Serosorting Intervention for HIV Negative MSM

HIV 阴性 MSM 的血清分选干预

• 批准号: 8462298
• 负责人: Lisa A Eaton
• 金额: $ 51.31万
• 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/8462298
• 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; HIV risk; 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; 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; screening; 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）：男男性行为者继续构成艾滋病毒感染事件的大多数。尽管艾滋病毒感染率高得惊人，但几乎没有有效的干预措施来预防这些男子中的艾滋病毒传播。这项为期五年的研究，由一个新的/早期阶段的研究者提出，包括一项随机对照试验，以测试一种行为干预措施，旨在减少艾滋病毒/艾滋病的风险所造成的性伴侣选择策略，特别是血清分选，在风险艾滋病毒阴性的男性谁与男性发生性关系在亚特兰大，GA。血清分类-将无保护的性伴侣限制在艾滋病毒感染状况相同的性伴侣-已成为一种减少风险的战略，公共卫生机构几乎没有投入。男男性行为者通常采用这种做法，以避免感染艾滋病毒。然而，从事血清分选是艾滋病毒传播的预测因素，而不是一种可靠的预防形式。血清分选是无效的，由于几个因素，包括：在一定的能力，自己或伴侣的艾滋病毒状态的多重缺陷，常规艾滋病毒检测，以检测急性艾滋病毒感染的失败，由于急性艾滋病毒感染的传染性提高，和感染其他性传播感染，可以促进艾滋病毒传播的风险增加。因此，我们建议测试一个简短的，单届会议，冲突理论的决策为基础的干预在公共卫生环境中使用。该项目使用一种新的知情决策理论来指导为日常服务设计的干预措施，即，HIV检测后咨询。干预措施，以解决男性谁测试艾滋病毒阴性的需求，符合目前的努力，以扩大艾滋病毒检测，也被称为寻求，测试和treat. The拟议的研究建立在一个试点测试的优势，行为干预解决血清分选的男男性行为者。在筛选、知情同意、基线评估和HIV检测（我们预测70名男性将检测HIV阳性）后，600名HIV阴性参与者将被随机分配接受两个干预组之一：（a）血清分选、伴侣选择干预，或（B）时间匹配、基于CDC的HIV检测后咨询、标准护理。参与者将接受为期12个月的随访，评估将包括血清分类信念，决策平衡，急性艾滋病毒感染知识，艾滋病毒状态披露以及生物学（STI事件）和行为结果（性行为）。本研究将测试以下假设：短暂的单次血清分类干预将导致与风险相关的血清分类信念减少，对艾滋病毒传播风险的了解/认识增加，艾滋病毒状况披露增加，性伴侣数量减少，无保护的性行为干预参与者中的性传播感染事件比对照组参与者更多。此外，我们将测试的假设，干预措施将节省成本时，测试的成本效益分析。如果证明有效，干预模式将准备立即推广到艾滋病毒检测服务。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不成比例的艾滋病毒感染率。