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）：男男性行为者仍占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性中的艾滋病毒传播。这项为期五年的研究由一名新/早期研究者提出，包括一项随机对照试验，旨在测试一种行为干预措施，该干预措施旨在降低性伴侣选择策略（特别是血清分类）在佐治亚州亚特兰大市与男性发生性行为的高危艾滋病毒阴性男性中所带来的艾滋病毒/艾滋病风险。血清分类——将未受保护的性伴侣限制为具有相同艾滋病毒状况的性伴侣——已成为一种降低风险的策略，而公共卫生机构的投入很少。这种做法在男男性行为者中很常见，以避免感染艾滋病毒。然而，进行血清分选是艾滋病毒传播的预测指标，而不是可靠的预防形式。血清分选无效的原因有多种，包括：确定自己或伴侣的艾滋病毒状况的能力存在多重缺陷、常规艾滋病毒检测无法检测急性艾滋病毒感染、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感染的风险增加。因此，我们建议测试一种简短的、单次的、基于决策冲突理论的干预措施，用于公共卫生环境。该项目使用一种新颖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。满足艾滋病毒检测呈阴性的男性需求的干预措施非常适合当前扩大艾滋病毒检测范围的努力，也称为寻求、检测和治疗。这项拟议的研究建立在一项经过试点测试的行为干预的优势之上，旨在解决男男性行为者之间的血清分类问题。经过筛查、知情同意、基线评估和 HIV 检测（我们预测 70 名男性将检测出 HIV 呈阳性）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) 血清分类、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。参与者将被跟踪超过 12 个月，评估将包括血清分类信念、决策平衡、急性 HIV 感染知识、HIV 状况披​​露以及生物学（性传播感染事件）和行为结果（性行为）的测量。本研究将检验以下假设：短暂、单次的血清分类干预将导致干预参与者比对照组参与者减少与风险相关的血清分类信念，提高对艾滋病毒传播风险的了解/意识，增加艾滋病毒状况披露，减少性伴侣数量，减少无保护的性行为和性传播感染事件。此外，我们将检验这样的假设：在成本效益分析中进行测试时，干预措施将节省成本。如果显示有效，干预模型将准备好立即传播到艾滋病毒检测服务。迫切需要采取有效和新颖的策略来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。