Young Hispanic Men - Entre Culturas: Navigating Culture, Identity and HIV Risk

描述(由申请者提供)：成年初期的关键任务是发展成人的综合身份(职业、性和文化)，这是危险行为达到顶峰的人生阶段。对于正在与男性发生性行为的年轻拉美裔男性(YHMSM)来说，在一个传统规范污蔑和拒绝同性恋思想、情感和行为并期望强烈遵守文化规范的文化中发展同性恋身份，这个过程可能特别具有挑战性和风险。这不仅意味着参与主流拉美裔文化不普遍接受的行为，而且他们正在迈阿密这样做，因为迈阿密是MSM中艾滋病毒流行率很高的背景。YHMSM迫切需要的是量身定做的干预措施，利用有效、灵活的方法，例如可以通过互联网提供的动机增强干预措施(MEI)，这是一种年轻人完全接受的模式，也是一种为干预研究提供巨大希望的模式。在这项1a/b阶段的研究中，我们将开发和试行一种在文化和发育上量身定做的MEI，以减少青年男性接触者之间的危险性行为(无保护的肛交和多个伴侣)，通过面对面(FTF)和使用实时实施方法通过互联网进行。在阶段1a，我们将收集定量和定性的数据，以确定与青年男性接触者危险性行为相关的文化、发育和个人因素，为两种分娩方式制定量身定制的MEI，以及在时间和疗程数量上相当的健康教育对照(健康)。我们将从社区和互联网场所招募100名基督教青年会横断面样本，以完成ACASI。我们将用25次定性访谈、10次关键线人访谈和6-8个焦点小组来补充这些数据，以指导干预发展。在阶段1b，我们将测试新开发的MEI的可接受性和可行性，获得干预措施减少危险性行为力度的效应大小估计，并确定是否准备好转移到阶段2进行有效性测试。我们将从社区和互联网场所招募90名YHMSM，并将他们随机分配到三种情况(Mei-FTF；Mei-Internet；Health)中的一种。参与者将在基线、干预后3个月和6个月时使用ACASI完成评估。每次会议结束后，他们将完成可接受性和可行性评估。如果试点试验显示出希望，我们将处于有利地位，将干预措施转移到全面的疗效测试，并推进对YHMSM的预防工作。

DESCRIPTION (provided by applicant): The critical task of emerging adulthood, the life period when risk-behaviors peak, is the development of an integrated adult identity (professional, sexual and cultural). For young Hispanic men who are having sex with men (YHMSM) developing a gay identity in a culture whose traditional norms stigmatize and reject homosexual thoughts, feelings and behaviors and that expects strong adherence to cultural norms, this process can be particularly challenging and risky. Not only does it entail participating in behaviors that are not generally accepted by mainstream Hispanic culture, but they are doing so in Miami, a context where HIV prevalence among MSM is high. Urgently needed for YHMSM are tailored interventions that utilize effective, flexible approaches such as Motivational Enhancement Interventions (MEIs) that can be delivered through the Internet, a modality thoroughly embraced by young adults and one that offers much promise for intervention research. In this Stage 1a/b study, we will develop and pilot test a culturally and developmentally tailored MEI to reduce risky sex (unprotected anal sex and multiple partners) among YHMSM to be delivered face-to-face (FtF) and through the Internet using a real-time implementation approach. In Stage 1a, we will collect quantitative and qualitative data to identify the cultural, developmental, and personal factors associated with risky sex in YHMSM, develop a tailored MEI for two delivery modalities, and a health education control (HEALTH) comparable in time and number of sessions. We will recruit across-sectional sample of 100 YHMSM from community and Internet venues to complete an ACASI. We will supplement these data with 25 qualitative interviews, 10 key informant interviews and 6-8 focus groups to guide intervention development. In Stage 1b, we will test the newly developed MEI's acceptability and feasibility, obtain effect size estimates of the intervention's strength to reduce risky sex, and determine if it is ready to be moved to Stage 2 for efficacy testing. We will recruit a total of 90 YHMSM from community and Internet venues and randomly assign them to one of the 3 conditions (MEI-FtF; MEI-lnternet; HEALTH). Participants will complete assessments using ACASI at baseline, 3 and 6 month post intervention. After each session, they will complete acceptability and feasibility assessments. If the pilot trial shows promise, we will be well positioned to move the intervention to full-scale efficacy testing and advance prevention efforts for YHMSM.