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(申请人提供)：在美国，男同性恋者、双性恋者和其他与其他男性(MSM)发生性行为的男性仍然不成比例地感染艾滋病毒，占2010年新增病例的61%。年轻的非洲裔美国人或黑人MSM是美国唯一一个在2006年至2009年期间艾滋病毒新感染人数在统计上显著增加(48%)的群体。在纽约市(NYC)，2011年，51%的艾滋病毒新诊断病例是男男性接触者，从2001年到2010年，年轻男男性接触者(&lt；30)的新诊断病例有所增加。在纽约市，年轻的黑人男男性接触者约占2011年年轻男男性接触者新增艾滋病毒诊断病例的50%。年轻的非裔美国MSM的不成比例的流行率不能用性危险行为或吸毒和酗酒来解释，尽管贫穷和监禁史等社会结构性因素与艾滋病毒感染具有显著和一致的相关性。艾滋病毒/艾滋病污名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、医疗和采用新的生物医学艾滋病毒预防技术的机会，例如暴露前/暴露后艾滋病毒预防(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。在这些地区，污名和同性恋恐惧症往往很严重，男男性接触者直接在他们的社区和社区体验到这一点。尽管如此，很少有社区层面的反耻辱和同性恋恐惧症干预措施得到开发和严格测试。在这里，我们建议进行重要的形成性研究，以开发和测试基于社区空间的、反耻辱和同性恋恐惧症的干预措施。设计的新组件将被添加到一个既定的反耻辱计划中，该计划由LGBTQ社区组织开发，并在一年内集中交付给单一社区。为了获得对干预效果的初步估计，我们计划进行一项准 实验研究，在两个HIV高发社区进行400个横断面街道截取调查，干预前后的社会人口统计数据和“同性恋的存在”相匹配(N=1600)。使用线性变化模型和倾向评分方法来控制干预组和对照组之间的残余混淆，我们将评估我们的结果、艾滋病毒/艾滋病污名和同性恋恐惧症以及艾滋病毒知识和艾滋病毒预防服务的知识和感知获得方面的次要结果的变化。建立社区一级反污名干预的初步效力可解决一个重大缺口，有可能增加获得艾滋病毒预防技术的机会，从而在艾滋病毒高发地区和人群中减少艾滋病毒感染和降低社区病毒载量。