Using CBPR to Reduce HIV Risk Among Immigrant Latino MSM

描述(申请人提供)：东南部拥有美国增长最快的拉丁裔人口，同时也背负着不成比例的艾滋病毒负担。对于拉丁裔或男男性行为者(MSM)来说，几乎没有有效的艾滋病毒预防干预措施，而对于新来的、讲西班牙语、文化适应程度较低的拉丁裔MSM，则没有任何有效的预防措施。作为对PA-08-074“社区参与研究”的回应，我们的社区和大学合作伙伴关系建议共同进行一项为期5年的准实验研究(R01)，以完善、全面实施和严格评估非专业健康顾问(LHA)干预措施，旨在增加最近到达的、讲西班牙语、文化适应程度较低的拉美裔MSM中的避孕套使用和艾滋病毒检测，这些MSM正在东南农村定居。该干预措施以社会认知理论和赋权教育理论为基础，采用基于社区的参与性研究(CBPR)。这项研究是社区-大学长期伙伴关系的结果，这种伙伴关系已经并将继续在研究的所有阶段使用CBPR。北卡罗来纳州乡郊共有20名拉丁裔男男性接触者将被筛选和招募为当地居民。我们的合作伙伴关系将根据自然帮手和非正式领导人的素质以及拥有其他拉丁裔MSM的现有社交网络来选择LHA。每个LHA的社交网络中的12名成员也将被筛选和招募参与。LHA及其社交网络将被随机分为干预组或延迟干预组。干预组中的LHA(n=10)将在第二年接受培训，并在其社会网络中担任LHA。延迟干预的LHA(n=10)将在第三年接受相同的LHA培训并在其社会网络中担任LHA。定量评估数据将从每个LHA(n=20)及其12个社交网络成员(n=240)的纵向收集：(1)基线，(2)干预后立即，(3)12个月随访。这是一项“意向治疗”研究，参与者的数据是根据他们的随机分组进行分析的。我们假设，相对于延迟干预对照组，HIV预防干预的参与者将表现出(1)性行为中自我报告的避孕套使用量增加，(2)自我报告的HIV检测增加。这项研究的结果和产品将被传播，为公共卫生实践、研究和政策提供信息。成果和产品将包括：(1)西班牙语干预：具有文化相关性和性别针对性；旨在降低拉丁裔MSM中的艾滋病毒风险；并为传播和适应做好准备；(2)更深入地了解艾滋病毒风险和拉丁裔MSM中的干预措施；(3)深入了解包括社区成员、组织代表和学术研究人员在内的CBPR进程。

DESCRIPTION (provided by applicant): The Southeast has the fastest-growing Latino population in the United States and at the same time carries a disproportionate HIV burden. Few efficacious HIV prevention interventions exist for either Latinos or men who have sex with men (MSM), and none exists for recently arrived, Spanish-speaking, less-acculturated Latino MSM. In response to PA-08-074 "Community Participation in Research," our community-university partnership proposes to jointly conduct a 5-year quasi-experimental study (R01) to refine, fully implement, and rigorously evaluate a lay health advisor (LHA) intervention designed to increase condom use and HIV testing among recently arrived, Spanish-speaking, less-acculturated Latino MSM who are settling in the rural Southeast. The intervention is based on social cognitive theory and theory of empowerment education and was developed using community-based participatory research (CBPR). This study is a result of a long-term community- university partnership that has used and will continue to use CBPR throughout all phases of research. A total of 20 Latino MSM in rural NC will be screened and recruited to serve as LHAs. Our partnership will select LHAs based on qualities of natural helpers and informal leaders and having existing social networks of other Latino MSM. Twelve members of each LHA's social network will be screened and recruited to participate as well. The LHAs, coupled with their social networks, will be randomized to intervention or delayed- intervention groups. LHAs (n=10) in the intervention group will be trained and serve as LHAs within their social networks in Year 2. Delayed-intervention LHAs (n=10) will receive the same LHA training and serve as LHAs within their social networks in Year 3. Quantitative assessment data will be collected from each LHA (n=20) and the 12 members of his social network (n=240) longitudinally at: (1) baseline, (2) immediate post- intervention, and (3) 12-month follow-up. This is an "intent-to-treat" study, in which participant data are analyzed based on their randomization group. We hypothesize that participants in the HIV prevention intervention, relative to those in the delayed- intervention comparison group, will demonstrate (1) increased self-reported use of condoms during sexual intercourse and (2) increased self-reported HIV testing. The results and products from this study will be disseminated to inform public health practice, research, and policy. Results and products will include: (1) a Spanish-language intervention that is: culturally relevant and gender-specific; designed to reduce HIV risk among Latino MSM; and ready for dissemination and adaptation; (2) a deeper understanding of HIV risk and intervention among Latino MSM; and (3) insight into a CBPR process that includes community members, organizational representatives, and academic researchers.