Hosek
• 金额: $ 17.82万
• 依托单位: HEKTOEN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8012312
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Adopted; Affect; Age; Appearance; Area; Attitude; Beauty; Behavior Therapy; Categories; Centers for Disease Control and Prevention (U.S.); Characteristics; Chicago; Child; Communities; Coupled; Dancing; Data; Development; Diffusion; Discrimination; District of Columbia; Elements; Employee Strikes; Epidemic; Ethnography; Exercise; Exposure to; Family; Fathers; Focus Groups; Friends; Gatekeeping; Gays; Gender; Gender Identity; HIV; HIV Infections; Health; Health Personnel; Health Services Research; Hispanics; Home environment; Housing; Human Resources; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Intervention Trial; Life; Manuals; Marketing; Measures; Minority; Modeling; Mothers; Names; New York; Parents; Perception; Persons; Population; Population Sizes; Prevalence; Prevention; Prevention Research; Preventive Intervention; Procedures; Public Health; Recruitment Activity; Reporting; Research; Research Project Grants; Research Training; Resistance; Resources; Risk; Risk Assessment; Risk Reduction; Rosa; Sampling; Schedule; Schools; Series; Seroprevalences; Sex Orientation; Sexual Partners; Social Change; Social Network; Social support; Stigmata; Structure; Surveys; Target Populations; Techniques; Test Result; Testing; Time; Training; Voice; Walking; Work; Youth; aged; base; condoms; design; experience; follow up assessment; high risk; innovation; member; men; men who have sex with men; metropolitan; novel strategies; pilot trial; prevention service; programs; public health relevance; safer sex; sex; sex risk; skills; social; social stigma; success; surveillance data; transmission process

DESCRIPTION (provided by applicant): Recent HIV surveillance data show that men who have sex with men (MSM) are the only risk group in which the number of new infections rose annually from 2001-2006 (Hall et al., 2008). Among persons aged 13-24, Blacks are disproportionately affected by HIV infection accounting for 55% of all HIV infections reported (CDC, 2005). These racial disparities among MSM persist in the Chicago area, with the HIV prevalence rate among Black MSM (30.1%) more than twice that of White (11.3%) and Hispanic MSM (12.0%) (Chicago Department of Public Health, 2009). The racial disparity in HIV prevalence rate is even more striking among youth ages 18-24, with 24.2% among Black YMSM compared to 2.3% for White YMSM and 6.5% for Hispanic YMSM (CDPH, 2009). Despite the urgent need, there are no theoretically based, culturally appropriate behavioral interventions to reduce the risk of sexual acquisition or transmission of HIV among BYMSM. Furthermore, there are no HIV prevention interventions specifically targeting the House Ball community, an understudied and clandestine subculture of the Black gay community with high HIV prevalence (Sanchez et al., 2009; Marks et al., 2008; Murill et al., 2005). The d-up! Defend Yourself" intervention, which has shown efficacy with BMSM (Jones et al., 2008), may be particularly well-suited for reaching BYMSM in the House Ball community. An adaptation of Kelly's Popular Opinion leader (POL) intervention ((Kelly et al., 1991,1992,1997,2006; Fernandez et al., 2003, 2005), d-up! Defend Yourself! utilizes opinion leaders from within the community to change social norms and perceptions of BMSM regarding safer sex practices (Jones et al., 2008). d-up! is delivered by members of the targeted community, thus providing "intravention", an approach most appropriate for insulated and marginalized communities such as the House Ball community (Bailey, 2009; Friedman et al., 2004). In this application, we propose to tailor the d-up! intervention for relevance with the Chicago House Ball community and then conduct a small, pilot trial to test for feasibility and acceptability. We will begin by conducting a series of focus groups in order to identify persuasive, culturally-appropriate messages and identify intervention targets. Based on focus group data, we will then tailor the intervention to be relevant for the Chicago House Ball community. We will then use Kelly and colleagues (2004) procedures for identifying popular opinion leaders from within the community and inviting them to participate in the study. We will implement a baseline community risk assessment by obtaining a convenience sample of approximately 150 youth attending the School of Opulence over three consecutive weeks. Then, opinion leaders will be trained on the tailored intervention over a period of four weeks. We will conduct four equally spaced (3, 6, 9, 12 months post-baseline) cross-sectional follow-up assessments of convenience samples of youth (i.e. approximately 150 youth at each time point) from the House Ball community. The follow-up assessments will include measures of sexual risk behavior in the past 3 months and exposure to the intervention through opinion leaders and marketing materials over the past 3 months. Opinion leaders will be asked to rate the acceptability of the intervention and the feasibility of communicating risk reduction messages within their social networks. Feasibility of the overall intervention will also be assessed by the number of opinion leaders recruited that agreed to be trained, the number of risk reduction conversations documented by opinion leaders, and retention of the opinion leaders over the project period. PUBLIC HEALTH RELEVANCE: For this application, we will examine the feasibility and acceptability of a popular opinion leader intervention for use with Black, young men who have sex with men that participate in the House Ball community in Chicago. The aim of such an intervention is to decrease HIV infections in a community already disproportionately impacted by HIV. This intervention has great potential to directly impact the lives of young men who have sex with men in the House Ball community and to decrease HIV transmission to sexual partners inside and outside of the community.

