HIV Education for African American Men

 描述（由申请人提供）：每16名黑人男性中就有一名在其一生中被诊断出患有艾滋病毒，而每102名白色男性中就有一名被诊断出患有艾滋病毒。在非洲裔美国男性中，大约20%的新艾滋病毒病例是由于异性性传播。尽管如此，与女性发生性关系的黑人男性（MSW）很少受到经验主义的关注。传统的性别角色和权力不平等倾向于让男性在非裔美国人关系中对性决策有更大的控制权。然而，黑人男子在与妇女发生性关系时通常不使用避孕套，这是禁欲之外最有效的艾滋病毒预防方法之一。这些发现表明，在艾滋病毒预防工作中未能针对异性恋活跃的非洲裔美国人是一个错失的机会。 使用男用避孕套的一个主要障碍是性快感降低。女用避孕套（FC）是一种替代性的艾滋病毒保护方法，可以克服这一障碍。研究表明，黑人妇女对FC教育反应良好，但性别规范可能会阻碍她们向男性伴侣介绍FC的努力。克服这一障碍的一种方法是直接向男性提供FC培训。事实上，研究表明，男性可以学习FC技能，将帮助女性伴侣使用FC，并在接受FC和男用避孕套培训后报告更少的无保护性伴侣。此外，男性认可使用FC的几个好处，包括STI保护和自然的感觉。重要的是，一些男性更喜欢FC，因为它们比男用避孕套提供更大的性感觉。 为了利用FC培训的潜力，为黑人城市固体废物，我们打算开发电子焦点，一个基于计算机的艾滋病毒行为干预异性恋活跃的非洲裔美国男子，包括在男用和女用避孕套的使用培训。e-focus将通过网络实现Focus on the Future（FOF）的核心组成部分，这是针对高危黑人城市固体废物的唯一最佳证据艾滋病毒行为干预措施。FOF是一个一小时的干预，解决了正确和一致使用男用避孕套和润滑剂，避孕套谈判，以及男性保护自己未来的重要性。FOF的主要信息是，有许多类型的避孕套和润滑剂，男人应该尝试找到让性感觉最好的选择。通过提供FC作为一个额外的，有时是首选的选择，电子焦点旨在减少减少性快感和其他避孕套障碍对艾滋病毒预防的影响。另一个障碍，黑人城市固体废物的艾滋病毒风险降低行为是在传统的男性意识形态，强调男性的性能力，女性的从属地位，和异性恋信仰。信奉这些信念的黑人男性更有可能从事危险的性行为。为了解决这个问题，电子焦点将包括对男性身份的讨论，并将提供方法，将潜在危险的男性信念重新构建为更健康的性行为和关系行为。 第一阶段原型开发将通过对目标最终用户和非洲裔美国妇女的形成性研究以及我们的专家顾问的投入来了解。完成的原型将进行可用性测试和原型审查与非洲裔美国城市固体废物寻求服务的艾滋病毒/性传播感染服务提供者。

 DESCRIPTION (provided by applicant): One in 16 Black men will be diagnosed with HIV in his lifetime as compared to 1 in 102 White men. Approximately 20% of all new HIV cases among African American men are due to heterosexual transmission. Despite this, Black men who have sex with women (MSW) have received very little empirical attention. Traditional gender roles and power inequalities tend to give men greater control over sexual decision-making in African American relationships. However, Black men do not routinely use condoms, one of the most effective HIV prevention methods beyond abstinence, during sex with women. These findings suggest that the failure to target heterosexually active African American men in HIV prevention efforts is a missed opportunity. A key barrier to male condom use is reduced sexual pleasure. The female condom (FC) is an alternative HIV protection method that may overcome this barrier. Research shows that Black women respond well to FC education, but gender norms may impede their efforts to introduce FCs to male partners. One way to overcome this roadblock is to provide FC training directly to men. Indeed, studies have shown that men can learn FC skills, will help female partners use FC, and report fewer unprotected sex partners after receiving FC and male condom training. In addition, men endorse several benefits to FC use, including STI protection and natural feel. Importantly, some men prefer FCs because they provide greater sexual sensation than male condoms. To harness the potential of FC training for Black MSW, we intend to develop e-focus, a computer-based HIV behavioral intervention for heterosexually active African American men that includes training in both male and female condom use. e-focus will web-enable the core components of Focus on the Future (FOF), the only best-evidence HIV behavioral intervention for high-risk Black MSW. FOF is a one-hour intervention that addresses the correct and consistent use of male condoms and lubricant, condom negotiation, and the importance of men protecting their future. The main message of FOF is that there are many types of condoms and lubricants and men should experiment to find the choice that make sex feel best. By providing FC as an additional, and sometimes preferred, choice, e-focus aims to lessen the influence of decreased sexual pleasure and other condom barriers on HIV prevention. Another obstacle to Black MSW's HIV risk reduction behavior is belief in a traditional masculine ideology, which emphasizes male sexual prowess, female subordination, and heterosexuality. Black men who espouse these beliefs are more likely to engage in sexual risk behavior. To combat this, e-focus will include a discussion of masculine identity and will provide methods to reframe potentially dangerous masculine beliefs into healthier sexual and relationship behaviors. Phase I prototype development will be informed by formative research with target end-users and African American women, as well as input from our expert consultants. The completed prototype will undergo usability testing and a prototype review with African American MSW seeking services at an HIV/STI service provider.