International Mobility of HIV

艾滋病毒的国际流动性

• 批准号: 7686718
• 负责人: HONG-HA M TRUONG
• 金额: $ 38.93万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7686718
• 关键词: Acquired Immunodeficiency Syndrome; Address; Affect; Alcohol or Other Drugs use; Anti-Retroviral Agents; Antiretroviral drug resistance; Anus; Area; Behavioral; Biological; Blood specimen; Border Crossings; Characteristics; Communities; Cross-Sectional Studies; Data; Destinations; Developed Countries; Developing Countries; Development; Disclosure; Disinhibition; Environment; Epidemiology; HIV; HIV Infections; HIV Seropositivity; Handheld Computers; High Prevalence; Holidays; Individual; Infection; International; Interview; Language; Lead; Location; Measures; Methods; Modeling; Motivation; Outcome; Participant; Persons; Pharmaceutical Preparations; Population; Prevalence; Prevention strategy; Quality of life; Questionnaires; Recruitment Activity; Reporting; Research Design; Respondent; Risk; Risk Assessment; Risk Behaviors; Risk Reduction Behavior; Sampling; San Francisco; Self-Administered; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Testing; Travel; Unsafe Sex; Viral Load result; Visit; behavior change; behavior influence; design; high risk behavior; high risk sexual behavior; improved; information framework; men who have sex with men; population based; public health relevance; safer sex; sex risk; skills; transmission process; treatment adherence

DESCRIPTION (provided by applicant): International travel poses multiple challenges to the control of HIV in the US and worldwide. US residents may acquire HIV abroad and introduce infection into local networks not previously affected. HIV-seropositive US residents may transmit HIV to others while traveling. Transmission of antiretroviral (ARV) drug resistance is also of concern. High treatment levels in the US raise the specter of spreading ARV drug resistance worldwide, an outcome particularly worrisome to developing countries with limited second-line treatment options. HIV transmission risk may be compounded in foreign settings by destination-specific information, differing motivation and additional behavioral skills that are necessary for risk reduction behaviors while traveling internationally. International travel creates a change in environment that may facilitate behavioral disinhibition and lead to increased levels of high-risk behavior and substance use. The community of men who have sex with men (MSM) in San Francisco and the greater Bay Area represents a population with a high degree of international travel, along with a high prevalence of HIV, high ARV coverage and a high level of ARV drug resistance. Our study proposes to measure transmission risk of HIV and ARV drug resistance in the population of seropositive MSM who travel internationally. The specific aims are: 1) to measure the prevalence of sexual risk behavior among HIV-seropositive MSM during international travel; 2) to document the prevalence of ARV drug resistance among MSM international travelers; and 3) to examine the informational, motivational and behavioral skills correlates of safer sex disinhibition during international travel. Our study will employ a mixed-methods approach combining quantitative and qualitative components to assess sexual risk behavior and potential correlates of behavioral disinhibition, organized according to the Information- Motivation-Behavioral Skills (IMB) model of HIV behavior change. We will use Respondent-Driven Sampling (RDS) to recruit a representative cross-sectional survey of 500 HIV-seropositive MSM in San Francisco and the greater Bay Area who traveled internationally in the past 12 months. We will obtain population-based estimates of unprotected anal intercourse and ARV drug resistance prevalence (Aims 1 and 2). HIV risk behavior data will be collected through quantitative questionnaires and qualitative interviews regarding both the individual and destination-specific informational, motivational and behavioral skills components that may affect safer sex disinihibition while traveling internationally (Aims 1, 2, and 3). Public health relevance: Our study design will provide data on individual characteristics that may influence HIV risk behavior across situations, as well as destination-specific attributes that influence behavior while visiting particular locations. Ultimately, our study will contribute to the development of prevention strategies specifically addressing the correlates of behavioral disinhibition associated with cross-border HIV transmission and spread of ARV drug resistance in an era of expanding treatment worldwide.

描述（由申请人提供）：国际旅行对美国和世界范围内的艾滋病毒控制提出了多重挑战。美国居民可能在国外感染艾滋病毒，并将感染引入以前未受影响的当地网络。 HIV 血清阳性的美国居民可能在旅行时将 HIV 传播给其他人。抗逆转录病毒（ARV）耐药性的传播也令人担忧。美国的高治疗水平引发了抗逆转录病毒药物耐药性在全球蔓延的担忧，这一结果对于二线治疗选择有限的发展中国家尤其令人担忧。在国外，艾滋病毒传播风险可能会因目的地特定信息、不同动机和国际旅行时降低风险行为所需的额外行为技能而加剧。国际旅行造成环境变化，可能会促进行为抑制，并导致高风险行为和药物使用水平增加。 旧金山和大湾区的男男性行为者 (MSM) 群体是一个国际旅行频繁、艾滋病毒感染率高、抗逆转录病毒药物覆盖率高以及抗逆转录病毒药物耐药性高的人群。我们的研究旨在测量出国旅行的血清阳性 MSM 人群中 HIV 和 ARV 耐药性的传播风险。具体目标是： 1) 衡量国际旅行期间 HIV 血清阳性 MSM 中性危险行为的流行率； 2) 记录 MSM 国际旅行者中抗逆转录病毒药物耐药性的流行情况； 3) 检查国际旅行期间与安全性行为去抑制相关的信息、动机和行为技能。 我们的研究将采用定量和定性相结合的混合方法来评估性危险行为和行为去抑制的潜在相关性，并根据艾滋病毒行为改变的信息-动机-行为技能（IMB）模型进行组织。我们将使用受访者驱动抽样 (RDS) 对旧金山和大湾区过去 12 个月内出国旅行的 500 名 HIV 血清阳性 MSM 进行代表性横断面调查。我们将获得基于人群的无保护肛交和抗逆转录病毒药物耐药率的估计（目标 1 和 2）。将通过定量调查问卷和定性访谈收集艾滋病毒风险行为数据，这些数据涉及个人和目的地特定的信息、动机和行为技能成分，这些成分可能会影响国际旅行时的安全性行为抑制（目标 1、2 和 3）。 公共卫生相关性：我们的研究设计将提供可能影响各种情况下的艾滋病毒风险行为的个人特征的数据，以及影响访问特定地点时的行为的目的地特定属性的数据。最终，我们的研究将有助于制定预防策略，专门解决在全球范围内扩大治疗范围的时代与跨境艾滋病毒传播和抗逆转录病毒药物耐药性传播相关的行为去抑制的相关性。