描述（由申请人提供）：最近的艾滋病毒监测数据显示，男男性行为者（MSM）是2001-2006年新发感染人数每年上升的唯一风险群体（Hall等人，2008年）。在13-24岁的人群中，黑人受艾滋病毒感染的比例过高，占报告的所有艾滋病毒感染的55%（疾病预防控制中心，2005年）。在芝加哥地区，男男性行为者之间的种族差异持续存在，黑人男男性行为者的艾滋病毒感染率（30.1%）是白色男男性行为者（11.3%）和西班牙裔男男性行为者（12.0%）的两倍多（芝加哥公共卫生部，2009年）。在18-24岁的青年中，艾滋病毒流行率的种族差异更加显著，黑人青年男同性恋者中艾滋病毒流行率为24.2%，而白色青年男同性恋者中为2.3%，西班牙裔青年男同性恋者中为6.5%（艾滋病毒公共卫生委员会，2009年）。尽管迫切需要，有没有理论基础，文化上适当的行为干预措施，以减少性行为获得或传播艾滋病毒的风险BYMSM。 此外，没有专门针对House Ball社区的艾滋病毒预防干预措施，House Ball社区是艾滋病毒流行率高的黑人同性恋社区的一个研究不足和秘密的亚文化（Sanchez等人，2009; Marks等人，2008; Murill等人，2005年）。 上！“保护自己”干预，其对BMSM显示出有效性（Jones等人，2008年），可能是特别适合达到BYMSM在众议院球社区。改编凯利的民意领袖（POL）干预（凯利等人，1991，1992，1997，2006;费尔南德斯等人，2003年，2005年），d-up！保护自己！利用社区内的意见领袖来改变BMSM关于安全性行为的社会规范和看法（Jones等人，2008年）。上！是由目标社区的成员提供的，从而提供了“内部预防”，这是一种最适合于被隔离和边缘化社区的方法，如House Ball社区（Bailey，2009年; Friedman等人，2004年）。 在这个应用程序中，我们建议量身定制的d-up！干预的相关性与芝加哥众议院球社区，然后进行一个小的，试点试验，以测试的可行性和可接受性。我们将开始进行一系列的焦点小组，以确定有说服力的，文化上适当的信息和确定干预目标。根据焦点小组的数据，我们将调整干预措施，使之与芝加哥众议院舞会社区相关。然后，我们将使用凯利和同事（2004）的程序，从社区中识别流行的意见领袖，并邀请他们参与研究。我们将通过连续三周获取约150名就读富裕学校的青少年的便利样本来实施基线社区风险评估。然后，意见领袖将接受为期四周的量身定制干预措施培训。我们将对来自House Ball社区的便利青年样本（即每个时间点约150名青年）进行四次等间隔（基线后3、6、9、12个月）横断面随访评估。后续评估将包括过去3个月内的性风险行为测量，以及过去3个月内通过意见领袖和营销材料进行的干预措施。将要求意见领袖对干预措施的可接受性和在其社交网络内传播减少风险信息的可行性进行评级。 总体干预措施的可行性还将根据同意接受培训的意见领袖的招募人数、意见领袖记录的减少风险对话的数量以及意见领袖在项目期间的保留情况进行评估。 公共卫生关系：对于这个应用程序，我们将研究的可行性和可接受性的流行的意见领袖干预用于黑人，年轻男子与男子发生性关系，参加在芝加哥的众议院舞会社区。这种干预措施的目的是减少已经受到艾滋病毒不成比例影响的社区的艾滋病毒感染。这种干预措施具有很大的潜力，可以直接影响House Ball社区中与男性发生性关系的年轻男子的生活，并减少艾滋病毒向社区内外性伙伴的传播。