HIV-Prevention Intervention Targets in High-risk Alcohol Venues in Argentina

阿根廷高风险酒精场所的艾滋病毒预防干预目标

• 批准号: 7694321
• 负责人: Ivan C Balan
• 金额: $ 20.51万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7694321
• 关键词: AIDS prevention; Address; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcoholism; Alcohols; Area; Argentina; Behavior; Behavioral; Beverages; Characteristics; Cities; Clinical; Cognitive; Collaborations; Country; Data; Data Analyses; Educational workshop; Environment; Focus Groups; Funding; Future; Gatekeeping; Gays; General Population; Goals; Government Programs; HIV; HIV Infections; High Prevalence; Human Activities; Human Resources; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Interview; Knowledge; Lighting; Literature; Locales; Location; Maps; Measures; Modeling; Multiple Partners; Music; Pattern; Persons; Phase; Play; Population; Prevalence; Prevention program; Preventive Intervention; Prostitution; Recruitment Activity; Relative (related person); Research; Research Personnel; Resources; Respondent; Risk; Risk Behaviors; Risk Reduction; Rosa; Sampling; Sex Behavior; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Site; Socioeconomic Status; South America; Specialist; System; Testing; Time; Treatment Cost; Universities; Work; alcohol availability; base; design; high risk; high risk sexual behavior; lens; meetings; men; men who have sex with men; public health relevance; sex; sex risk; social; theories; transmission process; willingness

DESCRIPTION (provided by applicant): The HIV prevalence rate in Argentina is 0.6 percent in the general population, with much higher rates in high risk segments of the population. While the cost of treatment for HIV is covered by the government, programs in HIV prevention are limited. Venue based interventions have the potential to reach segments of the population at high risk for HIV infection. Given the associations between alcohol use and sexual risk behavior, venues where alcohol is sold and sexual behavior occurs could be particularly effective settings for HIV prevention efforts. However, although there has been much research on venues, alcohol use, and sexual risk behavior, no studies have sought to understand the interaction between these three factors, an essential step in developing interventions that target HIV risk behavior in these settings. Targeting public venues in Buenos Aires where men meet, alcohol is consumed, and sexual behavior occurs, the goal of this 2-year exploratory study is to understand the various factors that contribute to the creation of a high risk sexual space. To that end, the study seeks to describe the relative contribution of physical characteristics of the place, patron characteristics, type and level of alcohol consumption, and social dynamics that are at play and potentiate each other to result in sexual risk behavior. The specific aims of this study are to 1) describe 6 public venues in terms of their physical characteristics, alcohol availability, patron characteristics, and sexual behavior that occurs in the venue; 2) identify factors that contribute to alcohol use and high-risk sexual behavior in the venues; 3) identify HIV risk reduction possibilities in the venues and how they can be targeted by interventions; 4) assess willingness of venue owners/personnel to partner with HIV prevention organizations in reducing HIV risk in these settings and the types of prevention programs they find acceptable or unacceptable; and 5) assess ways to measure the efficacy of future interventions in these settings. This qualitative study consists of site observations of 6 venues frequented by men where alcohol is consumed and sexual behavior occurs, as well as in-depth interviews with 48 patrons of those venues, 18 owners/personnel from the venues, and 10 HIV prevention and alcoholism specialists. Venue patrons will also undergo a brief quantitative assessment to gather descriptive data on sexual behavior and substance use among this sample. Grounded theory will guide the qualitative data analysis, with the venue patron data undergoing a second level of analysis to develop cross-case causal models of HIV risk behavior in the context of alcohol use in these venues. We expect findings from this study to provide a blueprint for developing a venue-based HIV prevention intervention for these settings, which could be more fully developed and tested in a subsequent study. PUBLIC HEALTH RELEVANCE: Venue-based HIV-prevention interventions target places versus individuals, thereby tapping into high risk sexual networks and disrupting channels of sexual transmission (Weir, Pailman, Mahlalela, Coetzee, Meidany, & Boerma, 2003; Wohlfeiler & Potterat, 2005). Given the limited HIV-prevention programs in Argentina and high rates of HIV infection among high risk populations, intervening in these settings can be particularly useful in reaching large segments of the population, especially those at high risk of infection. Although this study will be conducted through the lens of Argentine culture (which affects norms of alcohol use and sexual behavior), we expect findings to be useful in informing venue-based interventions for these types of venues in other countries.

描述（由申请人提供）：阿根廷的艾滋病毒流行率在一般人群中为0.6%，在高风险人群中的流行率要高得多。虽然艾滋病毒的治疗费用由政府承担，但艾滋病毒预防方案有限。基于场所的干预措施有可能触及艾滋病毒感染高危人群。考虑到饮酒与性风险行为之间的关联，出售酒精和发生性行为的场所可能是预防艾滋病毒工作特别有效的场所。然而，尽管有很多关于场所，酒精使用和性风险行为的研究，但没有研究试图了解这三个因素之间的相互作用，这是制定针对这些环境中艾滋病毒风险行为的干预措施的重要一步。这项为期2年的探索性研究以布宜诺斯艾利斯的男性聚会、饮酒和发生性行为的公共场所为目标，旨在了解造成高风险性空间的各种因素。为此，本研究旨在描述场所的物理特征、顾客特征、酒精消费的类型和水平以及社会动态的相对贡献，这些因素相互作用并相互增强，导致性风险行为。本研究的具体目的是：1）描述6个公共场所的物理特征、酒精供应、顾客特征和场所中发生的性行为; 2）确定导致场所中酒精使用和高危性行为的因素; 3）确定场所中降低艾滋病毒风险的可能性以及如何通过干预措施将其作为目标; 4）评估场馆所有者/人员与艾滋病毒预防组织合作降低这些环境中艾滋病毒风险的意愿，以及他们认为可接受或不可接受的预防方案类型; 5）评估衡量这些环境中未来干预措施有效性的方法。这项定性研究包括现场观察的6个场所经常光顾的男性饮酒和性行为发生，以及深入访谈48顾客的这些场所，18业主/人员从场馆，和10艾滋病毒预防和酗酒专家。场馆顾客还将接受简短的定量评估，以收集有关性行为和物质使用的描述性数据。扎根理论将指导定性数据分析，与场馆顾客数据进行第二层次的分析，以开发艾滋病毒风险行为的跨案例因果模型，在这些场所的酒精使用的背景下。我们希望这项研究的结果能够为这些环境提供一个基于场所的艾滋病预防干预措施的蓝图，这可以在随后的研究中得到更充分的开发和测试。 公共卫生关系：基于场所的艾滋病毒预防干预措施针对的是场所而不是个人，从而利用高风险的性网络并破坏性传播渠道（Weir，Pailman，Mahlalela，Coetzee，Meidany，& Boerma，2003; Wohlfeiler & Potterat，2005）。鉴于阿根廷的艾滋病毒预防方案有限，高危人群的艾滋病毒感染率很高，在这些情况下进行干预对于接触大部分人口特别是感染高危人群特别有用。虽然这项研究将通过阿根廷文化的透镜进行（这会影响酒精使用和性行为的规范），我们希望研究结果是有用的，在其他国家的这些类型的场地为基础的干预提供信息。