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: 9920523
• 负责人: Tyrel J Starks
• 金额: $ 7.23万
• 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 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9920523
• 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; Cost Analysis; 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 Seronegativity; 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; Professional counselor; Publishing; Qualitative Research; Randomized; Reporting; Research; Risk; Risk Reduction; Science; Service provision; Sexual Health; Sexual Partners; Site; System; Testing; Urine; base; black men who have sex with men; 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; pre-exposure prophylaxis; prevention service; programs; public health relevance; racial diversity; racial minority; recruit; reduced substance use; relative effectiveness; sex; sexual encounter; sexual risk behavior; surveillance data; testing services; 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）： 与男性发生性关系的少数族裔和少数族裔青年男性 (MYMSM) 仍然是物质使用和艾滋病毒/艾滋病关系中的关键人群：自 2002 年以来，观察到新感染病例增加了 132%，集中在非裔美国人和西班牙裔 YMSM 中。 青年男性健康项目 (YMHP) 是一项为期 4 期的干预措施，采用针对艾滋病毒阴性或未经检测的动机访谈进行干预 研究发现，18-29 岁的 YMSM 可有效显着减少物质使用和无套肛交 (CAS)。迄今为止，这是任何已发表的试验或 CDC DEBI 与 YMSM 中第一个也是唯一一个随机对照试验，显示药物使用和性风险均显着降低。 CDC 最近将 YMHP 评为“最佳证据”，并将其列入艾滋病毒预防循证干预措施和最佳实践纲要中。 YMHP 通过在研究中心环境中进行的功效试验进行了测试，具有多种纳入和排除标准，因此，基于社区的复制是研究工作人员向客户提供的干预措施在现实世界中的有效性的关键下一步。我们将在两个现实世界的社区组织 (CBO) 中进行一项比较有效性试验 (CET)，在现场艾滋病毒咨询和检测 (C&T) 后提供两种强度的治疗 - YMHP 干预和强化“照常治疗”(eTAU) 艾滋病毒预防服务 - 以测试它们在减少艾滋病毒阴性 MYMSM 中物质使用和 CAS 方面的相对有效性。具体目标是： 1) 调整 YMHP 干预措施，以便由同伴辅导员在 CBO 中实施； 2) 测试纽约市艾滋病毒高发区两个 CBO 的同伴辅导员实施 YMHP 干预的有效性； 3) 评估 YMHP 相对于 TAU 的成本效益。拟议的研究将分两个阶段实施。在第一阶段，我们将与合作机构的工作人员进行定性研究，以使有效的 YMHP 干预适应 MYMSM 的独特需求，并纳入现场合作者使用的现有系统和方法，以促进同伴辅导员的交付。在第 2 阶段，我们将使用 MYMSM 将 260 名 HIV 阴性物质随机分配到 YMHP 干预措施或 eTAU 中。评估将包括行为自我报告措施、药物使用尿液检测以及性健康结果的艾滋病毒和性传播感染检测。与我们的 CBO 合作者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综合计划铺平道路。如果有效，我们的计划有可能对经济上处于不利地位、使用 MYMSM 药物且最容易感染 HIV 的行为干预措施的有效性产生持续而强大的影响。

项目成果

Comparing the Efficiency of Online and Field-Based Outreach for the Recruitment of Black and Latino Sexual Minority Men into an HIV Prevention Implementation Trial.

• DOI: 10.1007/s11121-022-01367-3
• 发表时间: 2022-08
• 期刊: PREVENTION SCIENCE
• 影响因子: 3.5
• 作者: Bradford-Rogers, Jesse;Lopez-Matos, Jonathan;Cain, Demetria;Lopez, David;Starks, Tyrel J
• 通讯作者: Starks, Tyrel J