HIV-related risk behaviors among MSM: implications of new prevention technologies

描述（由申请人提供）：最近的临床试验结果表明，暴露前预防（PrEP）是一种潜在的预防艾滋病毒的生物医学干预措施，可预防艾滋病毒感染。然而，已经确定了广泛实施PrEP的几个障碍。为了应对其中的一些挑战，许多研究人员认为，PrEP应该在包括生物医学，行为和结构干预在内的综合艾滋病毒预防计划中向高危人群提供。在美国，男男性行为者（MSM）仍然是受艾滋病毒影响最严重的人群，因此应优先提供PrEP。然而，随着时间的推移，需要更好地了解MSM中的性风险行为，以告知此类计划的发展。为了实现这一目标，拟议的研究项目将使用收集的数据对一个队列的成年男男性接触者随后一年的网络艾滋病研究在洛杉矶项目2：注册研究登记处的杀微生物剂临床试验（NARLA 2）。拟议的研究项目将检查随着时间的推移，男男性接触者的性风险行为模式，以确定这一人群中高风险行为的持续时间。此外，拟议的研究将确定由他们随时间推移所遵循的风险模式定义的人口中的不同亚组，以及与亚组成员资格相关的特征。特别令人感兴趣的是药物使用在预测亚组成员中的作用。此外，拟议的研究项目将扩展社会行动理论的早期应用，该理论认为自我保护行为受个人和社会背景因素的影响，以研究MSM中的风险行为。这项分析将集中在伙伴关系的特点和无保护的接受肛交之间的关系，男男性接触者在多个伙伴关系随着时间的推移。最后，拟议的研究将描述MSM之间血清不一致伙伴关系的性质。因此，拟议的研究项目将产生关键信息的设计全面的艾滋病毒预防包在美国的男男性接触者。

DESCRIPTION (provided by applicant): Recent clinical trial results suggest that pre-exposure prophylaxis (PrEP), a potential biomedical intervention for HIV prevention, protects against HIV infection. However, several barriers to widespread PrEP implementation have been identified. In response to some of these challenges, many researchers argue that PrEP should be delivered to high-risk populations within integrated HIV prevention programs that consist of biomedical, behavioral, and structural interventions. In the United States, men who have sex with men (MSM) remain the most highly HIV affected population, and thus should be prioritized for PrEP delivery. However, a better understanding of sexual risk behaviors among MSM over time is needed to inform the development of such programs. To achieve this goal, the proposed research project will use data collected on a cohort of adult MSM followed for one year by the Network for AIDS Research in Los Angeles Project 2: Enrollment in a Research Registry for Microbicide Clinical Trials (NARLA2). The proposed research project will examine patterns in sexual risk behaviors among MSM over time to determine the duration of high-risk behaviors within this population. Further, the proposed research will identify distinct sub-groups within thi population defined by the patterns of risk they follow over time, as well as characteristics associated with sub-group membership. Of particular interest will be the role of drug use in predicting sub-group membership. Further, the proposed research project will extend earlier applications of the Social Action Theory, which posits that self-protective behaviors are regulated by both individual and social-contextual factors, to the study of risk behaviors among MSM. This analysis will focus on the relationship between partnership characteristics and unprotected receptive anal intercourse among MSM across multiple partnerships over time. Finally, the proposed research will characterize the nature of sero-discordant partnerships among MSM. Thus, the proposed research project will yield critical information for the design of comprehensive HIV prevention packages for MSM in the United States.