Testing a Community-Level Intervention for Young African American Men

测试针对年轻非洲裔美国男性的社区一级干预措施

• 批准号: 8604913
• 负责人: Victoria Frye
• 金额: $ 20.12万
• 依托单位: NEW YORK BLOOD CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-11 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8604913
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adult; Affect; African; African American; Alcohol consumption; Area; Attitude; Belief; Bisexual; Caring; Cities; Communities; Control Groups; Development; Diagnosis; Discrimination; Drug usage; Education; Fright; Gays; Goals; HIV; HIV Infections; HIV diagnosis; Home environment; Household; Human immunodeficiency virus test; Imprisonment; Individual; Intercept; Intervention; Knowledge; Lesbian; Life; Maps; Medical; Modeling; Neighborhoods; New York City; Outcome; Phase; Population; Population Sizes; Poverty; Prevalence; Prevention; Prophylactic treatment; Provider; Public Health; Qualitative Research; Recording of previous events; Reporting; Research; Research Design; Research Methodology; Residual state; Resources; Role; Scientist; Services; Sex Orientation; Sexuality; Shame; Social support; Stratification; Subway; Surveys; Technology; Testing; Treatment Efficacy; United States; Violence; Viral Load result; Work; Youth; base; community organizations; design; experience; high risk; member; men; men who have sex with men; novel; prevention service; programs; public health relevance; racism; research study; secondary outcome; sex; sex risk; social stigma; tool; transgender; transmission process; uptake; urban area

DESCRIPTION (provided by applicant): In the United States (US), gay, bisexual and other men who have sex with other men (MSM) continue to be disproportionately affected by HIV accounting for 61% of new cases in 2010. Young African American or Black MSM were the only group in the US with a statistically significant increase (48%) in new HIV infections between 2006 and 2009. In New York City (NYC) in 2011, 51% of new HIV diagnoses were among MSM, and new diagnoses among young MSM (<30) increased from 2001 to 2010. In NYC, young Black MSM accounted for approximately 50% of new HIV diagnoses among young, MSM in 2011. The disproportionate prevalence among young African American MSM is not explained by sexual risk behavior or drug and alcohol use, although sociostructural factors, such as poverty and history of incarceration, represent significant and consistent correlates on HIV infection. HIV/AIDS stigma and homophobia are major barriers to effective HIV prevention and treatment, reducing access to testing, medical treatment, and uptake of novel biomedical HIV prevention technologies, such as pre/post-exposure HIV prophylaxis (PEP/PrEP), critical tools to interrupt HIV transmission in high risk populations and areas. Stigma and homophobia are often high in these areas and MSM experience them directly in their home neighborhoods and communities. Despite this, few community- level, anti-stigma and homophobia interventions have been developed and rigorously tested. Here we propose to conduct significant, formative research to develop and test a neighborhood space-based, anti-stigma and homophobia intervention. The novel components designed will be added to an established anti-stigma program, developed by an LGBTQ community organization, and delivered intensely to a single neighborhood over a 1-year period. To obtain a preliminary estimate of the efficacy of the intervention, we plan a quasi- experimental study, conducting 400 cross sectional street intercept surveys in two high HIV-prevalence neighborhoods, matched for sociodemographics and "gay presence" before and after the intervention (N=1600). Using linear change models with propensity score approaches to control for residual confounding between the intervention and control groups, we will assess changes in our outcomes, HIV/AIDS stigma and homophobia, as well as secondary outcomes in HIV knowledge and knowledge of and perceived access to HIV prevention services. Establishing preliminary efficacy of a community-level anti-stigma intervention addresses a major gap, potentially increasing access to HIV prevention technologies that can reduce HIV infection and lower community viral load in high HIV prevalence areas and populations.

描述（由申请人提供）：在美国（US），同性恋、双性恋和其他与其他男性发生性关系的男性（MSM）继续不成比例地受到艾滋病毒的影响，占2010年新病例的61%。年轻的非洲裔美国人或黑人男男性行为者是美国唯一一个在2006年至2009年期间新感染艾滋病毒的人数有统计学显著增加（48%）的群体。在纽约市，2011年，51%的新艾滋病毒诊断是男男性行为者，2001年至2010年，年轻男男性行为者（<30岁）的新诊断有所增加。在纽约市，2011年，年轻的黑人男男性行为者占年轻男男性行为者中新诊断的艾滋病毒的约50%。年轻的非洲裔美国男男性接触者的不成比例的患病率是不能解释的性风险行为或药物和酒精的使用，虽然社会结构因素，如贫困和监禁的历史，代表显着和一致的相关性艾滋病毒感染。艾滋病毒/艾滋病污名化和同性恋恐惧症是有效预防和治疗艾滋病毒的主要障碍，减少了获得检测、医疗和采用新型生物医学艾滋病毒预防技术的机会，如接触前/接触后艾滋病毒预防（PEP/PrEP），这是在高危人群和地区阻断艾滋病毒传播的关键工具。污名化和同性恋恐惧症在这些地区往往很高，男男性接触者在他们的家庭社区和社区直接经历他们。尽管如此，社区一级的反污名化和仇视同性恋干预措施很少得到制定和严格测试。在这里，我们建议进行重大的，形成性的研究，以开发和测试邻里空间为基础的，反污名和同性恋恐惧症的干预。设计的新组件将被添加到一个由LGBTQ社区组织开发的既定反污名计划中，并在一年内集中交付给一个社区。为了对干预的效果进行初步评估，我们计划进行一次准- 实验研究，在两个HIV高流行率社区进行400次横断面街道拦截调查，在干预前后匹配社会人口统计学和“同性恋存在”（N=1600）。使用线性变化模型与倾向评分方法来控制干预组和对照组之间的残余混杂，我们将评估我们的结果，艾滋病毒/艾滋病的耻辱和同性恋恐惧症，以及艾滋病毒知识和知识的次要结果的变化和感知获得艾滋病毒预防服务。确定社区一级反羞辱干预措施的初步效力，可以解决一个重大差距，有可能增加获得艾滋病毒预防技术的机会，从而减少艾滋病毒感染，降低艾滋病毒高流行地区和人口的社区病毒载量。