Structural Alcohol Intervention to Reduce HIV Risk Behavior

结构性酒精干预可减少艾滋病毒危险行为

• 批准号: 8538871
• 负责人: Edwin Duncan Charlebois
• 金额: $ 13.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8538871
• 关键词: AIDS prevention; AIDS/HIV problem; Alcohol abuse; Alcohol consumption; Alcoholic Intoxication; Alcohols; Automobile Driving; Awareness; Behavior; Behavioral; Blood alcohol level measurement; Calendar; Communities; Complex; Computers; Coupled; Data; Development; Effectiveness; Environment; Exposure to; Failure; Frequencies; Gays; HIV; HIV risk; Hand; Heavy Drinking; Individual; Informal Social Control; Intake; Intervention; Intoxication; Legal; Link; Measures; Media Campaign; Mediation; Online Systems; Outcome Measure; Population; Prevalence; Preventive Intervention; Public Health; Reporting; Research; Risk; Risk Behaviors; Safe Sex; Sampling; San Francisco; Services; Sex Behavior; Socialization; Surveys; Testing; Time; Visit; Water; Water consumption; alcohol behavior; alcohol intervention; alcohol risk; combat; condoms; design; effectiveness trial; follow-up; high risk; intervention effect; men who have sex with men; normative feedback; novel; safer sex; sex; sexual encounter; social norm; transmission process; uptake

DESCRIPTION (provided by applicant): An extensive body of research documents elevated rates of alcohol and use among MSM and evidence links alcohol use with unsafe sexual behavior, condom failure, and risks for HIV acquisition. However, there has been very little research on alcohol use interventions in the context of HIV prevention in this population. While most HIV prevention interventions for MSM have focused on individual level interventions, it has become increasingly clear that these strategies are insufficient to halt the spread of HIV and that approaches that combine individual and structural interventions should be developed. In our preliminary research with MSM in San Francisco we have found that bar attendance is very common along with high rates of heavy alcohol use and that consumption of water in bars is the most frequent tactic used to decrease intoxication and pace alcohol use. However bar patrons report several structural barriers to availability and accessibility of water. We propose to develo and pilot test a multi-level intervention to alter the environment where alcohol consumption occurs by installing a self-service water dispenser facilitating patrons' self-regulation of alcoho intake coupled with a bar media campaign focusing on alcohol and HIV risk (structural level interventions) and to influence individual alcohol consumption through real-time, normative feedback to exiting bar patrons of blood alcohol levels as measured by breathalyzer (individual level intervention). To evaluate the potential effectiveness of the multi-level structural intervention we will compare data from an exit sample 1,200 bar patrons taken from 4 pairs of matched intervention and control bars in San Francisco and web-based follow-up alcohol and sexual behavior survey. See aims for specific measures and comparisons. The specific aims of this developmental research are: 1) To measure exposure to and uptake of a structural intervention of free, self-service water in gay bars and an associated bar media campaign and its impact on bar patron blood alcohol concentration (BAC). We will compare mean quantity/frequency measures of alcohol use, free water awareness and usage measures, and mean BAC among exiting bar patrons between intervention bars with installed free water taps and media messages and control bars without taps and media. 2) To measure acceptability and utility of normative feedback of BAC and alcohol and sexual HIV risk. We will provide individual normative feedback to exiting bar patrons of their BAC level in comparison to real-time average BAC all exiting patrons displayed graphically along with reference points for bar average and distribution and legal driving limits. 3) To estimate impact of the free bar water structural intervention and normative feedback on alcohol-associated HIV risk. We will calculate the estimated multi-level structural intervention effect size on alcohol associated HIV risk behavior by comparing the mean proportion of HIV transmission risk acts reported in follow-up between exiting bar patrons sampled from intervention and control bars. To our knowledge this will be the first study to test a novel combination of structural and individual level intervention components targeted at reducing alcohol associated HIV risks in MSM. Results from this study will be used to design a large-scale community-wide effectiveness trial of the multi-level intervention.

描述(由申请人提供)：大量研究文件提高了MSM的饮酒率和使用率，并有证据表明酒精使用与不安全的性行为、避孕套失效和感染艾滋病毒的风险有关。然而，关于在这一人群中预防艾滋病毒的酒精使用干预措施的研究很少。虽然大多数针对男男性行为者的艾滋病毒预防干预措施都集中在个人层面的干预措施上，但越来越明显的是，这些战略不足以阻止艾滋病毒的传播，而且 应制定将个人干预和结构性干预相结合的方法。在我们对旧金山MSM的初步研究中，我们发现，酒吧出席率很高，同时重度饮酒率也很高，在酒吧喝水是减少醉酒和加快饮酒速度的最常见策略。然而，酒吧顾客报告说，在获得和获得水方面存在几个结构性障碍。我们建议开发和试行多层次干预措施，通过安装自助式饮水机来促进顾客对酒精摄入量的自我调节，并开展侧重于酒精和艾滋病毒风险的酒吧媒体宣传活动(结构性干预措施)，并通过向退出酒吧的顾客提供实时、规范的反馈，通过酒精测定仪测量血液酒精水平(个人水平干预)，来改变饮酒环境。为了评估多层次结构性干预的潜在有效性，我们将比较从旧金山4对匹配的干预和对照酒吧中提取的1200名酒吧顾客的出口样本数据，以及基于网络的后续酒精和性行为调查。有关具体衡量和比较，请参阅目标。这项发展研究的具体目的是：1)测量同性恋酒吧和相关酒吧媒体活动中接触和吸收免费自助水的结构性干预及其对酒吧顾客血液酒精浓度(BAC)的影响。我们将比较安装了免费水龙头和媒体信息的干预酒吧和没有安装水龙头和媒体的对照酒吧之间饮酒的平均数量/频率指标、免费水意识和使用措施，以及退出酒吧顾客的平均BAC。2)测量BAC、酒精和性HIV风险规范性反馈的可接受性和有效性。我们将向退出的酒吧顾客提供他们的BAC水平的个人规范反馈，与实时平均BAC相比，所有退出的顾客都以图形方式显示，以及酒吧平均和分布的参考点以及合法的驾驶限制。3)评估免费酒吧水结构干预和规范反馈对酒精相关艾滋病毒风险的影响。我们将通过比较从干预酒吧和对照酒吧抽样的退出酒吧顾客在随访中报告的艾滋病毒传播风险行为的平均比例，来计算估计的多水平结构性干预对酒精相关艾滋病毒危险行为的影响大小。据我们所知，这将是第一项测试结构性和个体水平干预成分的新组合的研究，旨在降低MSM中与酒精相关的艾滋病毒风险。这项研究的结果将被用来设计一项大规模的社区范围内多层次干预的有效性试验。