Family influences on HIV-related sexual risk of young men who have sex with men

家庭对男男性接触者的艾滋病毒相关性风险的影响

• 批准号: 8408745
• 负责人: Brian Thoma
• 金额: $ 4.02万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-16 至 2015-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8408745
• 关键词: AIDS prevention; Adolescent; Affect; Age; Area; Bisexual; Categories; Child; Clinical; Communication; Data; Environment; Epidemic; Faculty; Family; Frequencies; Future; Gays; Goals; HIV; HIV Infections; HIV Seropositivity; Health; Heterosexuals; Incidence; Individual; Interdisciplinary Study; Intervention; Interview; Knowledge; Light; Longitudinal Studies; Mentors; Modeling; Monitor; Parents; Population; Prevalence; Prevention; Preventive Intervention; Qualitative Methods; Relative (related person); Research; Research Training; Resources; Risk; Risk Behaviors; Risk Reduction; Sampling; Science; Sex Behavior; Sex Orientation; Sexual Partners; Statistical Methods; Supervision; Surveys; Teenagers; Testing; Training; Work; Writing; condoms; cost; effective intervention; experience; family influence; health care service utilization; improved; male; member; men who have sex with men; parent-child communication; parental influence; parental monitoring; peer; sex; sex risk; sexual debut; transmission process; young man

DESCRIPTION (provided by applicant): Young men who have sex with men (YMSM) are severely affected by the current HIV epidemic. While incidence via all other HIV transmission categories has recently remained stable or decreased, male-to-male sexual contact resulting in HIV infection continues to increase, particularly among young men. HIV prevalence is alarmingly high within the YMSM population (previously estimated at 7% for YMSM ages 15 - 22), but no effective interventions to reduce risk behaviors have been developed for MSM under 23. Parents of YMSM have been identified as an underutilized resource for future risk-reduction interventions within this population, but we know virtually nothing about parental influences on sexual behavior among YMSM. Studies of general adolescent samples reveal that parents have a significant influence on the sexual behaviors of their adolescents. Parental monitoring, parent disapproval of teen sex, family connectedness, and parent-child communication are associated with adolescents' sexual behaviors, including condom use, sex frequency, number of sex partners, and sexual debut. Whether these findings generalize to HIV-related sexual risk behaviors of YMSM is unclear. Limited previous evidence suggests that family connectedness may be protective against sexual risk behaviors among YMSM, but the influences of monitoring, disapproval, or communication have not been examined among YMSM. Moreover, the unique parent-adolescent dynamics that occur when a child is gay, including coming out and parent rejection of sexual orientation, could alter the ways in which previously established family factors influence risk among YMSM. Given the importance of family factors in determining HIV-related sexual risk behaviors, the aims of the current study are threefold: 1) to use data from a large national study to determine which well-established family predictors of adolescent sexual risk also predict risk among YMSM and gay or bisexual young men; 2) to identify through qualitative methods the unique family factors that could predict risk within a family environment where a child is gay or bisexual and 3) to test new family-focused models of YMSM sexual risk behaviors that combine both previously established and newly identified family-relevant predictors. The results of the proposed study could significantly improve future HIV prevention interventions targeting YMSM by advancing knowledge of how to most effectively incorporate parents into prevention efforts. These goals aim to be accomplished within the context of a research training plan focused on developing expertise in the areas of HIV prevention science, advanced mixed-method statistical approaches, and family factors and adolescent health. The training plan proposed includes completion of a number of specific courses, close supervision and individualized mentoring, multidisciplinary collaborations with faculty members, scientific writing and presentation experience, and hands-on clinical work with families and HIV positive individuals. PUBLIC HEALTH RELEVANCE: HIV prevalence is alarmingly high among young men who have sex with men (YMSM) and continues to increase, but no effective interventions to reduce risk behaviors have been developed for YMSM under 23. Family factors are associated with adolescents' sexual risk behaviors, including condom use, sex frequency, number of sex partners, and sexual debut, but it is unclear whether these findings generalize to HIV-related sexual risk behaviors of YMSM. Findings from this study will shed light on the ways that family factors influence HIV risk among YMSM and could help to incorporate parents into and improve future risk-reduction efforts with this population. Such improvements may more broadly reduce health care utilization and national costs of treating HIV positive individuals.

描述（由申请人提供）：男男性行为者（YMSM）受到当前艾滋病毒流行的严重影响。虽然通过所有其他艾滋病毒传播类别的发病率最近保持稳定或有所下降，但导致艾滋病毒感染的男男性接触继续增加，特别是在年轻男子中。YMSM人群中的艾滋病毒流行率高得惊人（以前估计15 - 22岁的YMSM为7%），但没有为23岁以下的MSM制定有效的干预措施来减少风险行为。 YMSM的父母已被确定为一个未充分利用的资源，为未来的风险降低干预措施在这个人群中，但我们几乎不知道父母的影响YMSM的性行为。对一般青少年样本的研究表明，父母对青少年的性行为有显着的影响。父母的监控、父母对青少年性行为的反对、家庭联系和亲子沟通与青少年的性行为有关，包括安全套的使用、性频率、性伴侣的数量和首次性行为。这些发现是否适用于YMSM的HIV相关性风险行为尚不清楚。有限的以前的证据表明，家庭的连通性可能是保护YMSM之间的性风险行为，但监测，不赞成，或沟通的影响还没有被检查YMSM之间。此外，当一个孩子是同性恋时，独特的父母-青少年动态发生，包括出柜和父母拒绝性取向，可能会改变以前建立的家庭因素影响YMSM风险的方式。 鉴于家庭因素在决定HIV相关性风险行为中的重要性，本研究的目的有三个：1）使用来自一项大型全国性研究的数据来确定哪些成熟的青少年性风险家庭预测因子也预测YMSM和同性恋或双性恋年轻男性的风险; 2）通过定性方法确定可以预测儿童为同性恋或双性恋的家庭环境中的风险的独特家庭因素，3）测试新的家庭-YMSM性风险行为的集中模型，联合收割机以前建立的和新发现的家庭相关的预测因素。拟议的研究结果可以显着改善未来的艾滋病毒预防干预措施，通过推进知识，如何最有效地将父母纳入预防工作的目标YMSM。 这些目标将在一项研究培训计划的范围内实现，该计划的重点是发展艾滋病毒预防科学、先进的混合方法统计方法以及家庭因素和青少年健康等领域的专门知识。拟议的培训计划包括完成一些具体课程，密切监督和个性化辅导，与教师的多学科合作，科学写作和演示经验，以及与家庭和艾滋病毒阳性个人的实际临床工作。 公共卫生相关性：男男性行为者（YMSM）中的艾滋病毒流行率高得惊人，并继续增加，但尚未制定有效的干预措施来减少23岁以下YMSM的风险行为。家庭因素与青少年的性危险行为有关，包括安全套的使用、性频率、性伴侣数量和首次性行为，但这些发现是否适用于YMSM的HIV相关性危险行为尚不清楚。这项研究的结果将揭示家庭因素影响YMSM中艾滋病毒风险的方式，并有助于将父母纳入并改善未来与这一人群的风险降低工作。这种改善可能会更广泛地减少卫生保健的利用和治疗艾滋病毒阳性个体的国家成本。