PS09-007, Evaluating Locally Developed Homegrown HIV Prevention Interventions

PS09-007，评估当地开发的本土艾滋病毒预防干预措施

• 批准号: 8651770
• 负责人: DARRELL P WHEELER
• 金额: $ 49.82万
• 依托单位: LOYOLA UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8651770
• 关键词: PS09; 007; Evaluating; Locally; Developed

DESCRIPTION (provided by applicant): HIV infection directly or indirectly related to male-to-male sexual intercourse is the single major contributor to HIV infection among African-Americans, accounting for an estimated 50% of all US AIDS cases diagnosed among African-American men. Despite this disproportionate burden, few HIV prevention/risk reduction interventions have been specifically designed and evaluated for efficacy among African American men who have sex with men (AAMSM). The proposed study will address this gap by implementing and rigorously testing the efficacy in reducing HIV risk behaviors among a sample of 300 AAMSM aged 18-55 in New York City of the Critical Thinking and Cultural Affirmation (CTCA) HIV risk behavior intervention. The CTCA strategy is a home-grown, African-American culturally-informed model which has been implemented for over a decade in Los Angeles, California, and since 2002, in New York City. Based in social cognitive behavioral theory, the CTCA intervention combines critical thinking, African- American cultural awareness, health literacy, counseling and group dynamics to empower AAMSM to reduce their HIV risk behaviors and move toward self-actualization and greater responsibility for themselves and their community. The proposed study will compare the CTCA intervention to standard HIV testing and counseling protocol (standard of care), hypothesizing: 1) that participants who complete the intervention will report greater reductions in sexual risk behaviors than the standard care comparison group; and 2) that the CTCA intervention is more cost effective than the standard of care. Consistent with established criteria for providing best-evidence of intervention efficacy, the study will be a pre-test/post- test design with randomized assignment to intervention and comparison groups; have a strategy to retain at least 70% of participants through study completion; collect data at baseline, immediately post- intervention, and at a minimum, at 3 and 6 months post-intervention; rigorously measure outcomes that directly impact AAMSM's HIV risk (e.g., number of sex partners, condom use) or a biologic measure indicating HIV or STD infection. The Specific Aims of this study are 1) to further explicate and develop the homegrown CTCA intervention, 2) to evaluate its efficacy and cost-effectiveness in reducing AAMSM's HIV risk behaviors, and 3) thereby to expand the limited body of research on HIV prevention/risk reduction practices for AAMSM. Relevance: Given the shortage of tested and effective HIV prevention interventions for AAMSM and their disproportionate and rising HIV burden, the proposed study addresses a most urgent public health need. Advancing understanding of the risk behaviors, rates and incidence of HIV/AIDS among AAMSM, and creating effective risk interventions for them must be part of the agenda to reverse the worsening epidemic among African-Americans in the United States.

描述（由申请人提供）：与男性间性交直接或间接相关的艾滋病毒感染是非洲裔美国人感染艾滋病毒的单一主要因素，估计占美国非洲裔男性诊断的所有艾滋病病例的50%。尽管存在这种不成比例的负担，但很少有专门针对非裔美国男男性行为者（AAMSM）设计和评估艾滋病毒预防/降低风险干预措施的效果。本研究将通过在纽约市批判性思维和文化肯定（CTCA）艾滋病风险行为干预的300名18-55岁的AAMSM样本中实施和严格测试减少艾滋病毒风险行为的效果来解决这一差距。CTCA战略是一种土生土长的非裔美国人文化知情模式，已在加利福尼亚州洛杉矶实施了十多年，自2002年起在纽约市实施。基于社会认知行为理论，CTCA干预结合了批判性思维、非裔美国人文化意识、健康素养、咨询和群体动力学，使AAMSM能够减少他们的艾滋病毒风险行为，走向自我实现和对自己和社区承担更大的责任。拟议的研究将比较CTCA干预与标准艾滋病毒检测和咨询方案（标准护理），假设：1)完成干预的参与者将比标准护理对照组报告更多的性危险行为减少；2) CTCA干预比标准护理更具成本效益。与提供干预效果最佳证据的既定标准一致，该研究将采用测试前/测试后设计，随机分配到干预组和对照组；制定一个策略，通过完成研究来留住至少70%的参与者；在基线、干预后立即以及至少在干预后3个月和6个月收集数据；严格测量直接影响AAMSM艾滋病毒风险的结果（例如，性伴侣的数量，避孕套的使用）或表明艾滋病毒或性病感染的生物测量。本研究的具体目的是：1)进一步阐明和发展国产CTCA干预措施；2)评估其在减少AAMSM艾滋病风险行为方面的效果和成本效益；3)从而扩大AAMSM艾滋病预防/风险降低实践的有限研究主体。相关性：考虑到针对男男性行为者缺乏经过检验和有效的艾滋病毒预防干预措施，以及他们的艾滋病毒负担不成比例且不断上升，拟议的研究解决了一项最紧迫的公共卫生需求。为扭转美国非裔美国人中艾滋病毒/艾滋病日益恶化的趋势，必须将增进对非裔美国人的危险行为、艾滋病毒/艾滋病发病率和发病率的了解，并为他们制定有效的风险干预措施列入议程。