Reducing HIV Disparities: Sexual Concurrency Communication for HIV Prevention amo

描述（由申请人提供）：人类免疫缺陷病毒（HIV）对不同种族/族裔群体的负担仍然是美国人健康方面种族差异最极端的例子之一。非西班牙裔黑人的艾滋病毒感染率明显高于美国其他任何种族/族裔群体。现在有证据表明，性网络动态，包括重叠的性伙伴关系（并发性）在艾滋病毒的种族差异中起着重要作用。由于结构性因素，包括高度不成比例的监禁率，非洲裔美国人更有可能处于拥有更多并发性伴侣的性网络中。数学模型表明，在性同时性行为水平上实现非常小的减少，就能对艾滋病毒传播链产生巨大影响。我们艾滋病和性病差异问题工作组中心的社区行动委员会（CAB）已优先发展关于性网络的健康传播信息，以帮助减少艾滋病毒在非洲遗产社区的耻辱和传播。在这项研究中，我们将利用基于社区的参与式研究方法，将性网络科学转化为文化共鸣的艾滋病毒预防信息，作为帮助减少艾滋病毒种族差异的新方法。目标1：在华盛顿州金县开展形成性研究，制定艾滋病毒预防信息，传达性网络动态的重要性。CAB差异工作组将对以下人群进行焦点小组和访谈：a)本地出生的非洲裔美国人和b)外国出生的黑人（埃塞俄比亚和肯尼亚移民，他们是金县外国出生的黑人中感染艾滋病毒的主要人群）。我们将以英语、斯瓦希里语和阿姆哈拉语制作多媒体工具，说明艾滋病毒在性网络中的传播原理，以供社区讨论使用。我们将确定目标人群中的性网络信息传播渠道，包括社会网络途径（人与人之间的交流）、民间社会途径（基于信仰的组织、社区活动和组织）和媒体。Subaim 2.1.1。我们将继续通过研讨会和讨论了解社区参与研究的最佳做法。目标2：在金县非洲裔美国人和非洲裔人口中试点和评估艾滋病预防同步信息的影响。CAB差异工作组将启动艾滋病预防同步信息传递，并评估可接受性和影响，包括信息理解和回忆（在30名非洲裔美国人和30名肯尼亚人和埃塞俄比亚人中进行1个月的回忆）、意图和态度强度。CAB工作组将编制和实施一本以社区为基础的研究翻译过程手册，其中包括社区外展、艾滋病毒预防信息编制和受影响社区的信息传播。Subaim 2.2.1。我们将自我教育，了解制定和宣传卫生信息的尖端方法，从而建设能力。目标3：艾滋病毒差异信息的发现和工具将在一次国家研讨会上分享。我们将邀请国家艾滋病研究网络中心和他们的cab参加全国会议，在那里我们还将探讨一项社区合作的多地点随机对照试验的可行性，评估性并发干预在非洲裔美国人和非洲移民人口众多的地区预防艾滋病毒的影响。公共卫生相关性：本研究解决了非洲血统人群中艾滋病毒的关键和持续差异。一种新颖的性网络方法，将新的科学理解转化为在社区参与框架内传递的文化共鸣预防信息，有可能在美国其他类似人群中实施。

DESCRIPTION (provided by applicant): The burden of human immunodeficiency virus (HIV) on different racial/ethnic groups remains one of the most extreme examples of a racial disparity in health among Americans. HIV infection is significantly higher among non-Hispanic blacks than among any other racial/ethnic group in the United States. There is now evidence that sexual network dynamics, including overlapping sexual partnerships (concurrency) play an important role in racial disparities in HIV. Due to structural factors, including highly disproportionate incarceration rates, African- Americans are more likely to be in sexual networks where people have more concurrent sexual partners. Mathematical models show that achieving very small reductions in levels of sexual concurrency can have a dramatic impact on the chain of HIV transmission. Our Community Action Board (CAB) of the Center for AIDS & STD Working Group on Disparities has prioritized developing health communication messages about sexual networks to help reduce HIV stigma and transmission in communities of African heritage. In this research, we will utilize community-based participatory research methods to translate the science of sexual networks into culturally-resonant HIV prevention messages as a new approach to help reduce racial disparities in HIV. Aim 1: Undertake formative research to develop HIV prevention messages that convey the importance of sexual network dynamics in King County, Washington. The CAB Disparities Working Group will conduct focus groups and interviews with a) native-born African-Americans and b) foreign-born blacks (Ethiopian and Kenyan immigrants, who are the majority of incident HIV among foreign-born blacks in King County). We will develop a multimedia tool in English, Kiswahili, and Amharic illustrating principles of HIV transmission in sexual networks for use in community discussions. We will identify sexual network message dissemination channels in the target populations including social network approaches (person-to-person communication), civil society approaches (faith-based organizations, community events and organizations), and the media. Subaim 2.1.1. We will continue to inform ourselves about best practices in community-participatory research via seminars and discussions. Aim 2: Pilot and evaluate the impact of the HIV prevention concurrency messages among populations of African-Americans and African-born populations in King County. The CAB Disparities Working Group will launch HIV prevention concurrency messaging and evaluate acceptability and impact, including message comprehension and recall (1-month post recall among n=30 African-Americans and n=30 Kenyans and Ethiopians), intention, and attitude strength. The CAB Working Group will develop and implement a manual of community-based research translation processes used including community outreach, HIV prevention message development, and message dissemination in affected communities. Subaim 2.2.1. We will build capacity by educating ourselves about cutting edge approaches to development and marketing of health messages. Aim 3: HIV disparity message findings and tools will be shared in a national seminar. We will invite the national Center for AIDS Research network and their CABs to a national meeting, where we will also explore the feasibility of a community-collaborative multi-site randomized controlled trial assessing impact of a sexual concurrency intervention for HIV prevention in areas with large populations of African- Americans and African immigrants. PUBLIC HEALTH RELEVANCE: This study addresses the critical and persistent disparity in HIV among persons of African heritage. A novel sexual network approach that translates new scientific understanding into culturally-resonant prevention messages delivered within a community-participatory framework has the potential to be implemented for other similar populations across the US.