Testing an Intervention to Increase HIV Self-Testing among Young, Black MSM

测试一种干预措施，以增加年轻黑人男男性接触者的艾滋病毒自我检测

基本信息

批准号：
8769814
负责人：
Victoria Frye
金额：
$ 60.78万
依托单位：
NEW YORK BLOOD CENTER
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-15 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8769814
关键词：
AIDS prevention Address African American Caring Cognitive Communication Communities Complex Confidentiality Counseling Couples Development Diffuse Discrimination Drug usage Drug user Education Face Generic Drugs HIV HIV Infections HIV diagnosis HIV risk Health Homophobia Human immunodeficiency virus test Incidence Internet Intervention Interview Knowledge Mails Maintenance Maps Medical Methods Modeling Motivation Participant Patient Self-Report Perception Phase Preventive Intervention Privacy Provider Randomized Randomized Controlled Trials Recruitment Activity Reporting Research Research Design Risk Behaviors Risk Reduction Sex Behavior Sexual Health Site Social Network Structure System Techniques Technology Testing Text Time Training Treatment Efficacy United States aged alcohol and other drug arm base behavior influence behavior test brief intervention burden of illness condoms design empowered experience improved innovation men who have sex with men motivational enhancement therapy novel peer preference prevent programs resilience screening skills skills training social social stigma success theories uptake

项目摘要

DESCRIPTION (provided by applicant): Increasing HIV testing rates among young, African American or Black men who have sex with men (YBMSM) is critical to reducing the disproportionate disease burden in the African American/Black community. Rates of new HIV infections increased 48% between 2006 and 2009 among YBMSM; a recent study reported a nearly 6% annual HIV incidence among YBMSM. A significant portion of YBMSM has not tested in the prior year and YBMSM are 7 times more likely to be unaware of their HIV infection, as compared to other young MSM. The stigma associated with accessing fixed site HIV testing prevents many YBMSM from testing. In addition, alcohol and other drug (AOD) use represent a significant barrier to HIV prevention, including testing, among YBMSM, reflecting complex social structures, enhancing the impact of stigma and discrimination. We propose a study to design and test a brief intervention to increase uptake of consistent HIV self-testing among YBMSM using a novel and culturally-relevant "buddy system" approach. In our model, peer educators train pairs of YBMSM (or "buddies") to initiate self-testing and support each other in consistent self-testing (every 3 months) and sexual and AOD use risk reduction. The self-test is a promising new method that reduces several barriers to testing for YBMSM, such as HIV testing stigma, homophobia, mistrust of medical care providers/system, limited access, and confidentiality/privacy concerns. The intervention, which is brief, focused and tailored, has three primary components. First, buddies will receive a 25-minute self-testing skills-building, motivation- enhancing and peer support-focused session, rapid HIV testing and free self-test kits at our fixed site or on our mobile testing unit. Second, additional self-tests will be deliverd (or accessed) as needed, using the delivery method of their choice. Third, booster messages, based on personalized testing plans developed during the initial session, will be delivered using preferred type of communication technology (e.g., texts, e-mail, calls). A peer educator will deliver the intervention and on-demand technical support will be available from the study team using the full range of communication technology. As part of the study, we propose to conduct 30 in- depth interviews to identify barriers to, facilitators of, perceptions of and preferences fo regular HIV self- testing, describe how AOD use and sexual behavior influence HIV self-testing behaviors, and assess participant perspectives on the proposed buddy intervention. Next, based on the formative research, we will use intervention mapping to adapt couples testing, integrating enhanced motivational interviewing techniques to create a brief, peer educator-delivered, face-to-face intervention. Finally, we will use web- and app-based approaches to recruit 376 HIV-negative, BMSM aged 18 to 24 who will be randomized as pairs to either the intervention arm (skills training; free test kits on demand; tailored booster messages) or the control arm (generic health screening information; free test kits on demand) and followed for 12 months to estimate the intervention's efficacy in increasing regular self-reported HIV self-testing

描述（由申请人提供）：与男性发生性关系（YBMSM）的年轻，非裔美国人或黑人男性的艾滋病毒测试率提高对于减轻非裔美国人/黑人社区的不成比例疾病负担至关重要。在YBMSM中，新艾滋病毒感染的发生率在2006年至2009年之间增加了48％；最近的一项研究报告说，YBMSM的年HIV发病率接近6％。 YBMSM的很大一部分尚未在上一年进行测试，与其他年轻MSM相比，YBMSM不知道其HIV感染的可能性高7倍。与访问固定现场HIV测试有关的污名可阻止许多YBMSM测试。此外，酒精和其他药物（AOD）的使用代表了预防HIV的重要障碍，包括在YBMSM中进行测试，反映复杂的社会结构，增强了污名和歧视的影响。我们提出了一项研究，以设计和测试简短的干预措施，以使用一种新颖的和文化上的“好友系统”方法来增加YBMSM之间一致的HIV自我测试的吸收。在我们的模型中，同伴教育者训练成对的YBMSM（或“好友”），以一致的自我测试（每3个月）和性和AOD使用风险降低以一致的自我测试（每3个月）进行自我测试和支持。自我测试是一种有希望的新方法，可减少YBMSM测试的几个障碍，例如艾滋病毒测试污名，同性恋恐惧症，对医疗服务提供者/系统的不信任，有限的访问以及机密性/隐私问题。干预措施是简短的，专注的和量身定制的，有三个主要组件。首先，好友将在我们的固定站点或我们的移动测试单元上获得25分钟的自测技巧，增强和同伴支持的课程，快速HIV测试和免费的自我测试套件。其次，使用他们选择的交付方法，将根据需要进行（或访问）的其他自我测试。第三，基于初始会议期间制定的个性化测试计划的助推器消息将使用首选类型的通信技术（例如文本，电子邮件，呼叫）提供。同伴教育者将提供干预措施，并使用各种通信技术向学习团队提供按需技术支持。作为研究的一部分，我们建议进行30次深度访谈，以确定对常规艾滋病毒自我测试的障碍，促进，感知和偏爱，描述AOD的使用和性行为如何影响HIV的自我测试行为，并评估参与者对提议的好友干预的观点。接下来，根据形成性研究，我们将使用干预映射来调整夫妻测试，并将增强的动机访谈技术整合在一起，以创建简短的，同伴教育者进行的，面对面的干预。最后，我们将使用基于网络和应用程序的方法来招募376名HIV阴性，年龄在18至24岁之间的BMSM，他们将被随机地作为对干预组（技能培训；按需免费测试套件；量身定制的助推器消息）或控制臂（一般的健康筛查套件）（一般的健康筛查套件；需求免费），以进行12个月的自我自我估算，以自行自行自行自行自行自行自行自行审查。