PS09-007 Evaluating Locally-Developed Homegrown HIV Prevention Interventions

描述（由申请人提供）：美国33个有艾滋病毒报告的州报告的艾滋病毒病例数据表明，与其他种族/族裔群体相比，艾滋病毒/艾滋病的负担最集中在非洲裔美国人中。 在2001年至2004年期间被诊断出感染艾滋病毒的49 704名非洲裔美国男性中，54%的病例是男男性行为者（MSM）。 在洛杉矶县（LAC），非洲裔美国男性中可归因于男男性传播的艾滋病毒/艾滋病病例比例甚至更高（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）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组织已经为他们制定了一些个人和团体层面的艾滋病毒干预措施，实际上没有记录这些方案有效性的评估数据。 鉴于明显缺乏1）以证据为基础的艾滋病毒干预措施和2）现有AAMSM计划的“最佳实践”结果评估，我们的合作团队打算通过对为18-29岁的AAMSM开发的未经充分评估的“本土”艾滋病毒预防计划进行科学严格的评估来解决一个明显的研究差距。 该申请直接响应了RFA-PS-09-007的资助机会公告，提出了对同时男子团体（ITMT）在当地开发的“我的生活我的风格”小组干预的系统性方案评估。MyLife MyStyle由洛杉矶县的AAMSM于2005-2006年设计，旨在满足18至29岁AAMSM的关键艾滋病毒预防需求，AAMSM是美国艾滋病毒发病率最高的人群。合作小组将测试一个假设，即“我的生活我的风格”项目的参与者将报告至少15%的干预后3个月，与男性伴侣无保护肛交的频率绝对下降。 为了检验我们的研究假设，并了解为有艾滋病毒感染和传播风险的年轻AAMSM设计的干预措施的关键要素，我们确定了5年项目期的以下具体目标：1）对至少300名年龄在18-29岁的AAMSM进行随机对照试验，测试与等待名单对照条件相比，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; 2）进行全面的项目评估，以确定与项目成功相关的干预要素，如：a）干预要素、流程和特征; B）招聘和保留策略; c）实施干预措施所需的组织基础设施要求; d）成本效益分析。 公共卫生相关性：在2001年至2004年期间被诊断出感染艾滋病毒的49 704名非洲裔美国男性中，54%的病例是男男性行为者（MSM）。 在洛杉矶县，非洲裔美国男性中因男男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）艾滋病毒高发病率的少数方法之一。 该项目建议对当地开发的、文化上胜任的干预措施进行严格评估，以减少18至29岁的AAMSM中的艾滋病毒风险行为。

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.