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：为男男性行为者重振艾滋病毒预防(R21)的回应。使用冰毒的男男性接触者(MUMSM)，其中许多人是多物质使用者，参与无保护的肛交的可能性是普通人的两到三倍，即使是偶尔使用。当与不接受传统避孕套预防信息的男性合作时，减少伤害的方法有可能重振艾滋病毒预防。如果我们能为高危人群提供干预， 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显著减少。这项研究的长期目标是为MUMSM和服务于这一人群的教育工作者开发一个移动在线工具，通过支持制定减少危害的战略，包括增加避孕套的使用，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性数据。目的1比较MUMSM在网上结识男性性伴侣的多物质使用和减少伤害的模式，以确定IMB和危险行为的预测因素的差异。目标2确定不同减少危害类别的MUMSM对在线艾滋病毒预防需求的看法有何不同，包括首选内容和设计特点。目标3确定定期为MUMSM进行外联和教育的艾滋病毒预防教育工作者的在线艾滋病毒预防需求，包括首选内容和设计特点。目的4整合定量和定性数据，以确定针对MUMSM的在线艾滋病毒干预的IMB内容和设计特点。除了接触可能忽视当前预防信息的高危MSM之外，这一应用程序还具有重要意义，因为移动在线干预将预防带到MUMSM与男性见面的危险环境中，在那里MUMSM正在与男性进行药物使用和性接触。该工具还为教育工作者和病例管理人员提供了与难以接触的MSM保持联系的机制。这个应用程序是创新的，因为它提出了一种收集、分析和综合定量和定性数据的有效方法，还因为它通过开发包括为MUMSM和预防教育者/病例管理者提供同行支持的移动在线工具，将IMB和减少危害模型扩展到结构性干预。这一应用程序的一个优点是它结合了明尼苏达大学艾滋病毒/性传播感染干预和预防研究的专业知识，该大学是基于互联网的艾滋病毒预防的领先者，以及旧金山卫生部MUMSM预防方面的知名研究人员的专业知识。 公共卫生相关性：基于互联网的甲基苯丙胺艾滋病毒预防--使用男男性接触者：形成性研究--在与甲基苯丙胺合作时，一种减少危害的方法有可能重振艾滋病毒预防工作。对于这一既表现出使用多种物质和无保护肛交的高危行为，又拒绝传统的基于避孕套的预防策略的高危人群，需要创新的干预措施。这项研究收集了开发移动在线工具所需的形成性数据，该工具可以向使用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，为从事这一人群的教育工作者和病例管理人员提供一种与他们的客户保持联系的手段，并提供一个电子基础设施，在其中，使用甲基苯丙胺的MSM和教育工作者和病例管理人员可以接受并为他们的减害努力提供社会支持。

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.