Overcoming Health Disparities to HIV Testing for Deaf MSM through the Internet

通过互联网克服聋哑男男性接触者艾滋病毒检测的健康差异

• 批准号: 8324832
• 负责人: Alessandra Iantaffi
• 金额: $ 18.34万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8324832
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adult; Affect; Applications Grants; Attitude; Awareness; Behavior; Caring; Characteristics; Childhood; Chronic; Cognitive; Communication; Communities; Counseling; Data; Development; Discrimination; Education; Epidemic; Face; HIV; HIV Infections; HIV/STD; Harm Reduction; Health; Health Personnel; Health Services Accessibility; Hearing; Hearing Impaired Persons; High Prevalence; Human immunodeficiency virus test; Individual; Internet; Intervention; Interview; Knowledge; Linguistics; Maryland; Measures; Methods; Minority Groups; Needs Assessment; Population; Prevalence; Prevention; Preventive Intervention; Provider; Public Health; Qualitative Methods; Reading; Recording of previous events; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Sampling; Screening procedure; Self Efficacy; Series; Services; Sign Language; Structure; Support System; Surveys; Target Populations; Technology; Test Result; Testing; Time; Translating; Trust; Underserved Population; United States; United States National Institutes of Health; Ursidae Family; Validity and Reliability; Work; base; burden of illness; cost; design; experience; follow-up; health disparity; high risk; high risk sexual behavior; improved; informant; innovation; instrument; interest; iterative design; literacy; male; member; men; men who have sex with men; prototype; response; sex; sexual minority; social; theories; third grade; tool; usability; user-friendly

DESCRIPTION (provided by applicant): This application is in response to PA-11-119 "HIV/AIDS Testing and Follow-up among the Underserved in the United States" (R21), which invites grant applications on populations experiencing "unique barriers or facilitators to testing and linkage to care". Deaf Men who have Sex with Men (D-MSM) are one such group, chronically excluded from HIV research, testing, surveillance, education and services. Data from Maryland, the only state to ask information about hearing status when screening for HIV, indicate that the prevalence of HIV in the general deaf and hard-of-hearing population is two to five times higher than for the hearing population. We expect the sub-set of D-MSM to be the highest risk group within the larger Deaf population. In 30 years of the HIV/AIDS epidemic, no national studies of HIV testing rates, risk behavior, prevention and treatment needs of D-MSM have been conducted in the US, a chronic problem we begin to address in this application. Internet- based technology can enable us to reach D-MSM for HIV research, services and education. The long term objective of this research is to improve HIV screening, testing, prevention, treatment and access for Deaf people, by developing innovative, culturally- and linguistically-accessible, Internet-based methods and interventions. As a first step, in this R21, we will develop and test online, visually-based qualitative and quantitative research tools (integrating American Sign Language [ASL] and English), while also conducting the first HIV testing and prevention needs assessment of D-MSM in ASL. Integrating the theory of intersectionality and a social cognitive approach, the four aims of this R21 allow us to develop and test the online tools needed to create effective health screening interventions with Deaf populations. Through Aim 1 we will utilize qualitative online interviews in ASL to assess the experiences of a geographically dispersed group of D-MSM in HIV risk behavior, knowledge, barriers and facilitators to testing, and prevention needs. For Aim 2, we will develop the quantitative measures needed to assess the Deaf experience of seeking services, including new Deaf-specific measures. In Aim 3, we will develop and test the resulting online, visually-based survey tools in ASL-English, including an HIV risk screening instrument. Through Aim 4, we will conduct the first online ASL- based HIV needs assessment of D-MSM using a national sample. The public health impact of this study resides in the contribution to advancing research in overcoming health disparities, by developing a suite of online tools and services available nationally to facilitate access to health services for Deaf people, and their providers, thereby addressing the needs of a chronically underserved population. PUBLIC HEALTH RELEVANCE: Deaf MSM (D-MSM) are a high-risk, underserved population experiencing chronic barriers to HIV testing and linkage to care. The principal challenge is that HIV research, testing, counseling and services is typically provided in English, while D-MSM communicate primarily through American Sign Language (ASL) and have, on average, very low (3rd-4th grade) English reading levels. Because the population is geographically dispersed through the USA, most places lack resources to provide confidential HIV testing services in ASL. This R21 is a feasibility and acceptability test of how to use technology to overcome the chronic barriers experienced by D- MSM. We will design, develop and test online methods to engage a diverse national sample of D-MSM in a study of HIV screening and prevention needs, using a combined ASL-English dual format. We plan to develop a suite of online ASL-English tools for providers, researchers, and surveillance to use, thus enabling D-MSM to finally engage in HIV prevention and care.

