Internet-Based HIV Prevention for Methamphetamine-Using MSM: Formative Research

描述（由申请人提供）：本申请是对RFA-MH-11-081：为男男性行为者（R21）重振艾滋病毒预防的回应。使用冰毒的男男性行为者（MUMSM），其中许多人是多种物质的使用者，即使偶尔使用，也有两倍到三倍的可能性进行无保护的肛交。在与不接受传统的基于安全套的预防信息的男子合作时，减少伤害的方法有可能重振艾滋病毒预防工作。如果我们能为高危男性提供一种干预措施， 满足他们的特定需求，我们就有更大的机会看到危险行为的可衡量的减少。这项研究的长期目标是为MUMSM和为这一人群服务的教育工作者开发一个移动的在线工具，通过支持制定减少危害战略，包括增加安全套的使用，促进减少艾滋病毒的传播。基于信息-动机-行为技能（IMB）模型，R21的四个目标允许收集和分析开发在线工具所需的形成数据。目的1比较多物质使用和减少伤害的MUMSM谁满足男性性伴侣在线模式，以确定IMB和危险行为的预测因素的差异。目标2确定了不同减少伤害分类中的MUMSM对在线艾滋病毒预防需求的看法如何不同，包括首选内容和设计功能。目标3确定经常为孕产妇、新生儿和性行为开展外联和教育的艾滋病毒预防教育工作者认为的在线艾滋病毒预防需求，包括首选的内容和设计特点。目标4整合了定量和定性数据，以确定IMB的内容和设计功能的在线艾滋病毒干预MUMSM。除了接触到可能忽视当前预防信息的高风险男男性行为者之外，这一应用程序还具有重要意义，因为移动的在线干预措施可以预防MUMSM与男性会面使用药物和性接触的风险环境。该工具还为教育工作者和个案管理人员提供了一种与难以接触的男男性行为者保持联系的机制。该应用程序是创新的，因为它提出了一种有效的方法来收集，分析和综合定量和定性数据，因为它扩展了IMB和减少伤害的模型，以结构性干预，通过开发一个移动的在线工具，包括同行支持的MUMSM和预防教育工作者/案例管理员。该应用程序的优势在于，它结合了明尼苏达大学HV/STI干预和预防研究的专业知识，该研究是基于互联网的艾滋病毒预防的领导者，并结合了旧金山弗朗西斯科卫生部预防MUMSM的著名研究人员的专业知识。 公共卫生相关性：使用甲基苯丙胺的男男性行为者基于互联网的艾滋病预防：形成性研究当与使用甲基苯丙胺的男男性行为者一起工作时，减少伤害的方法有可能重振艾滋病预防。需要对这一高危人群进行创新干预，这些人群既表现出多种物质使用和无保护肛交的高危行为，又拒绝传统的基于安全套的预防策略。这项研究收集了开发一个移动的在线工具所需的形成数据，该工具可以为使用MSM的甲基苯丙胺提供量身定制的信息，动机和行为技能内容，提供一种教育工作者和与这一人群合作的案例管理者可以与他们的客户保持联系的手段，并提供一个电子基础设施，其中甲基苯丙胺-使用男男性接触者和教育工作者和个案管理人员可以接受和提供社会支持，为他们的减少伤害的努力。

DESCRIPTION (provided by applicant): This application is in response to RFA-MH-11-081: Reinvigorating HIV Prevention for Men who have Sex with Men (R21). Meth-using MSM (MUMSM), many of whom are polysubstance users, have double to triple the probability of engaging in unprotected anal intercourse, even with episodic use. When working with men not receptive to traditional condom-based prevention messages, a harm reduction approach has the potential to reinvigorate HIV prevention. If we can provide high-risk men with an intervention that meets their specific needs, we have a much greater chance of seeing measurable reductions in risky behavior. The long-term objective of this research is to develop a mobile online tool for MUMSM and educators serving this population that will facilitate a reduction in HIV transmission by supporting the enactment of harm reduction strategies, including increased condom use. Grounded in the Information- Motivation-Behavioral Skills (IMB) Model, the four aims of this R21 allow for the collection and analysis of formative data needed to develop the online tool. Aim 1 compares patterns of polysubstance use and harm reduction in MUMSM who meet male sexual partners online to identify differences in IMB and predictors of risk behavior. Aim 2 identifies how MUMSM in different harm reduction classifications vary in their perception of online HIV prevention needs, including preferred content and design features. Aim 3 identifies perceived online HIV- prevention needs, including preferred content and design features, of HIV-prevention educators who regularly conduct outreach and education for MUMSM. Aim 4 integrates quantitative and qualitative data to identify the IMB content and design features of an online HIV intervention for MUMSM. In addition to reaching high-risk MSM who might ignore current prevention messages, this application is significant because a mobile online intervention brings prevention to the risk environment where MUMSM are meeting men for substance use and sexual encounters. This tool also provides educators and case managers a mechanism to stay in contact with hard-to- reach MSM. This application is innovate because it proposes an efficient method to collect, analyze, and synthesize quantitative and qualitative data, and because it extends both the IMB and harm reduction models to a structural intervention by developing a mobile online tool that includes peer support for both MUMSM and prevention educators/case managers. A strength of this application is that it combines the expertise of the University of Minnesota HV/STI Intervention and Prevention Studies, a leader in Internet-based HIV prevention, with the expertise of a well- known researcher in prevention for MUMSM from the San Francisco Department of Health. PUBLIC HEALTH RELEVANCE: Internet-based HIV Prevention for Methamphetamine-Using MSM: Formative Research When working with methamphetamine-using men who have sex with men, a harm reduction approach has the potential to reinvigorate HIV prevention. An innovative intervention is needed for this high-risk population that both exhibits high-risk behaviors of polysubstance use and unprotected anal intercourse and rejects traditional condom-based prevention strategies. This study collects formative data needed to develop a mobile online tool that can offer tailored information, motivation, and behavioral skills content to methamphetamine using MSM, provide a means by which educators and case managers working with this population can stay in touch with their clients, and provide an e-infrastructure in which both methamphetamine-using MSM and educators and case managers can receive and provide social support for their harm reduction efforts.