PS09-007 Evaluating Locally-Developed Homegrown HIV Prevention Interventions

描述（由申请人提供）：美国33个有HIV报告的州报告的HIV病例数据表明，与其他种族/族裔群体相比，HIV/AIDS的负担最集中在非洲裔美国人身上。在2001年至2004年期间，49704名非裔美国男性被诊断患有艾滋病毒，其中54%的病例是男男性行为者（MSM）。在洛杉矶县（LAC），非裔美国男性中由于男性间性传播而感染艾滋病毒/艾滋病的比例甚至更高（75%）。在缺乏有效疫苗的情况下，行为干预是减少非洲裔美国男男性行为者（AAMSM）中艾滋病毒高发病率的少数方法之一。虽然美国各地的各种AAMSM组织已经创建了许多个人和群体层面的艾滋病毒干预措施，但记录这些计划有效性的评估数据实际上是不存在的。鉴于现有AAMSM项目明显缺乏1)基于证据的艾滋病干预措施和2)“最佳实践”结果评估，我们的合作团队打算通过对18-29岁AAMSM开发的评估不足的“本土”艾滋病预防项目进行科学严格的评估，以解决一个明显的研究空白。本申请直接响应资助机会公告RFA-PS-09-007，建议对同时男士集团（ITMT）本地开发的“MyLife MyStyle”小组干预进行系统的项目评估。MyLife MyStyle是由洛杉矶县的AAMSM于2005-2006年设计的，旨在解决18至29岁的AAMSM人群的关键艾滋病毒预防需求，这一人群在美国经历了最高的艾滋病毒发病率。在MyLife MyStyle评估项目中，合作团队将测试一个假设，即MyLife MyStyle项目的参与者将报告在干预后三个月与男性伴侣进行无保护肛交的频率至少绝对减少15%。为了验证我们的研究假设，并了解针对有艾滋病毒感染和传播风险的年轻男男性接触者的干预措施的关键因素，我们确定了5年项目期间的以下具体目标：1)对至少300名年龄在18-29岁的AAMSM实施随机对照试验，以测试MyLife MyStyle在干预后三个月减少与男性伴侣无保护肛交（UAS）的有效性，与等候名单对照条件相比；2)进行全面的方案评价，识别与方案成功相关的干预要素，如：a)干预要素、过程和特征；B)招聘和保留策略；C)实施干预所需的组织基础设施要求；d)成本效益分析。

DESCRIPTION (provided by applicant): Data on HIV cases reported in 33 U.S. states with HIV reporting indicate the burden of HIV/AIDS is most concentrated in the African American population compared to other racial/ethnic groups. Of the 49,704 African American males diagnosed with HIV between 2001 and 2004, 54% of these cases were among men who have sex with men (MSM). In Los Angeles County (LAC), the proportion of HIV/AIDS cases among African American males attributable to male-to-male sexual transmission is even greater (75%). In the absence of an effective vaccine, behavioral interventions represent one of the few methods for reducing high HIV incidence rates among African American MSM (AAMSM). While a number of individual- and group-level HIV interventions have been created by and for a variety of AAMSM organizations across the U.S., evaluation data to document the effectiveness of these programs are practically non-existent. Given the conspicuous absence of both 1) evidence-based HIV interventions and 2) "best practices" outcome evaluations of existing AAMSM programs, our collaborative team intends to address a glaring research gap by implementing a scientifically rigorous evaluation of an insufficiently evaluated "homegrown" HIV prevention program developed for AAMSM ages 18-29 years. This application responds directly to the funding opportunity announcement RFA-PS-09-007 by proposing a systematic program evaluation of In The Meantime Men's Group's (ITMT) locally developed "MyLife MyStyle" small-group intervention. MyLife MyStyle was designed by AAMSM in Los Angeles County in 2005-2006 to address the crucial HIV prevention needs of 18- to 29-year-old AAMSM, a population experiencing the highest rate of HIV incidence in the U.S. In the MyLife MyStyle Evaluation Project, the collaborative team will test the hypothesis that participants of the MyLife MyStyle program will report at least a 15% absolute decrease in frequency of unprotected anal sex with male partners at three months post-intervention. To test our research hypothesis and to understand critical elements of an intervention designed for young AAMSM at risk of HIV acquisition and transmission, we have identified the following Specific Aims for the 5-year project period: 1) Implement a randomized controlled trial for a minimum of 300 AAMSM, ages 18-29 years, to test the effectiveness of MyLife MyStyle to reduce unprotected anal sex (UAS) with male partners at three months post-intervention compared to a wait-list control condition; 2) Conduct a comprehensive program evaluation to identify intervention elements associated with program success, such as: a) intervention components, processes, and characteristics; b) recruitment and retention strategies; c) requirements of the organization's infrastructure necessary to deliver the intervention; and d) a cost-effectiveness analysis. PUBLIC HEALTH RELEVANCE: Of the 49,704 African American males diagnosed with HIV between 2001 and 2004, 54% of these cases were among men who have sex with men (MSM). In Los Angeles County, the proportion of HIV/AIDS cases among African American males due to male-to-male sexual transmission is even greater (75%). In the absence of an effective vaccine, behavioral interventions represent one of the few methods for reducing high HIV incidence rates among African American MSM (AAMSM). This project proposes a rigorous evaluation of a locally developed, culturally competent intervention to reduce HIV risk behaviors among AAMSM ages 18 to 29 years.