描述（由申请人提供）：本申请是为了响应PA-11-119“美国服务不足人群中的艾滋病毒/艾滋病检测和后续行动”（R21），该申请邀请对经历“检测和护理联系的独特障碍或促进因素”的人群进行赠款申请。与男性发生性关系的聋哑男子（D-MSM）就是这样一个群体，长期被排除在艾滋病毒研究、检测、监测、教育和服务之外。马里兰州是唯一一个在筛查艾滋病毒时询问听力状况的州，其数据表明，一般聋人和听力困难人群中的艾滋病毒流行率是听力人群的2至5倍。我们预计D-MSM的子集是较大聋人人群中风险最高的群体。在HIV/AIDS流行的30年中，在美国没有进行过关于D-MSM的HIV检测率、危险行为、预防和治疗需求的全国性研究，这是我们开始在本申请中解决的一个长期问题。基于互联网的技术可以使我们能够接触到D-MSM进行艾滋病毒研究、服务和教育。这项研究的长期目标是通过开发创新的、文化上和语言上无障碍的、基于互联网的方法和干预措施，改善聋人的艾滋病毒筛查、检测、预防、治疗和获得。作为第一步，在R21中，我们将开发和测试在线的、基于视觉的定性和定量研究工具（整合美国手语和英语），同时还将对美国手语中的D-MSM进行首次艾滋病毒检测和预防需求评估。结合交叉性理论和社会认知方法，R21的四个目标使我们能够开发和测试为聋人群体创建有效的健康筛查干预措施所需的在线工具。通过目标1，我们将利用ASL中的定性在线访谈来评估地理上分散的D-MSM群体在艾滋病毒风险行为，知识，测试障碍和促进者以及预防需求方面的经验。对于目标2，我们将制定评估聋人寻求服务的经验所需的量化措施，包括新的聋人特定措施。在目标3中，我们将开发和测试ASL-英语的在线视觉调查工具，包括艾滋病毒风险筛查工具。通过目标4，我们将使用全国样本对D-MSM进行首次基于ASL的在线艾滋病毒需求评估。这项研究的公共卫生影响在于通过开发一套全国可用的在线工具和服务，促进聋人及其提供者获得卫生服务，从而解决长期服务不足人口的需求，从而促进克服健康差距的研究。 公共卫生相关性：聋人男男性行为者（D-MSM）是一种高风险，服务不足的人群，他们在艾滋病毒检测和护理方面遇到了长期障碍。主要的挑战是，艾滋病毒研究、检测、咨询和服务通常以英语提供，而D-MSM主要通过美国手语进行交流，平均而言，英语阅读水平很低（3 - 4年级）。由于人口在地理上分散在美国各地，大多数地方缺乏资源来提供保密的艾滋病毒检测服务。这个R21是一个可行性和可接受性的测试，如何使用技术来克服慢性障碍所经历的D- MSM。我们将设计，开发和测试在线方法，以使不同国家的D-MSM样本参与艾滋病毒筛查和预防需求的研究，使用ASL-英语双重格式。我们计划开发一套在线ASL-英语工具，供提供者、研究人员和监测人员使用，从而使D-MSM最终能够参与艾滋病毒预防和护理。