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Serosorting Intervention for HIV Negative MSM

HIV 阴性 MSM 的血清分选干预

基本信息

批准号：
8843960
负责人：
Lisa A Eaton
金额：
$ 45.89万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-11 至 2017-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8843960
关键词：
18 year old AIDS/HIV problem Accounting Acute Address Anal Sex Awareness Behavior Therapy Belief Biological Caring Centers for Disease Control and Prevention (U.S.)Cities Communities Conflict (Psychology)Contracts Control Groups Cost Effectiveness Analysis Counseling Decision Making Diagnosis Disclosure Effectiveness Employee Strikes Epidemic Equilibrium Failure Fatigue Financial compensation Guidelines HIV HIV Infections HIV Seropositivity HIV risk Human immunodeficiency virus test Individual Infection Infection Control Informed Consent Intervention Intervention Trial Knowledge Measures Modeling Participant Prevention Public Health Randomized Randomized Controlled Trials Recruitment Activity Reporting Research Research Personnel Risk Risk Behaviors Risk Reduction Risk-Taking Safe Sex Security Services Sex Behavior Sexual Partners Sexually Transmitted Diseases Site Staging Structure Test Result Testing Time United States Public Health Service Unsafe Sex arm base behavioral outcome condoms cost design economic evaluation effective intervention high risk improved male meetings men men who have sex with men novel novel strategies prevent response scale up screening sex stem theories therapy design transmission process

项目摘要

DESCRIPTION (provided by applicant): Men who have sex with men continue to make up a majority of incident HIV infections. Despite alarmingly high rates of HIV infection, there are few effective interventions to prevent HIV transmission among these men. This five year study, proposed by a New/Early Stage Investigator, consists of a randomized controlled trial to test a behavioral intervention designed to reduce risks for HIV/AIDS posed by sexual partner selection strategies, specifically serosorting, among at-risk HIV negative men who have sex with men in Atlanta, GA. Serosorting - limiting unprotected sexual partners to those of the same HIV status- has emerged as a risk reduction strategy with little input from public health agencies. It is commonly practiced among men who have sex with men to avoid HIV infection. However, engaging in serosorting is a predictor of HIV transmission rather than a reliable form of prevention. Serosorting is ineffective due to several factors, including: multiple flaws in the ability to be certain of own or partner's HIV statuses, the failure of routine HIV tests to detect acute HIV infection, elevated infectiousness due to acute HIV infection, and increased risk for contracting other STIs that can facilitate HIV transmission. We are therefore proposing to test a brief, single-session, Conflict Theory of Decision Making based intervention for use in public health settings. This project uses a novel theory of informed decision making to guide an intervention designed for use in routine services, i.e., HIV post-test counseling. An intervention to address the needs of men who test HIV negative fits well with current efforts to scale up HIV testing, also referred to as seek, test and treat. The proposed research builds on the strengths of a pilot tested, behavioral intervention for addressing serosorting among men who have sex with men. Following screening, informed consent, baseline assessments, and HIV testing (we predict 70 men will test HIV positive), 600 HIV- negative participants will be randomly assigned to receive one of two intervention arms: (a) a serosorting, partner selection intervention, or (b) a time-match, CDC based, post-HIV test counseling, standard-of-care. Participants will be followed over 12-months and assessments will include measures of serosorting beliefs, decisional balance, knowledge of acute HIV infection, HIV status disclosure, and biological (incident STI) and behavioral outcomes (sexual behaviors). This study will test the hypotheses that a brief, single session, serosorting intervention will result in less risk-related serosorting beliefs, greater knowledge/awareness of HIV transmission risk taking, increased HIV status disclosure, reductions in number of sex partners, unprotected sex acts, and incident STIs among intervention participants more so than the control group participants. Moreover, we will test the hypothesis that the intervention will be cost saving when tested in cost-effectiveness analyses. If shown effective, the intervention model will be ready for immediate dissemination to HIV testing services. Effective and novel strategies for reducing risk taking among men who have sex with men are urgently needed to reduce the disproportionate rate of incident HIV infections among this highest risk group.

