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Implementation of a Sexual Health Intervention for YMSM in Two Vietnamese Cities

在越南两个城市实施 YMSM 性健康干预措施

基本信息

批准号：
8475439
负责人：
Michael C. Clatts
金额：
$ 69.72万
依托单位：
NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-06-01 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8475439
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Africa South of the Sahara Age Alcohol abuse Asia Awareness Behavioral Cambodia Caring Cessation of life China Cities Clinic Collaborations Communities Community Health Services Community Outreach Complex Country Cross-Sectional Studies Data Dependency Development Discipline of Nursing Discrimination Early Diagnosis Economics Education Effectiveness Enrollment Epidemic Epidemiologic Studies Epidemiology Ethnography Evaluation Exposure to Face Female Fostering Funding Future Gays Goals HBV Vaccination HIV HIV risk HIV/STD Harm Reduction Health Promotion Health Services Healthcare Hepatitis B Virus Hepatitis C virus High Prevalence Human Papillomavirus Human immunodeficiency virus test Incidence Income India Individual Indonesia Infection International Intervention Knowledge Life Mental Depression Mental Health Methods Modeling Myanmar National Institute of Drug Abuse Nurses Outcome Outcome and Process Assessment Participant Pattern Pharmaceutical Preparations Policies Population Population Sizes Prevention Prevention program Process Protocols documentation Recording of previous events Research Research Design Research Infrastructure Risk Risk Reduction Route Self Perception Services Sexual Health Singapore South Korea Southeastern Asia Symptoms Technology Testing Thailand Time Unsafe Sex Vaccination Vietnam Work Youth base disorder control experience high risk holistic approach implementation science improved interest male male sex worker men who have sex with men metropolitan neglect outreach peer prevention service programs response risk perception screening service intervention sex skills social social stigma surveillance data systematic review therapy development transmission process uptake

项目摘要

DESCRIPTION (provided by applicant): Both surveillance and behavioral epidemiological studies show that young male sex workers (YMSWs) in Vietnam have high rates of unprotected sex with multiple, concurrent partners - including both male and female partners - contributing to high rates of STIs and HIV and amplifying already high HIV incidence. Exposure to existing prevention programming is low, with major gaps in HIV knowledge and sexual risk reduction skills. Existing community outreach activities have primarily reached gay-identified YMSM. Moreover, owing to profound risk for stigma and discrimination in health care settings, few YMSW are engaged and retained in protective health services (including STI/HIV screening, HBV/HPV vaccination, and early linkages to HIV care). Our collaborative US/Vietnam research team has been conducting NIDA-funded HIV research among high risk youth populations, including YMSWs, for the past eight years. Building on the substantial research capacity and health services infrastructure that has been achieved in our prior work, we propose to address these gaps in community outreach and health services access by implementing a composite intervention package targeted to YMSWs in the two strategically selected cities in Vietnam (Hanoi and Ho Chi Minh City). Using Sexual Health Promotion as a conceptual framework, we will combine already proven intervention technologies - community outreach nursing and sexual health promotion interventions - to enhance outreach coverage and to foster engagement and retention in health services. Significant levels of outreach coverage will be achieved (with an estimated 12,000 outreach contacts) and substantial numbers of health services will be delivered (2,400 health services participants). Using a mixed-methods approach that includes anthropological ethnography, social and behavioral epidemiology, and health services assessments, process and outcomes evaluation of both the community outreach and health services intervention will be undertaken. Repeated cross-sectional surveys, administered both prior to and following implementation of the community outreach and health services intervention, will document community-level increases in exposure to outreach, increased knowledge and awareness of behavioral HIV risk, increased sexual risk reduction skills and participation in the clinic-based sexual health promotion intervention, thus demonstrating effective engagement and retention in health services. Of particular interest to implementation science, both qualitative and quantitative analysis will assess between-city differences in intervention uptake and effectiveness, data that will inform our understanding of the impact, adaptability, and generalizability of the intervention and guide future dissemination.

描述(申请人提供)：监测和行为流行病学研究表明，越南的年轻男性性工作者(YMSW)与多个同时存在的伴侣--包括男性和女性伴侣--发生无保护措施的性行为的比率很高，这导致了高的性传播感染和艾滋病毒感染率，并放大了本已很高的艾滋病毒发病率。对现有预防方案的接触较少，在艾滋病毒知识和减少性风险技能方面存在重大差距。现有的社区外展活动主要惠及以同性恋为身份的基督教青年会。此外，由于在卫生保健环境中存在污名和歧视的严重风险，很少有女青年妇女参与和保留保护性卫生服务(包括性传播感染/艾滋病毒筛查、乙肝病毒/人乳头瘤疫苗接种以及与艾滋病毒护理的早期联系)。在过去的八年里，我们的美国/越南合作研究团队一直在NIDA资助的高危青年人群中进行艾滋病毒研究，其中包括女童子军。在我们前期工作已取得的大量研究能力和医疗服务基础设施的基础上，我们建议通过实施针对越南两个战略选择的城市(河内和胡志明市)的YMSW的综合干预方案，来弥补社区外展和医疗服务获得方面的这些差距。以性健康促进为概念框架，我们将结合已经证实的干预技术--社区外展护理和性健康促进干预--以扩大外展覆盖面，并促进健康服务的参与度和保留率。将实现很大程度的外联覆盖面(估计有12000名外联接触者)，并将提供大量保健服务(2400名保健服务参与者)。将采用包括人类学人种学、社会和行为流行病学以及卫生服务评估在内的混合方法，对社区外展和卫生服务干预的过程和结果进行评估。在实施社区外展和保健服务干预措施之前和之后进行的反复横断面调查将记录社区一级接触外展活动的增加、对行为艾滋病毒风险的认识和认识的增加、减少性风险的技能以及对以诊所为基础的性健康促进干预的参与，从而证明有效地参与和保留了保健服务。实施科学特别感兴趣的是，定性和定量分析都将评估城市之间在干预吸收和有效性方面的差异，这些数据将使我们了解干预的影响、适应性和概括性，并指导未来的传播。