Developing a Community Level Behavioral Intervention for MSM in Thailand

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My long-term goal is to become an independent investigator in behavioral intervention research. My short- term goal is to respond to a quickly escalating HIV crisis among men who have sex with men (MSM) populations in Thailand. Recent surveillance data among MSM assessed by my team of investigators found a serious and expanding epidemic that is becoming worse, increasing HIV prevalence in Bangkok from 17.3% in 2003 to 28.3% in 2005. This epidemic may have the potential to spread, affecting emerging MSM communities in Cambodia, Laos, Malaysia, Myanmmar and Vietnam. Currently, there are no interventions for MSM that have been evaluated in Thailand. I believe I am an ideal person to take the lead on interventions for Thai MSM due to previous training and experience in epidemiologic surveillance research and community-based sampling of hard-to-reach populations, native fluency in the Thai language and culture, and having spent several years conducting research in Thailand, including being part of the first assessment of HIV prevalence and correlates among MSM populations in Thailand. These experiences have brought me to this juncture and I am now ready to go beyond descriptive epidemiology in order to respond to an escalating HIV crisis among Thai MSM by developing and testing a community-level behavioral intervention. To achieve this goal, I require interdisciplinary training in three areas: 1) conducting formativeevaluations using qualitative methods, 2) developing socially and culturally appropriate behavioral interventions and 3) implementing and evaluating community-level behavioral intervention trials. I will be mentored by a team of successful investigators from a multitude of disciplines under the direction of Dr. Ron Stall. We are also proposing to implement the following studies that will serve as a "laboratory" to practice the skills I learn as part of this application's training. Study 1: Qualitative assessment and analysis of risk-taking behaviors of HIV positive and negative MSM residing in Chiangmai, Thailand. Study 2: Behavioral intervention development for MSM populations in Chiangmai. Study 3: Implementation and evaluation of a pilot community-level behavioral intervention trial among MSM populations in Chiangmai. RELEVANCE (See instructions): The research plan in this application will respond to a quickly escalating HIV crisis among men who have sex with men in Thailand by developing, fielding and pilot testing the first behavioral intervention trial for this population.