Examining community-based effectiveness of a substance use and HIV risk reduction intervention for young men of color

检查基于社区的针对有色人种年轻男性的药物滥用和艾滋病毒风险降低干预措施的有效性

• 批准号: 9065055
• 负责人: JEFFREY T PARSONS
• 金额: $ 68.93万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-15 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065055
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Affect; African American; Age; Alcohol consumption; Alcohol or Other Drugs use; Anal Sex; Area; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Client; Clinical effectiveness; Collaborations; Color; Communities; Counseling; Development; Diagnosis; Drug usage; Economically Deprived Population; Effectiveness; Effectiveness of Interventions; Enrollment; Environment; Evidence based intervention; Exclusion Criteria; Feedback; Focus Groups; Gap Junctions; Goals; HIV; HIV Infections; HIV diagnosis; HIV risk; HIV/STD; Health; Hispanics; Incidence; Individual; Infection; Intervention; Intervention Studies; Latino; Link; Measures; Minority; Neighborhoods; New York City; Newly Diagnosed; Outcome; Participant; Patient Self-Report; Phase; Population; Prevention; Professional counselor; Prophylactic treatment; Publishing; Qualitative Research; Randomized; Recruitment Activity; Reporting; Research; Risk; Risk Reduction; Science; Services; Sexual Health; Sexual Partners; Site; System; Testing; Urine; Work; base; comparative effectiveness; condoms; cost effective; cost effectiveness; design; effectiveness trial; efficacy trial; ethnic diversity; ethnic minority population; experience; high risk; inclusion criteria; male health; men; men who have sex with men; motivational enhancement therapy; novel strategies; peer; portability; pragmatic trial; prevention service; programs; public health relevance; racial diversity; racial minority; reduced substance use; sex; sex risk; sexual encounter; surveillance data; theories; treatment as usual; trend; uptake; young man; young men who have sex with men

 DESCRIPTION (provided by applicant): Ethnic and racial minority young men who have sex with men (MYMSM) remain a critical population at the nexus of substance use and HIV/AIDS: a 132% increase in new infections concentrated among African American and Hispanic YMSM has been observed since 2002. The Young Men's Health Project (YMHP), a 4- session intervention utilizing motivational interviewing designed for HIV-negative or untested YMSM ages 18- 29 was found to be efficacious in significantly reducing substance use and condomless anal sex (CAS). To date, this is the first and only RCT of any published trial or CDC DEBI with YMSM to show significant reductions in both substance use and sexual risk. The CDC recently rated YMHP as "Best Evidence" and placed it on the compendium of Evidence Based Interventions and Best Practices for HIV Prevention. YMHP was tested through an efficacy trial in a research center environment with numerous inclusion and exclusion criteria, and thus, a community-based replication is the crucial next step in studying the intervention's effectiveness in the real world when delivered by staff to their clients. We will conduct a comparative effectiveness trial (CET) with two intensities of treatment offered following field-based HIV counseling and testing (C&T) - the YMHP intervention and enhanced "treatment as usual" (eTAU) HIV prevention services - in two real-world community based organizations (CBOs) to test their relative effectiveness in reducing substance use and CAS among HIV-negative MYMSM. The Specific Aims are to: 1) adapt the YMHP intervention for delivery in CBOs by peer counselors; 2) test the effectiveness of the YMHP intervention when delivered by peer counselors at two CBOs situated in high HIV incidence neighborhoods in New York City; and 3) assess the cost-effectiveness of YMHP relative to TAU. The proposed study will be implemented over two phases. In Phase 1 we will conduct qualitative research with staff at our collaborating agencies to adapt the efficacious YMHP intervention to the unique needs of MYMSM and incorporate existing systems and approaches utilized by site collaborators to facilitate for delivery by peer counselors. In Phase 2 we will randomize 260 HIV-negative substance using MYMSM into the YMHP intervention or eTAU. Assessments will include behavioral self-report measures, urine testing for substance use, and HIV and STI testing for sexual health outcomes. Working together with our CBO collaborators will help to address practical problems at the frontline of service provision to pave the way for a comprehensive program to reduce substance use and HIV infection among MYMSM. If effective, our program has the potential to exert a sustained and powerful influence on the effectiveness of behavioral interventions for economically disadvantaged, substance using MYMSM who are most at risk for HIV infection.

 描述(由申请人提供)：少数民族和少数族裔男男性行为者(MYMSM)仍然是吸毒和艾滋病毒/艾滋病的关键人群：自2002年以来，观察到集中在非裔美国人和西班牙裔YMSM中的新感染增加了132%。青年男性健康项目(YMHP)是为18-29岁艾滋病毒阴性或未经检测的YMSM设计的一种利用激励访谈的4次干预措施，被发现在显著减少药物使用和无套肛交(CAS)方面有效。到目前为止，这是第一次也是唯一一次公开发表的试验或疾控中心DeBI对YMSM的随机对照试验，显示出物质使用和性风险的显著减少。美国疾病控制与预防中心最近将基督教青年会评为“最佳证据”，并将其列入艾滋病毒预防的循证干预和最佳实践纲要。YMHP通过在研究中心环境中进行的疗效试验进行了测试，其中包含许多纳入和排除标准，因此，基于社区的复制是研究工作人员向客户提供干预措施在现实世界中的有效性的关键下一步。我们将在两个真实的社区组织(CBO)中进行一项比较有效性试验(CET)，在现场HIV咨询和检测(C&T)后提供两种治疗强度--YMHP干预和增强的“照常治疗”(Etau)HIV预防服务，以测试它们在减少HIV阴性MYMSM的药物使用和CAS方面的相对有效性。具体目标是：1)调整基督教青年会的干预措施，使之适用于同伴辅导员在社区组织中提供的服务；2)测试在纽约市艾滋病毒高发社区的两个社区组织由同伴咨询师提供的干预措施的有效性；以及3)评估基督教青年会相对于TAU的成本效益。建议的研究将分两个阶段进行。在第一阶段，我们将与我们合作机构的工作人员进行定性研究，以使有效的YMHP干预措施适应MYMSM的独特需求，并纳入现场协作者使用的现有系统和方法，以促进同行辅导员的提供。在第二阶段，我们将使用MYMSM将260种HIV阴性物质随机纳入YMHP干预或Etau。评估将包括行为自我报告措施，尿液药物使用测试，以及艾滋病毒和性健康结果的性传播感染测试。与我们的CBO合作伙伴合作将有助于解决服务提供第一线的实际问题，为减少MYMSM中的药物使用和艾滋病毒感染的全面计划铺平道路。如果有效，我们的计划有可能对经济上处于不利地位的、使用艾滋病毒感染风险最大的MYMSM的行为干预的有效性产生持续而强大的影响。