Evaluating an intervention to increase HIV testing through chat room promotion

描述（由申请人提供）：与男性发生性行为（MSM）并使用互联网进行社交和性网络的男性已被确定为感染艾滋病毒的风险增加。尽管艾滋病毒预防推广和干预措施的实施是在线进行的，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（而不是行为变化），并受到高损失率和/或随访时间短的挑战。为了响应PA-08-074“社区参与研究”，促进“社区和研究人员共同开展”的“干预研究”，我们的社区参与研究（CBPR）伙伴关系提出了一项为期4年的研究（R01），以完善、实施和评估一种文化上一致的聊天室干预，旨在增加男男性接触者的艾滋病毒检测。干预被称为网络/测试；是基于社会认知理论和赋权教育理论；并在一项概念验证研究中提高了艾滋病毒检测率。共有4个聊天室，代表4个地理上不同的集水区在NC已经配对和匹配基于集水区大小。从每一对匹配的聊天室中，一个聊天室将被随机分配到干预组，另一个聊天室将被随机分配到延迟干预组。将收集横截面数据，并在(1)基线，(2)干预后立即，(3)12个月随访时从聊天室MSM中提取现有的“个人资料”数据。这是一项意向治疗研究，参与者数据将基于随机分组进行分析。我们的假设是，那些接受干预的人，相对于延迟干预对照组的同龄人，在干预后立即有更高的自我报告的艾滋病毒检测率。定性数据也将通过以下方式收集：(1)聊天室男同性恋者的焦点小组，他们报告曾在聊天室见过干预者；(2)对男同性恋者进行个人深度访谈，他们报告曾在聊天室与干预者交谈，并接受过艾滋病毒检测。我们还将通过直接观察伙伴会议和个别与伙伴的深入访谈，评估CBPR进程。本研究将在三个重要方面推动艾滋病预防研究领域的发展，填补现有的知识空白：(1)完善和提供与文化相一致的聊天室干预措施，以增加男同性恋者的艾滋病检测，为进一步实施做好准备，适应其他在线模式和社交媒体，并进行检测；(2)促进对网络聊天室男同性恋者艾滋病检测行为的深入了解；(3)阐明艾滋病毒预防研究伙伴关系过程，包括非专业社区成员、艾滋病服务机构、社区组织、多所大学以及地理上分散的广泛合作伙伴。

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.