Technology for HIV Prevention Among Vulnerable Men in India

印度弱势男性艾滋病毒预防技术

• 批准号: 8334488
• 负责人: Matthew James Mimiaga
• 金额: $ 23.19万
• 依托单位: FENWAY COMMUNITY HEALTH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8334488
• 关键词: AIDS prevention; AIDS/HIV problem; Alcohol or Other Drugs use; Behavior; Behavioral; Bilateral; Boston; Car Phone; Caring; Cities; Client; Communication; Communities; Community Health Centers; Comorbidity; Counseling; Cues; Data; Enrollment; Environment; Epidemic; Exploratory/Developmental Grant; Female; Focus Groups; Goals; HIV; HIV Infections; HIV/STD; Harm Reduction; Health; Health Status; Health behavior; High Prevalence; India; Individual; Intervention; Interview; Location; Mediator of activation protein; Medical Research; Modeling; Participant; Pattern; Persons; Phase; Philosophy; Play; Population; Prevalence; Prevention; Preventive Intervention; Problem Solving; Procedures; Professional counselor; Randomized; Randomized Controlled Trials; Readiness; Research; Research Institute; Risk; Risk Reduction; Risk-Taking; Schedule; Sexually Transmitted Diseases; Site; Spouses; Structure; Techniques; Technology; Testing; Text; Trust; Tuberculosis; Unsafe Sex; Work; base; brief intervention; condoms; evidence base; experience; innovation; intervention effect; intravenous drug user; male; male sex worker; men; men who have sex with men; minority health; motivational enhancement therapy; primary outcome; sex; sex risk; sexual minority; standard of care; therapy development; transmission process

DESCRIPTION (provided by applicant): Background. Male sex workers (MSWs) are at particularly elevated risk for HIV infection and represent an important bridge population potentiating the HIV/AIDS epidemic in India. Most (~60%) MSWs in Chennai and Mumbai have a steady male or female partner/spouse (Humsafar, 2007; Mimiaga 2010), thus the risk for HIV-infection/transmission is not only to/from their sex work clients but also to/from their primary partners. Our team's experience with the population suggests that MSWs are networked with each other and with their clients through the use of mobile phones. Overview of project. This proposal is to develop and pilot test a new intervention that will use mobile phone technologies to reduce sexual risk taking in MSWs in Chennai and Mumbai. Following initial formative work, we anticipate that the intervention will incorporate standard of care HIV and STI testing (during in person assessments) with behavioral risk reduction counseling approaches using problem-solving/motivational interviewing, as well as text messaging of motivational reminders and for risk reduction cues delivered by study staff via participant's mobile phones. Phase 1: The first six months will be an intervention development and refinement phase. We will first conduct qualitative interviews (N = ~20 at both the Chennai and Mumbai study sites) and focus groups to inform the content of the intervention. We will then conduct an open pilot of the intervention with up to 10 MSWs (5 per study site) and assess initial feasibility and acceptability. We will then revise the intervention based on these data and work out any remaining methodological or intervention-development details. Phase 2: The next 18 months will be a RCT pilot of the intervention. One hundred (80 completers: 40 per study site) MSWs at risk for transmitting or acquiring HIV will be randomized to either 1) the mobile phone delivered counseling intervention and standard of care HIV/STI counseling and testing or 2) the control condition-standard of care HIV/STI counseling and testing alone. To maximize generalizability and feasibility, we will include both HIV-infected and HIV-uninfected participants. Accordingly, following the U.S.-India Bilateral Collaborative Research Partnerships on the Prevention of HIV/AIDS and Co-morbidities (R21) mechanism, one of the goals of the project will be to determine whether the structure and content of an intervention can be similar across two heavily populated cities in India. Innovation. To our knowledge, despite the rapid increase in mobile phone usage globally, no study has been conducted using counselors to deliver an HIV prevention intervention via mobile phone technologies in India among MSWs. This will be the first study to assess the acceptability and feasibility of using this technology, with a largely underserved, marginalized, and at risk subpopulation who are already networked through mobile phones. Environment. This proposal grew from ongoing work between Fenway Health, a non-profit community health center and research institute specializing in sexual minority health including HIV/AIDS care and research in Boston, the Tuberculosis Research Centre/ICMR in Chennai, and Gaurav/Humsafar Trust, the largest NGO providing care for sexual minorities, as well as MSWs, in Mumbai.

