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: 8337529
• 负责人: DARRELL P WHEELER
• 金额: $ 17.11万
• 依托单位: LOYOLA UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8337529
• 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）：与男性间性交直接或间接相关的 HIV 感染是非裔美国人中 HIV 感染的唯一主要原因，估计占美国非裔美国男性中诊断出的所有艾滋病病例的 50%。 尽管负担不成比例，但很少有艾滋病毒预防/降低风险干预措施是专门针对男男性行为的非裔美国男性 (AAMSM) 设计和评估其效果的。 拟议的研究将通过实施并严格测试纽约市 300 名 18-55 岁 AAMSM 样本中批判性思维和文化肯定 (CTCA) HIV 危险行为干预措施在减少 HIV 危险行为方面的功效来解决这一差距。 CTCA 战略是一种土生土长的非裔美国人文化模式，已在加利福尼亚州洛杉矶实施了十多年，并自 2002 年起在纽约市实施。 CTCA 干预措施以社会认知行为理论为基础，结合了批判性思维、非裔美国人文化意识、健康素养、咨询和团体动力，使 AAMSM 能够减少艾滋病毒危险行为，走向自我实现，对自己和社区承担更大的责任。 拟议的研究将 CTCA 干预与标准 HIV 检测和咨询方案（护理标准）进行比较，假设：1）完成干预的参与者将报告性危险行为比标准护理对照组有更大程度的减少； 2) CTCA 干预比标准护理更具成本效益。根据提供干预效果最佳证据的既定标准，该研究将采用预测试/后测试设计，随机分配到干预组和对照组；制定一项策略，通过完成研究保留至少 70% 的参与者；在基线、干预后立即收集数据，并至少在干预后 3 个月和 6 个月收集数据；严格衡量直接影响 AAMSM 的 HIV 风险的结果（例如，性伴侣的数量、安全套的使用）或表明 HIV 或 STD 感染的生物测量值。本研究的具体目标是 1) 进一步阐明和发展本土 CTCA 干预措施，2) 评估其在减少 AAMSM 的 HIV 风险行为方面的功效和成本效益，以及 3) 从而扩大 AAMSM 的 HIV 预防/风险降低实践的有限研究范围。 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，及其不成比例且不断上升的艾滋病毒负担，拟议的研究解决了最紧迫的公共卫生需求。 加深对 AAMSM 中艾滋病毒/艾滋病风险行为、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，必须成为扭转美国非裔美国人中日益恶化的艾滋病毒/艾滋病流行趋势的议程的一部分。 公共卫生相关性：将对批判性思维和文化肯定 (CTCA) 进行评估，以评估其在性活跃的非裔美国男男性接触者中减少性风险行为（例如无保护性行为）的有效性。 该干预措施将与通常为纽约市男性提供的标准艾滋病毒检测和咨询服务进行比较。 这项干预措施的结果将与公共卫生相关，因为它们将为性活跃的非裔美国男男性接触者提供急需的预防干预资源。