The importance of Early Sexual Experiences Among Men Who Have Sex With Men

男男性行为者早期性经历的重要性

• 批准号: 7655323
• 负责人: Matthew R Golden
• 金额: $ 6.3万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-10 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7655323
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adolescent; Affect; Age; Agreement; Alcohol or Other Drugs use; Anus; Area; Asses; Behavior; Behavioral; Biological; Centers for Disease Control and Prevention (U.S.); Characteristics; Cohort Studies; Communities; Computers; County; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Disclosure; Enrollment; Epidemic; Epidemiology; Foundations; Frequencies; Future; Gays; Genetic; HIV; Heterosexuals; Homosexuals; Immunologic Factors; Incidence; Individual; Intervention; Intervention Studies; Interview; Knowledge; Lead; Life; Male Homosexuality; Measures; Methods; Morbidity - disease rate; Natural History; Online Systems; Participant; Pattern; Persons; Pilot Projects; Population; Prevention; Prevention program; Preventive Intervention; Prospective Studies; Public Health; Questionnaires; Randomized; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Retrospective Studies; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Schedule; Self-Administered; Sex Behavior; Sexual Development; Sexual Partners; Sexually Transmitted Diseases; Specimen; Testing; Theoretical model; Time; Typology; base; cohort; condoms; design; diaries; experience; follow-up; high risk; insight; interest; lifetime risk; male; mathematical model; men; men who have sex with men; novel strategies; population based; prevent; prospective; psychosocial; public health relevance; sex; sex risk; sexual debut; sound; success; therapy development; transmission process

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) experience rates of HIV and bacterial sexually transmitted infections (STI) that are many times those experienced by heterosexuals in the U.S. Despite the widely acknowledged importance of sexual behavior in defining HIV/STI transmission dynamics, little is known about how MSM form patterns of sexual behavior, what factors predict these patterns, and how those behavioral patterns change over a person's life. We propose to conduct a cohort study of 100 MSM who are: 1) age 16-20 with 1-3 lifetime male sex partners, or 2) age 16-30 within 3 years of their same-sex sexual debut. This cohort will be followed for 1 year during which participants will complete a baseline computer administered self-interview (CASI) regarding early homosexual experiences and sexual behavior; retrospective online follow-up questionnaires every 3 months; web-based sex diaries; and HIV/STI testing at baseline, 6, and 12 months. The study's first aim is to define the feasibility of enrolling a diverse sample of MSM near the time of same-sex sexual debut, following the cohort for 1 year, collecting frequent sexual behavioral data, and serially testing these men for HIV/STI. Success will be defined based on the number of men who enroll and complete the study, and the proportion who complete all questionnaires and HIV/STI testing. The study's second aim is to assess the feasibility of using web-based sex diaries to collect sexual behavior data and to identify the appropriate diary schedule. MSM will be randomly assigned diary schedules and we will compare the frequency of reported behaviors across diary schedules and against the retrospective questionnaire data. Finally, for the third aim we will conduct three analyses. First, we will asses the association between early sexual development and the context of initiation of contact with the gay community. Second, we will investigate the association between the context of same-sex sexual debut and risk behavior observed throughout the one year of follow-up. Third, investigators will conduct exploratory analyses to define patterns of sexual behaviors such as condom use, HIV status disclosure, and sexual role and repertoire. These analyses will assess how risk varies between individuals and within individuals (e.g., by partnership type), and will seek to establish typologies of risk that can be longitudinally measured in a future, larger and longer cohort study. Findings from the proposed study, as well as those from a larger and more definitive cohort study of MSM sexual behavior, could help define HIV/STI transmission dynamics; identify factors in early homosexual experiences that predict subsequent risk; provide insights into the development of interventions to prevent HIV in MSM; and provide a platform for future prospective intervention studies. PUBLIC HEALTH RELEVANCE: In 2005, MSM (including MSM/IDU) comprised 53% of new HIV/AIDS cases in the U.S (CDC, 2005). Current scientific and prevention efforts among MSM are hampered by the paucity of knowledge about how early homosexual experiences affect subsequent risk, and how the sexual behavior of MSM changes over a person's lifetime. We propose a pilot cohort study of young, sexually inexperienced MSM to define the feasibility of conducting a large, prospective cohort study of young MSM that might define the natural history of male homosexuality. In addition to informing the design of this larger study, findings from the proposed research could provide empirically derived parameters for mathematical models, assist in the design of prevention programs for MSM, and identify the highest risk young MSM for future interventions.

描述（由申请人提供）：男男性行为者 (MSM) 的 HIV 和细菌性性传播感染 (STI) 感染率是美国异性恋者的许多倍。尽管性行为在定义 HIV/STI 传播动态方面的重要性已得到广泛认可，但人们对 MSM 如何形成性行为模式、哪些因素预测这些模式以及这些行为模式在人的一生中如何变化知之甚少。我们建议对 100 名男男性行为者进行队列研究，他们是：1) 16-20 岁，有 1-3 个终生男性性伴侣，或 2) 16-30 岁，首次同性性行为 3 年内。该队列将被跟踪一年，在此期间，参与者将完成关于早期同性恋经历和性行为的基线计算机管理自我访谈（CASI）；每三个月进行一次回顾性在线随访调查问卷；基于网络的性日记；基线、6 个月和 12 个月时的 HIV/STI 检测。该研究的首要目标是确定在同性初次发生性关系时招募不同的 MSM 样本、跟踪该队列一年、收集频繁性行为数据并连续检测这些男性是否感染 HIV/STI 的可行性。成功将根据报名并完成研究的男性人数以及完成所有问卷和艾滋病毒/性传播感染检测的比例来定义。该研究的第二个目的是评估使用基于网络的性日记来收集性行为数据并确定适当的日记时间表的可行性。 MSM 将被随机分配日记时间表，我们将比较不同日记时间表和回顾性问卷数据的报告行为频率。最后，对于第三个目标，我们将进行三个分析。首先，我们将评估早期性发育与开始与同性恋群体接触的背景之间的关联。其次，我们将调查同性首次性行为的背景与在一年的随访期间观察到的危险行为之间的关联。第三，调查人员将进行探索性分析，以确定性行为模式，例如安全套的使用、艾滋病毒感染状况的披露以及性角色和性行为。这些分析将评估个体之间和个体内部的风险如何变化（例如，通过伙伴关系类型），并将寻求建立可以在未来更大和更长的队列研究中纵向测量的风险类型。拟议研究的结果，以及更大规模、更明确的男男性行为者性行为队列研究的结果，可能有助于确定艾滋病毒/性传播感染的传播动态；确定早期同性恋经历中预测后续风险的因素；为制定预防男男性接触者艾滋病毒的干预措施提供见解；并为未来的前瞻性干预研究提供平台。公共卫生相关性：2005 年，MSM（包括 MSM/IDU）占美国新发 HIV/艾滋病病例的 53%（CDC，2005）。由于缺乏关于早期同性恋经历如何影响随后的风险以及 MSM 的性行为在一个人的一生中如何变化的知识，目前 MSM 的科学和预防工作受到阻碍。我们提议对年轻、缺乏性经验的 MSM 进行一项试点队列研究，以确定对年轻 MSM 进行大型前瞻性队列研究的可行性，该研究可能会定义男性同性恋的自然史。除了为这项更大规模研究的设计提供信息外，拟议研究的结果还可以为数学模型提供经验得出的参数，协助设计 MSM 预防计划，并确定未来干预措施中风险最高的年轻 MSM。