REDUCING HIV RISK BEHAVIORS & PSYCHOSOCIAL STRESSORS AMONG BISEXUAL AFR/AMER MEN

与男男性行为者（MSM）直接或间接相关的艾滋病毒是导致艾滋病的最大单一因素。 黑人艾滋病毒/艾滋病病例。它占黑人男性所有病例的近一半， 但黑人妇女的病例数不详（CDC 2005年）。尽管存在巨大的种族/民族差异， 艾滋病毒流行率和风险，只有一个测试干预专门为非洲裔美国男男性接触者一直是 公开.由于他们缺乏对同性恋社区的认同， 社区，与两性的性关系，以及关于同性的频繁保密问题 行为，与男性和女性发生性关系的非洲裔美国人（MSMW）可能不会对 针对男同性恋者的干预措施。为了解决这些种族/族裔差异和在性别平等方面的一个重要差距， 干预文献，我们建议测试非洲裔美国人遗产的有效性 自我赋权（MAALES）项目-一个新开发的，新颖的，文化一致的干预措施 旨在减少性风险行为，改善非裔美国MSMW的心理社会结果。 MAALES干预-以理性行动和计划行为理论（TRA/TPB）为指导， 批判性思维和文化肯定（CTCA）模型和授权理论-被开发出来 通过一个广泛的、形成性的研究过程。小组干预包括六个两小时的 会议由种族匹配的主持人主持，为期三周，在1.5岁时举行助推会议， 4.5月后。在我们提议的2a期随机对照试验中，我们将测试MAALES 300 MSMW干预，平均随机分配至干预组和等待（标准治疗）对照组 条件在完成干预后，将对所有人进行为期三个月和六个月的评估。 此外，还对心理社会措施进行了额外的即时事后评估。 具体目标是：减少（1a）与艾滋病毒有关的危险性行为（即，无保护的事件 性交和伴侣的数量）和（1b）在药物或酒精的影响下发生性行为;和（2）改善 心理社会结果（即，减少对艾滋病毒的羞辱，增强种族和文化自豪感） 美国MSMW探索性目的考察理论中介的影响（即，减少 内化的同性恋恐惧症和性别角色冲突）对干预效果和潜在的调节作用， 心理困扰双变量和多元回归分析将用于比较结局 在两种干预条件之间，并检查中介效应和效应修正。研究 研究结果将用于开发NIH R 01应用程序，用于更大规模的（2b期）试验，以定制干预措施 与男性和女性伴侣发生性关系的非洲裔美国人的方法，并指导 适用于其他少数族裔的最低法定最低工资。

HIV directly or indirectly related to men who have sex with men (MSM) is the single largest contributor to HIV/AIDS cases among Blacks. It accounts for nearly half of all cases among Black men and a substantial but unknown number of cases among Black women (CDC 2005). Despite large racial/ethnic disparities in HIV prevalence and risk, just one tested intervention specifically for African American MSM has been published. Because of their lack of identification with gay communities, strong identification with ethnic communities, sexual relationships with both genders, and frequent secrecy issues regarding same-sex behavior, African American men who have sex with both men and women (MSMW) may not respond to interventions targeting gay men. In order to address these racial/ethnic disparities and an important gap in the intervention literature, we propose to test the efficacy of the Men of African American Legacy Empowering Self(MAALES) Project-a newly developed, novel, and culturally congruent intervention designed to reduce sexual risk behaviors and improve psychosocial outcomes in African American MSMW. The MAALES intervention - guided by the Theory of Reasoned Action and Planned Behavior (TRA/TPB), the Critical Thinking and Cultural Affirmation (CTCA) Model, and the Empowerment Theory- was developed through an extensive, formative research process. The small group intervention involves six two-hour sessions lead by ethnically matched facilitators and held over three weeks with booster sessions at 1.5 and 4.5 months post. In our proposed study, a Phase 2a randomized controlled trial, we will test the MAALES intervention with 300 MSMW evenly randomized to intervention and waitlisted (standard treatment) control conditions. Three- and six-month assessments will be conducted after completion of the intervention for all measures with an additional immediate post-assessment for psychosocial measures. The Specific Aims are to: reduce (1a) HIV-related sexual risk behaviors (i.e., episodes of unprotected intercourse and number of partners) and (1b) sex under the influence of drugs or alcohol; and (2) to improve psychosocial outcomes (i.e., reduce HIV stigma and increase racial and cultural pride) among African American MSMW. Exploratory aims examine the influences of theoretical mediators (i.e., reductions in internalized homophobia and gender role conflicts) on the intervention effect and potential moderation by psychological distress. Bivariate and multiple regression analyses will be used to compare outcomes between the two intervention conditions and to examine mediating effects and effect modification. Study findings will be used to develop a NIH R01 application for a larger (Phase 2b) trial, to tailor intervention approaches for African American men who have sex with both male and female partners, and to guide adaptation for use with other ethnic minority MSMW.