Developing an HIV Prevention Intervention for HIV-Positive Men in China

为中国艾滋病毒阳性男性制定艾滋病毒预防干预措施

• 批准号: 7838785
• 负责人: KYUNG HEE CHOI
• 金额: $ 20.14万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7838785
• 关键词: AIDS prevention; Acceleration; Accounting; Address; Advocate; Applications Grants; Area; Behavior Therapy; China; Chinese People; Clinical Trials; Communities; Data; Elements; Epidemic; Equilibrium; Evaluation; Funding; HIV; HIV Infections; HIV Seropositivity; Health Professional; Incidence; Individual; Intervention; Interview; Life; Medical; Modeling; Outcome; Phase; Prevalence; Prevention Research; Prevention program; Preventive Intervention; Process; Provider; Public Health; Review Literature; Risk; Risk Behaviors; Risk Reduction; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Surveys; Syphilis; Testing; Work; contextual factors; driving force; evidence base; experience; informant; innovation; men; men who have sex with men; prevent; psychosocial; public health relevance; sex risk; transmission process; working group

DESCRIPTION (provided by applicant): In China, sexual transmission has become the major driving force behind the HIV epidemic, accounting for more than half (52%) of the estimated 700,000 people currently living with HIV. Men who have sex with men (MSM) may contribute to the rapid acceleration of the epidemic throughout China. Studies with Chinese MSM have documented an increasing HIV prevalence, a high HIV incidence, and high rates of unprotected intercourse and sexually transmitted infections (e.g., syphilis) known to facilitate sexual transmission of HIV. Moreover, our work found that HIV-transmission risk behavior is highly prevalent among HIV-positive MSM in China. Nonetheless, no HIV prevention interventions have targeted HIV-positive Chinese MSM. Several interventions have demonstrated efficacy in reducing sexual risk behaviors among HIV- positive MSM in the U.S. Adapting such interventions for HIV-positive MSM in China would help accelerate the process of developing an efficacious intervention for this risk group. The proposed three-year study (R34) will adapt and pilot-test currently available evidence-based behavioral interventions to reduce HIV-transmission risk behavior among HIV-positive MSM in Chongqing, China. This study will be implemented in five phases, guided by Wainberg et al.'s intervention adaptation model. In Step 1, we will identify core components of efficacious interventions (e.g., key theoretical constructs, intervention messages, delivery modes) through the review of the literature. In Step 2, we will explore cultural, psychosocial, and contextual factors associated with sexual risk behaviors and generate ideas for intervention strategies for HIV-positive MSM by conducting 15 key informant interviews with individuals knowledgeable about HIV-positive MSM and 30 in-depth interviews with HIV-positive MSM. In Step 3, we will adapt efficacious interventions through reviewing the core elements of efficacious interventions identified in Step 1 and collating those elements with qualitative data collected in Step 2 with an intervention adaptation working group of 10 health professionals and MSM lay workers who serve HIV-positive MSM. In Step 4, we will pilot-test the adapted intervention with 16 HIV- positive MSM and refine the intervention if necessary. In Step 5, we will test the feasibility of implementing and assessing the intervention refined in Step 4 by conducting the intervention with 50 HIV-positive MSM and having these 50 men complete baseline and 3-month surveys. The proposed intervention is innovative because we are not aware of any efficacious interventions targeting HIV-positive MSM in China. This study will also expand the field of HIV prevention research by developing a risk reduction intervention critically needed because of the rapidly increasing numbers of HIV-positive MSM throughout China. PUBLIC HEALTH RELEVANCE: The proposed study addresses a critical public health issue facing MSM communities throughout China. The study has the potential to create a prevention program that could prevent sexual HIV transmission from HIV- positive MSM to their sexual partners and that, in turn, could facilitate curbing the rapidly rising number of HIV infection among Chinese MSM and their sexual partners.

描述（由申请人提供）：在中国，性传播已成为艾滋病毒流行的主要驱动力，占目前患有艾滋病毒的700,000人中的一半以上（52％）。与男性发生性关系（MSM）的男性可能会导致整个中国流行病的迅速加速。中国MSM的研究已记录了HIV患病率的增加，高HIV发病率以及无保护的性交和性传播感染（例如梅毒）的高率，已知可促进HIV的性传播。此外，我们的工作发现，在中国的HIV阳性MSM中，HIV传播风险行为非常普遍。但是，没有预防HIV的干预措施针对HIV阳性中国MSM。几项干预措施表明，美国在美国的HIV阳性MSM之间的性风险行为有效，在中国适应此类干预措施，将有助于加速为该风险群体开发有效的干预措施的过程。拟议的三年研究（R34）将适应和试点测试目前可用的基于证据的行为干预措施，以减少中国重庆HIV阳性MSM的HIV传播风险行为。 Wainberg等人的干预适应模型指导，这项研究将分为五个阶段。在步骤1中，我们将通过审查文献来确定有效干预措施（例如关键理论构建，干预消息，交付方式）的核心组成部分。在步骤2中，我们将探索与性风险行为相关的文化，社会心理和背景因素，并通过对HIV阳性MSM知识渊博的个人和30个对HIV阳性MSM的深入访谈进行15种关键的信息，以对HIV阳性MSM的干预策略产生思想。在步骤3中，我们将通过审查步骤1中确定的有效干预措施的核心要素来调整有效的干预措施，并将这些元素与步骤2中的定性数据与10个卫生专业人员和MSM专业人士组成的定性数据和MSM外行工人组成，这些工作组为HIV阳性MSM服务。在步骤4中，我们将使用16个HIV-MSM进行改编干预措施，并在必要时完善干预措施。在步骤5中，我们将通过使用50个HIV阳性MSM进行干预，并让这50名男性完成基线和3个月的调查，以测试步骤4中实施和评估干预措施的可行性。拟议的干预措施具有创新性，因为我们不知道针对中国HIV阳性MSM的任何有效干预措施。这项研究还将通过在整个中国迅速增加的HIV阳性MSM数量来扩大降低风险干预措施来扩大艾滋病毒预防研究领域。 公共卫生相关性：拟议的研究解决了整个中国MSM社区面临的关键公共卫生问题。该研究有可能制定一个预防计划，该计划可以防止性艾滋病毒从HIV阳性的MSM传播到其性伴侣，进而可以促进中国MSM及其性伴侣之间迅速增加的HIV感染。