Serosorting Intervention for HIV Negative MSM

HIV 阴性 MSM 的血清分选干预

• 批准号: 8299473
• 负责人: Lisa A Eaton
• 金额: $ 54.43万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-11 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8299473
• 关键词: 18 year old; AIDS/HIV problem; Accounting; Acute; Address; Anal Sex; Awareness; Behavior Therapy; Behavioral; Belief; Biological; Caring; Centers for Disease Control and Prevention (U.S.); Cities; Communities; Conflict (Psychology); Contracts; Control Groups; Counseling; Decision Making; Diagnosis; Disclosure; Effectiveness; Employee Strikes; Epidemic; Equilibrium; Failure; Fatigue; Financial compensation; Guidelines; HIV; HIV Infections; HIV Seropositivity; Human immunodeficiency virus test; Individual; Infection; Infection Control; Informed Consent; Intervention; Intervention Trial; Knowledge; Measures; Modeling; Outcome; Participant; Prevention; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Risk-Taking; Screening procedure; Security; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Site; Staging; Structure; Test Result; Testing; Time; United States Public Health Service; Unsafe Sex; arm; base; condoms; cost; cost effectiveness; design; economic evaluation; effective intervention; high risk; improved; male; meetings; men; men who have sex with men; novel; novel strategies; prevent; response; safer sex; scale up; sex; stem; theories; therapy design; transmission process

DESCRIPTION (provided by applicant): Men who have sex with men continue to make up a majority of incident HIV infections. Despite alarmingly high rates of HIV infection, there are few effective interventions to prevent HIV transmission among these men. This five year study, proposed by a New/Early Stage Investigator, consists of a randomized controlled trial to test a behavioral intervention designed to reduce risks for HIV/AIDS posed by sexual partner selection strategies, specifically serosorting, among at-risk HIV negative men who have sex with men in Atlanta, GA. Serosorting - limiting unprotected sexual partners to those of the same HIV status- has emerged as a risk reduction strategy with little input from public health agencies. It is commonly practiced among men who have sex with men to avoid HIV infection. However, engaging in serosorting is a predictor of HIV transmission rather than a reliable form of prevention. Serosorting is ineffective due to several factors, including: multiple flaws in the ability to be certain of own or partner's HIV statuses, the failure of routine HIV tests to detect acute HIV infection, elevated infectiousness due to acute HIV infection, and increased risk for contracting other STIs that can facilitate HIV transmission. We are therefore proposing to test a brief, single-session, Conflict Theory of Decision Making based intervention for use in public health settings. This project uses a novel theory of informed decision making to guide an intervention designed for use in routine services, i.e., HIV post-test counseling. An intervention to address the needs of men who test HIV negative fits well with current efforts to scale up HIV testing, also referred to as seek, test and treat. The proposed research builds on the strengths of a pilot tested, behavioral intervention for addressing serosorting among men who have sex with men. Following screening, informed consent, baseline assessments, and HIV testing (we predict 70 men will test HIV positive), 600 HIV- negative participants will be randomly assigned to receive one of two intervention arms: (a) a serosorting, partner selection intervention, or (b) a time-match, CDC based, post-HIV test counseling, standard-of-care. Participants will be followed over 12-months and assessments will include measures of serosorting beliefs, decisional balance, knowledge of acute HIV infection, HIV status disclosure, and biological (incident STI) and behavioral outcomes (sexual behaviors). This study will test the hypotheses that a brief, single session, serosorting intervention will result in less risk-related serosorting beliefs, greater knowledge/awareness of HIV transmission risk taking, increased HIV status disclosure, reductions in number of sex partners, unprotected sex acts, and incident STIs among intervention participants more so than the control group participants. Moreover, we will test the hypothesis that the intervention will be cost saving when tested in cost-effectiveness analyses. If shown effective, the intervention model will be ready for immediate dissemination to HIV testing services. Effective and novel strategies for reducing risk taking among men who have sex with men are urgently needed to reduce the disproportionate rate of incident HIV infections among this highest risk group.

描述(由申请人提供)：与男性发生性行为的男性仍占艾滋病毒感染病例的大多数。尽管艾滋病毒感染率高得令人震惊，但几乎没有有效的干预措施来预防艾滋病毒在这些男子中的传播。这项为期五年的研究由一名新/早期调查人员提出，由一项随机对照试验组成，旨在测试一种行为干预措施，旨在降低在佐治亚州亚特兰大与男性发生性行为的高危艾滋病毒阴性男子中，性伴侣选择策略带来的艾滋病毒/艾滋病风险，特别是血清浓度。Serosorting-将无保护措施的性伴侣限制在艾滋病毒状态相同的人-已经成为一种降低风险的策略，公共卫生机构几乎没有提供什么投入。这在男男性行为者中很常见，以避免感染艾滋病毒。然而，从事血清检测是艾滋病毒传播的预测指标，而不是一种可靠的预防形式。血清检测无效的原因有几个，包括：在确定自己或伴侣的艾滋病毒状况方面存在多个缺陷，常规艾滋病毒检测未能检测到急性艾滋病毒感染，急性艾滋病毒感染导致的传染性增加，以及感染其他可能促进艾滋病毒传播的性传播疾病的风险增加。因此，我们建议测试一种简短的、单次会议、基于决策的冲突理论的干预措施，用于公共卫生环境。该项目使用一种新的知情决策理论来指导旨在用于常规服务的干预措施，即艾滋病毒检测后咨询。一项旨在解决艾滋病毒检测呈阴性的男性需求的干预措施，与目前扩大艾滋病毒检测规模的努力非常吻合，也被称为寻求、检测和治疗。这项拟议的研究建立在一项试点测试的行为干预措施的优势之上，该干预措施用于解决与男性发生性行为的男性中的血清过敏问题。在筛查、知情同意、基线评估和艾滋病毒检测(我们预计将有70名男性检测艾滋病毒呈阳性)之后，600名艾滋病毒阴性参与者将被随机分配到两种干预措施中的一种：(A)血清检测、伴侣选择干预，或(B)基于疾病预防控制中心的时间匹配、艾滋病毒检测后咨询、标准护理。参与者将接受为期12个月的跟踪调查，评估将包括对血清浓度信念、决策平衡、对急性艾滋病毒感染的了解、艾滋病毒状况披露以及生物学(事件性传播感染)和行为结果(性行为)的测量。这项研究将检验这样的假设：与控制组参与者相比，短暂的单次血清滴注干预将导致与风险相关的血清滴注信念减少，对艾滋病毒传播风险承担的知识/意识增加，艾滋病毒状况披露增加，性伴侣数量减少，无保护的性行为和事件性传播感染。此外，我们将检验这样一种假设，即当在成本效益分析中进行检验时，干预将节省成本。如果证明有效，干预模式将准备好立即传播到艾滋病毒检测服务机构。迫切需要采取有效和新颖的战略，减少男男性行为者的冒险行为，以降低这一最高风险群体中艾滋病毒感染率过高的比例。