描述（由申请人提供）：背景。男性性工作者感染艾滋病毒的风险特别高，是加剧印度艾滋病毒/艾滋病流行的重要桥梁人群。金奈和孟买的大多数（约60%）MSWs有稳定的男性或女性伴侣/配偶（Humsafar, 2007; Mimiaga, 2010），因此艾滋病毒感染/传播的风险不仅存在于性工作客户之间，也存在于其主要伴侣之间。我们团队的经验表明，msw通过使用移动电话彼此联网，并与他们的客户联网。项目概述。这项建议是开发和试点测试一种新的干预措施，该措施将使用移动电话技术来减少钦奈和孟买的MSWs中的性风险。在最初的形成性工作之后，我们预计干预措施将包括艾滋病毒和性传播感染检测的标准护理（在亲自评估期间），以及使用问题解决/动机性访谈的行为降低风险咨询方法，以及动机提醒的短信和研究人员通过参与者的手机传递的风险降低提示。阶段1：前6个月将是干预措施的开发和改进阶段。我们将首先进行定性访谈（金奈和孟买研究地点的N = ~20人）和焦点小组，以告知干预措施的内容。然后，我们将对多达10个msw（每个研究站点5个）进行干预的公开试点，并评估初步可行性和可接受性。然后，我们将根据这些数据修改干预措施，并制定出任何剩余的方法或干预措施制定细节。第二阶段：接下来的18个月将是干预措施的随机对照试验。100名（80名完成者：每个研究地点40名）有传播或感染艾滋病毒风险的MSWs将被随机分为两组：1)使用手机提供咨询干预和标准护理艾滋病毒/性传播感染咨询和检测；2)对照组-仅使用标准护理艾滋病毒/性传播感染咨询和检测。为了最大限度地推广和可行性，我们将包括感染艾滋病毒和未感染艾滋病毒的参与者。因此，根据美印预防艾滋病毒/艾滋病及并发症双边合作研究伙伴关系（R21）机制，该项目的目标之一将是确定在印度两个人口稠密的城市进行干预的结构和内容是否相似。创新。据我们所知，尽管全球移动电话使用量迅速增加，但在印度，没有研究利用咨询师通过移动电话技术在MSWs中提供艾滋病毒预防干预。这将是第一个评估使用这项技术的可接受性和可行性的研究，主要针对已经通过移动电话联网的服务不足、边缘化和有风险的亚人群。环境。这一建议来自Fenway Health（一家专门从事性少数群体健康的非营利性社区卫生中心和研究机构，包括波士顿的艾滋病毒/艾滋病护理和研究）、钦奈的结核病研究中心/ICMR、以及为性少数群体提供护理的最大非政府组织Gaurav/Humsafar Trust以及孟买的MSWs之间正在进行的工作。

项目成果

A Pilot Randomized Controlled Trial of an Integrated In-person and Mobile Phone Delivered Counseling and Text Messaging Intervention to Reduce HIV Transmission Risk among Male Sex Workers in Chennai, India.

一项综合面对面和手机的飞行员随机对照试验提供了咨询和文本消息干预措施，以降低印度钦奈男性性工作者的HIV传播风险。

• DOI: 10.1007/s10461-017-1884-5
• 发表时间: 2017-11
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Mimiaga MJ;Thomas B;Biello K;Johnson BE;Swaminathan S;Navakodi P;Balaguru S;Dhanalakshmi A;Closson EF;Menon S;O'Cleirigh C;Mayer KH;Safren SA
• 通讯作者: Safren SA

Development and Open Pilot Trial of an HIV-Prevention Intervention Integrating Mobile-Phone Technology for Male Sex Workers in Chennai, India.

• DOI: 10.1007/s10508-015-0665-3
• 发表时间: 2017-05
• 期刊: Archives of sexual behavior
• 影响因子: 3.8
• 作者: Thomas B;Closson EF;Biello K;Menon S;Navakodi P;Dhanalakshmi A;Mayer KH;Safren SA;Mimiaga MJ
• 通讯作者: Mimiaga MJ

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India.

交易性行为和更安全的性行为的挑战：印度钦奈男性性工作者的研究。

• DOI: 10.1080/09540121.2016.1204421
• 发表时间: 2017-03
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: Biello KB;Thomas BE;Johnson BE;Closson EF;Navakodi P;Dhanalakshmi A;Menon S;Mayer KH;Safren SA;Mimiaga MJ
• 通讯作者: Mimiaga MJ