PS09-007, Evaluating Locally Developed Homegrown HIV Prevention Interventions

PS09-007，评估当地开发的本土艾滋病毒预防干预措施

• 批准号: 8067919
• 负责人: DARRELL P WHEELER
• 金额: $ 2.89万
• 依托单位: HUNTER COLLEGE
• 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 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8067919
• 关键词: PS09; 007; Evaluating; Locally; Developed

DESCRIPTION (provided by applicant): HIV infection directly or indirectly related to male-to-male sexual intercourse is the single major contributor to HIV infection among African-Americans, accounting for an estimated 50% of all US AIDS cases diagnosed among African-American men. Despite this disproportionate burden, few HIV prevention/risk reduction interventions have been specifically designed and evaluated for efficacy among African American men who have sex with men (AAMSM). The proposed study will address this gap by implementing and rigorously testing the efficacy in reducing HIV risk behaviors among a sample of 300 AAMSM aged 18-55 in New York City of the Critical Thinking and Cultural Affirmation (CTCA) HIV risk behavior intervention. The CTCA strategy is a home-grown, African-American culturally-informed model which has been implemented for over a decade in Los Angeles, California, and since 2002, in New York City. Based in social cognitive behavioral theory, the CTCA intervention combines critical thinking, African- American cultural awareness, health literacy, counseling and group dynamics to empower AAMSM to reduce their HIV risk behaviors and move toward self-actualization and greater responsibility for themselves and their community. The proposed study will compare the CTCA intervention to standard HIV testing and counseling protocol (standard of care), hypothesizing: 1) that participants who complete the intervention will report greater reductions in sexual risk behaviors than the standard care comparison group; and 2) that the CTCA intervention is more cost effective than the standard of care. Consistent with established criteria for providing best-evidence of intervention efficacy, the study will be a pre-test/post- test design with randomized assignment to intervention and comparison groups; have a strategy to retain at least 70% of participants through study completion; collect data at baseline, immediately post- intervention, and at a minimum, at 3 and 6 months post-intervention; rigorously measure outcomes that directly impact AAMSM's HIV risk (e.g., number of sex partners, condom use) or a biologic measure indicating HIV or STD infection. The Specific Aims of this study are 1) to further explicate and develop the homegrown CTCA intervention, 2) to evaluate its efficacy and cost-effectiveness in reducing AAMSM's HIV risk behaviors, and 3) thereby to expand the limited body of research on HIV prevention/risk reduction practices for AAMSM. Relevance: Given the shortage of tested and effective HIV prevention interventions for AAMSM and their disproportionate and rising HIV burden, the proposed study addresses a most urgent public health need. Advancing understanding of the risk behaviors, rates and incidence of HIV/AIDS among AAMSM, and creating effective risk interventions for them must be part of the agenda to reverse the worsening epidemic among African-Americans in the United States. PUBLIC HEALTH RELEVANCE: The Critical Thinking and Cultural Affirmation (CTCA) will be evaluated to assess its effectiveness to reduce sexual risk behaviors, (e.g. un-protected sex) among sexually-active African American MSM. This intervention will be compared to standard HIV testing and counseling services typically offered to men in New York City. The findings from this intervention will be relevant to public health, inasmuch as they will contribute to the much-needed prevention intervention resources for sexually-active African American MSM.

描述(由申请人提供)：与男性对男性性交直接或间接相关的艾滋病毒感染是非裔美国人感染艾滋病毒的唯一主要原因，估计占美国所有非裔美国男性艾滋病病例的50%。尽管有这种不成比例的负担，但针对非裔美国男男性行为者(AAMSM)的有效性专门设计和评估的艾滋病毒预防/降低风险干预措施很少。拟议的研究将通过实施并严格测试纽约市300名年龄在18-55岁的AAMSM样本在减少艾滋病毒危险行为方面的有效性来解决这一差距。CTCA战略是一种本土的、非裔美国人了解文化的模式，已在加利福尼亚州洛杉矶和2002年以来在纽约市实施了十多年。CTCA干预以社会认知行为理论为基础，结合批判性思维、非裔美国人文化意识、健康素养、咨询和群体动力，使AAMSM能够减少他们的艾滋病毒危险行为，走向自我实现和对自己和社区更大的责任。这项拟议的研究将把CTCA干预与标准艾滋病毒检测和咨询方案(护理标准)进行比较，假设：1)完成干预的参与者报告的性危险行为比标准护理对照组减少的更多；2)CTCA干预比标准护理更具成本效益。与提供最佳干预效果证据的既定标准一致，这项研究将是一项测试前/测试后的设计，随机分配到干预组和对照组；制定一项战略，在研究完成期间保留至少70%的参与者；在基线、干预后立即以及至少在干预后3个月和6个月收集数据；严格衡量直接影响AAMSM的艾滋病毒风险的结果(例如性伴侣数量、避孕套使用)或表明艾滋病毒或性传播疾病感染的生物指标。本研究的具体目的是：1)进一步阐明和发展自主开发的CTCA干预措施；2)评价其在减少AAMSM的HIV危险行为方面的有效性和成本效益；3)从而扩大AAMSM在HIV预防/降低风险实践方面的有限研究范围。相关性：鉴于AAMSM缺乏经过测试和有效的艾滋病毒预防干预措施，以及它们的艾滋病毒负担不成比例且不断上升，拟议的研究满足了最紧迫的公共卫生需求。提高对AAMSM中艾滋病毒/艾滋病危险行为、发病率和发病率的了解，并为他们制定有效的风险干预措施，必须是扭转美国非裔美国人日益恶化的流行病的议程的一部分。 公共卫生相关性：将对批判性思维和文化肯定(CTCA)进行评估，以评估其在减少性行为活跃的非裔美国人MSM中的性危险行为(例如，无保护的性行为)方面的有效性。这一干预措施将与纽约市通常为男性提供的标准艾滋病毒检测和咨询服务进行比较。这项干预的结果将与公共卫生相关，因为它们将有助于为性行为活跃的非裔美国人MSM提供急需的预防干预资源。