Critical Consciousness-Based HIV Prevention for Black Gay/Bi/MSM Male Adolescents

描述（由申请人提供）：在美国，与男性发生性关系的黑人青少年男性（BA-MSM）受艾滋病毒/艾滋病的影响不成比例，是新增感染人数增加最多的群体之一。本研究旨在开发和测试一种文化和发展适当的关键意识为基础的艾滋病预防干预BA-MSM。虽然基于意识的关键公共卫生干预措施已被用于一系列健康状况，但尚未广泛用于艾滋病毒预防。我们建议评估的可行性和可接受性的关键意识为基础的方法来修改艾滋病毒的性风险行为的BA-MSM，并获得所需的一个更大规模的有效性试验的先决条件的初步数据。以社区为基础的服务提供者和BA-MSM将参与干预措施的制定/测试，以弥合干预措施制定和社区执行之间的差距。 在第一阶段，我们建议分析艾滋病毒/艾滋病干预青少年试验网络内进行的三项先前研究的定性和定量数据，这些研究重点关注年轻的男男性行为者，并分析将从BA-MSM（n=20）收集的新焦点小组数据和服务提供商（n=10）在芝加哥。授权理论，批判意识教育学和社会认知理论将作为指导数据收集和综合的第一阶段的理论框架。在第二阶段，我们将利用第一阶段建立的经验和理论驱动的框架，为BA-MSM制定一个文化和发展上适当的基于关键意识的艾滋病毒预防（CC-HIV）干预措施。将与我们的青年咨询委员会（YAB）和社区提供者咨询委员会（CPAB）合作开展干预发展。我们还将调整注意力控制比较健康促进干预（健康），在时间和注意力上与CC-HIV相匹配。将对两种干预措施进行可接受性和可行性的初步测试。在第三阶段，我们将进行一项试验性随机对照试验（RCT），比较CC-HIV和HEALTH（2个月、4个月和6个月的随访评估），以评估干预措施的可接受性和可行性，并为更大规模的疗效试验（在随后的申请中）收集初步数据。 我们的具体目标是：目标1：为BA-MSM制定文化和发展上适当的基于批判意识的艾滋病毒预防干预（CC-HIV）（15-19岁）;目标2：调整健康促进比较干预措施（健康），使之适合BA-MSM;目标3：向一小群BA-MSM提供CC-HIV（n=16）和HEALTH（N=16）干预措施，以收集有关干预可行性、可接受性、并进一步完善干预手册，为一项小型试点随机对照试验做准备;目标4：进行一项小型试点随机对照试验（RCT），比较完善的CC-HIV（N=40）和HEALTH（N= 40），以进一步评估可行性和可接受性，并探索减少艾滋病毒性风险行为的初步疗效证据。

DESCRIPTION (provided by applicant): Black adolescent males who have sex with males (BA-MSM) are disproportionately affected by HIV/AIDS in the U.S., and are one of the groups with the largest increases in new infections. This study seeks to develop and test a culturally and developmentally appropriate critical consciousness-based HIV prevention intervention for BA-MSM. Although critical consciousness-based public health interventions have been utilized for an array of health conditions, they have not been widely used in HIV prevention. We propose to evaluate the feasibility and acceptability of a critical consciousness-based approach to modifying the HIV sexual risk behaviors of BA-MSM, and to obtain the preliminary data needed as a pre-requisite to a larger- scale efficacy trial. Community-based service providers and BA-MSM will be involved in intervention development/testing to bridge the gap between intervention development and community implementation. In Stage 1 we propose to analyze qualitative and quantitative data from three prior studies conducted within the Adolescent Trials Network for HIV/AIDS Interventions which were focused on young MSM, and to analyze new focus group data that will be collected from BA-MSM (n=20) and service providers (n=10) in Chicago. Empowerment Theory, Critical Consciousness Pedagogy, and Social Cognitive Theory will serve as theoretical frameworks guiding this first stage of data collection and synthesis. In Stage 2 we will utilize the empirically and theoretically-driven framework created in Stage 1 to develop a culturally and developmentally appropriate critical consciousness-based HIV prevention (CC-HIV) intervention for BA-MSM. Intervention development will be conducted in collaboration with both our Youth Advisory Board (YAB) and Community Providers Advisory Board (CPAB). We will also adapt an attention-control comparison health promotion intervention (HEALTH) that will match CC-HIV in time and attention. Initial testing for acceptability and feasibility will occur for both interventions. In Stage 3 we will conduct a pilot randomized controlled trial (RCT) of the CC-HIV compared to the HEALTH (with 2, 4, and 6 month follow up assessments) to assess the acceptability and feasibility of the intervention, and to gather preliminary data for a larger-scale efficacy trial (in a subsequent application). Our Specific Aims are: Aim 1: To develop a culturally and developmentally appropriate critical consciousness-based HIV prevention intervention (CC-HIV) for BA-MSM (ages 15-19); Aim 2: To adapt a health promotion comparison intervention (HEALTH) to be appropriate for BA-MSM; Aim 3: To deliver the CC- HIV (n=16) and HEALTH (N=16) interventions to a small group of BA-MSM in order to collect preliminary data on intervention feasibility, acceptability, and to further refine the intervention manual in preparation for a small pilot randomized controlled trial; and Aim 4: To conduct a small pilot randomized controlled trial (RCT) of the refined CC-HIV (N=40) as compared to HEALTH (N=40) in order to further assess feasibility and acceptability and to explore evidence of preliminary efficacy to reduce HIV sexual risk behaviors.