STI Screening as a Combined HIV Prevention Platform for MSM in Peru

性传播感染筛查作为秘鲁男男性行为者艾滋病毒综合预防平台

• 批准号: 9230435
• 负责人: JESSE LAWTON CLARK
• 金额: $ 13.4万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-15 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9230435
• 关键词: AIDS prevention; Address; Age; Alcohol or Other Drugs use; Antibiotic Therapy; Anus; Anxiety; Area; Assessment tool; Behavior assessment; Behavioral; Biological; Chlamydia; Cognitive; Communities; Control Groups; Counseling; Diagnosis; Dose; Enrollment; Epidemic; Evaluation; Focus Groups; Frequencies; Future; Gonorrhea; HIV; HIV Infections; HIV risk; IL8 gene; Incidence; Individual; Infection; Infection Control; Inflammatory; Interleukin-1 beta; Interleukin-6; Intervention; Intervention Studies; Intervention Trial; Interview; Link; Measurement; Mediator of activation protein; Mental Depression; Modeling; Mucositis; Mucous Membrane; Nucleic Acid Amplification Tests; Outcome; Outcome Assessment; Participant; Patient Self-Report; Periodicity; Peru; Peruvian; Population; Prevalence; Prevention strategy; Preventive Intervention; Prospective Studies; Randomized; Recurrence; Risk; Risk Behaviors; Risk Factors; Self Efficacy; Sexually Transmitted Diseases; Social Environment; Surveys; TNF gene; Testing; Translating; Translations; base; behavioral construct; co-infection; condoms; cytokine; epidemiologic data; high risk; high risk men; immune activation; improved; instrument; intervention effect; member; men who have sex with men; prevention service; primary outcome; programs; prospective; public health relevance; rectal; screening; secondary outcome; sex risk; synergism; therapy design; transmission process

 DESCRIPTION (provided by applicant): Periodic counseling, testing, and treatment for rectal sexually transmitted infections (STIs) provides a multi- dimensional platform to integrate behavioral and biological HIV prevention strategies for men who have sex with men (MSM) in Peru. Rectal STIs like gonorrhea and chlamydia are key risk factors for HIV acquisition among MSM, both as indirect behavioral markers of recent unprotected receptive anal intercourse (URAI), and as inflammatory factors that increase cellular risk for HIV co-transmission. However, there have been no prospective studies of interventions addressing the specific behavioral and biological risk factors associated with rectal STI transmission or the potential impact on HIV transmission risk of integrating rectal GC/CT screening with other prevention services. We will use nucleic acid testing to screen 750 behaviorally high-risk MSM for rectal gonorrheal and/or chlamydial (GC/CT) infection. GC/CT-positive subjects will receive single- dose antibiotic treatment and either single-session Personal Cognitive Counseling (PCC) (n=50) or standard post-test counseling (n=50). A GC/CT-negative control group (n=50) will also be enrolled to compare biological outcomes including changes in levels of inflammatory cytokines following rectal STI. Aim 1: To adapt a Personalized Cognitive Counseling (PCC) model for use with MSM in Peru. Aim 2: To adapt and pre-test the SJEI and behavioral assessment instruments for use with MSM in Peru. Aim 3: To pilot a combined HIV prevention intervention based on rectal STI counseling, testing, and treatment for MSM in Peru. Estimates of feasibility/acceptability of the intervention, GC/CT prevalence/re-infection rate and the effect on behavioral and biological mediators of HIV infection will be used to plan an R01 evaluation of rectal STI surveillance as HIV prevention for MSM in Peru.

 描述（由申请人提供）：直肠性传播感染 (STI) 的定期咨询、检测和治疗提供了一个多维平台，为秘鲁男男性行为者 (MSM) 整合行为和生物艾滋病毒预防策略。淋病和衣原体等直肠性传播感染是 MSM 中感染 HIV 的关键危险因素，既是近期无保护性肛交 (URAI) 的间接行为标志，又是增加 HIV 共同传播细胞风险的炎症因素。然而，目前还没有针对与直肠性传播感染相关的特定行为和生物风险因素或将直肠 GC/CT 筛查与其他预防服务相结合对艾滋病毒传播风险的潜在影响的干预措施进行前瞻性研究。我们将使用核酸检测对 750 名行为高危 MSM 进行直肠淋病和/或衣原体 (GC/CT) 感染筛查。 GC/CT 阳性受试者将接受单剂量抗生素治疗和单次个人认知咨询 (PCC) (n=50) 或标准测试后咨询 (n=50)。还将招募 GC/CT 阴性对照组 (n=50) 来比较生物学结果，包括直肠 STI 后炎症细胞因子水平的变化。目标 1：调整个性化认知咨询 (PCC) 模型以供秘鲁的 MSM 使用。目标 2：调整和预测试 SJEI 和行为评估工具，以便与秘鲁的 MSM 一起使用。目标 3：在秘鲁针对 MSM 试点基于直肠性传播感染咨询、检测和治疗的综合艾滋病毒预防干预措施。干预措施的可行性/可接受性、GC/CT 患病率/再感染率及其影响的估计 HIV 感染的行为和生物介质将用于计划直肠 STI 监测的 R01 评估，作为秘鲁 MSM 的 HIV 预防。