描述（由申请人提供）：男男性行为者继续占艾滋病毒感染事件的大多数。尽管艾滋病毒感染率高得惊人，但在这些男性中预防艾滋病毒传播的有效干预措施却很少。这项为期五年的研究，由一名新/早期研究者提出，包括一项随机对照试验，以测试一种行为干预，旨在降低由性伴侣选择策略引起的艾滋病毒/艾滋病风险，特别是血清分类，在佐治亚州亚特兰大的艾滋病毒阴性高危男男性行为者中。血清分拣——将未受保护的性伴侣限定为感染艾滋病毒相同的人——已成为一种减少风险的战略，而公共卫生机构的投入很少。这种做法在男男性行为者中普遍存在，以避免感染艾滋病毒。然而，参与血清分类是艾滋病毒传播的预测因子，而不是一种可靠的预防形式。由于几个因素，血清分选是无效的，包括：在确定自己或伴侣的艾滋病毒状况方面存在多重缺陷，常规艾滋病毒检测无法发现急性艾滋病毒感染，急性艾滋病毒感染导致传染性升高，以及感染可促进艾滋病毒传播的其他性传播感染的风险增加。因此，我们建议测试一个简短的、单次会议的、基于决策冲突理论的干预措施，用于公共卫生环境。该项目采用一种新的知情决策理论来指导一种旨在用于常规服务的干预措施，即艾滋病毒检测后咨询。解决艾滋病毒检测呈阴性的男性需求的干预措施与目前扩大艾滋病毒检测的努力非常吻合，也被称为寻找、检测和治疗。这项拟议的研究建立在一项试点测试的优势之上，即行为干预，用于解决男男性行为者的血清分类问题。在筛查、知情同意、基线评估和艾滋病毒检测（我们预测70名男性将检测出艾滋病毒阳性）之后，600名艾滋病毒阴性参与者将被随机分配接受两种干预组中的一种：(a)血清分类、伴侣选择干预，或(b)时间匹配、基于CDC的艾滋病毒检测后咨询、标准护理。参与者将被随访超过12个月，评估将包括血清分类信念、决策平衡、对急性艾滋病毒感染的了解、艾滋病毒状况披露、生物学（偶发性传播感染）和行为结果（性行为）。本研究将检验以下假设：与对照组参与者相比，短暂的单次血清分类干预会降低与风险相关的血清分类信念，提高对艾滋病毒传播风险的认识/意识，增加艾滋病毒状况披露，减少性伴侣数量，无保护的性行为和性传播感染事件。此外，我们将在成本效益分析中测试干预措施将节省成本的假设。如果证明有效，干预模式将准备好立即传播到艾滋病毒检测服务机构。迫切需要有效和新颖的战略来减少男男性行为者的冒险行为，以降低这一最高风险群体中不成比例的艾滋病毒感染率。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Transactional Sex With Regular and Casual Partners Among Young Men Who Have Sex With Men in the Detroit Metro Area.

在底特律都会区与男人发生性关系的年轻人中的常规和休闲伴侣的交易性行为。

DOI：
10.1177/1557988315609110
发表时间：
2017-05
期刊：
American journal of men's health
影响因子：
0
作者：
Bauermeister JA;Eaton L;Meanley S;Pingel ES;UHIP Partnership
通讯作者：
UHIP Partnership

An evaluation of factors associated with sexual risk taking among Black men who have sex with men: a comparison of younger and older populations.

DOI：
10.1007/s10865-016-9734-x
发表时间：
2016-08
期刊：
Journal of behavioral medicine
影响因子：
3.1
作者：
Maksut JL;Eaton LA;Siembida EJ;Driffin DD;Baldwin R
通讯作者：
Baldwin R

Black men who have sex with men, sexual risk-taking, and willingness to use rapid home HIV tests.

与男人发生性关系的黑人，性冒险和使用快速家庭艾滋病毒测试的意愿。

DOI：
10.1007/s11121-014-0496-9
发表时间：
2015-02
期刊：
PREVENTION SCIENCE
影响因子：
3.5
作者：
Eaton, Lisa A.;Driffin, Daniel D.;Smith, Harlan;Conway-Washington, Christopher;White, Denise;Cherry, Chauncey
通讯作者：
Cherry, Chauncey

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men.