Evaluating an intervention to increase HIV testing through chat room promotion

描述(由申请人提供)：男男性行为者(MSM)和使用互联网进行社交和性交的男性已被确定为感染艾滋病毒的风险增加。虽然艾滋病毒预防宣传和干预措施的提供是在网上进行的，但对这些干预措施的评估往往强调过程(而不是结果)，侧重于假设的变化预测因素(相对于行为变化)，并受到高流失率和/或短期后续行动的挑战。为了响应PA-08-074“社区参与研究”，促进“社区和研究人员共同进行的干预研究”，我们的基于社区的参与性研究(CBPR)伙伴关系提出了一项为期4年的研究(R01)，以完善、实施和评估旨在增加MSM中HIV检测的文化契合的聊天室干预。这项干预措施名为网络/测试；以社会认知理论和赋权教育理论为基础；在概念验证研究期间提高了艾滋病毒检测率。总共有4个聊天室，代表北卡罗来纳州4个地理上不同的集水区，根据集水区的大小进行了配对和匹配。在每对匹配的聊天室中，一个聊天室将被随机分配到干预，另一个聊天室将被随机分配到延迟干预。将收集横断面数据，并从聊天室MSM中提取(1)基线、(2)干预后立即和(3)12个月随访的现有“概况”数据。这是一项意向治疗研究，参与者数据将基于随机化组进行分析。我们的假设是，与延迟干预对照组中的同龄人相比，干预中的人在干预后立即进行自我报告的艾滋病毒检测的比率会更高。定性数据也将通过以下方式收集：(1)聊天室MSM的焦点小组，他们报告在聊天室看到了干预者，以及(2)对MSM的个人深入访谈，他们报告在聊天室与干预者交谈，并进行了艾滋病毒检测。我们还将通过对伙伴关系会议的直接观察和对合作伙伴的个别深入访谈，对CBPR进程进行评估。这项研究将在3个重要方面推进HIV预防研究领域，并填补现有的知识空白：(1)完善和提供具有文化一致性的聊天室干预措施，以增加MSM中的HIV检测，为进一步实施做好准备，适应其他在线模式和社交媒体，以及检测；(2)促进对使用互联网聊天室的MSM进行HIV检测行为的更深入了解；以及(3)阐明包括非专业社区成员、艾滋病服务组织、社区组织、多所大学和越来越广泛的地理分散合作伙伴在内的HIV预防研究伙伴关系过程。

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) and use the Internet for social and sexual networking have been identified as at increased risk for HIV. Although HIV prevention outreach and intervention delivery is being done online, evaluations of these interventions tend to emphasize process (not outcomes), focus on hypothesized predictors of change (versus behavior change), and are challenged by high attrition rates and/or short follow-up. In response to PA-08-074 "Community Participation in Research," which promotes "intervention research" that "communities and researchers jointly conduct," our community-based participatory research (CBPR) partnership proposes a 4-year study (R01) to refine, implement, and evaluate a culturally congruent chat room intervention designed to increase HIV testing among MSM. The intervention is entitled CyBER/testing; is based on social cognitive theory and theory of empowerment education; and increased HIV testing rates during a proof-of-concept study. A total of 4 chat rooms that represent 4 geographically distinct catchment areas in NC have been paired and matched based on catchment area sizes. From each matched pair, 1 chat room will be randomized to intervention and the other chat room to delayed intervention. Cross-sectional data will be collected and extant "profile" data will be abstracted from chat room MSM at (1) baseline, (2) immediate post intervention, and (3) 12-month follow-up. This is an intent-to-treat study, in which participant data will be analyzed based on randomization group. Our hypothesis is that those in the intervention, relative to peers in the delayed-intervention comparison group, will have a higher rate of self-reported HIV testing at immediate post-intervention. Qualitative data also will be collected using (1) focus groups with chat room MSM who report having seen the interventionists in the chat rooms, and (2) individual in-depth interviews with MSM who report having talked with an interventionist in the chat rooms and having been tested for HIV. We also will evaluate the CBPR process, using direct observation of partnership meetings and individual in-depth interviews with partners. This study will advance the field of HIV prevention research and fill existing gaps in knowledge in 3 important ways: (1) refining and making available a culturally congruent chat room intervention to increase HIV testing among MSM, ready for further implementation, adaptation to other online modalities and social media, and testing; (2) promoting a deeper understanding of HIV testing behavior among MSM who use Internet chat rooms; and (3) elucidating an HIV prevention research partnership process that includes lay community members, AIDS service organizations, community-based organizations, multiple universities, and an expanding broad spectrum of geographically dispersed partners.