Predictors of HIV Risk Behavior Among Men in Argentina

描述（由申请人提供）：尽管艾滋病流行病对拉丁美洲造成的破坏没有达到世界其他地区所见的程度，但人们担心，除非现在作出一贯的预防努力，否则它可能在未来十年对该大陆造成严重破坏。在阿根廷，估计有13万成年人感染艾滋病毒，其流行率为0.7%，与南美洲最高的巴西相当。在高危男性中，艾滋病毒感染率可高达13.8%。然而，人们缺乏与不安全性行为相关的社会心理和环境因素的知识，而这些因素是艾滋病预防规划的基础。这一知识上的差距将通过我们的研究来弥补。针对生活在布宜诺斯艾利斯的高危男性，我们研究的主要目的是：(1)评估艾滋病毒相关风险行为的认知、情感、社会文化和背景预测因素；(2)评估男性高危人群的艾滋病毒检测模式以及促进或阻碍检测的因素；(3)评估艾滋病毒和性传播感染的患病率和发病率。总的来说，这项研究旨在促进美国和阿根廷研究伙伴之间相互丰富的合作关系，在此基础上建立一个未来的干预计划，以减少阿根廷男性的风险行为。这将是一个为期4.5年的研究，包括两个阶段：形成阶段和评估阶段。形成阶段本质上是定性的，将包括：(a)与系统代表和看门人的个人深入访谈；(b)对高危男子进行焦点小组和个人访谈；(c)对人们见面的地方进行现场观察。在评估阶段，从布宜诺斯艾利斯市区系统招募的500名男子将接受(a)基于理论的风险行为及其社会心理和背景预测因素以及艾滋病毒检测的障碍和促进因素评估，以及(b)艾滋病毒和性传播感染检测。在这个评估阶段，我们将使用受访者驱动抽样来招募一个无偏样本，并使用CASI技术来最大限度地减少受访者的偏见。扎根理论将指导定性数据分析，定量数据分析将包括GLM， GEE，线性和逻辑回归方法。到研究结束时，我们将获得可靠的数据，这些数据将作为制定专门为布宜诺斯艾利斯高风险男性设计的艾滋病毒预防方案的基础。这项研究将有助于确定心理、文化和环境因素，鼓励阿根廷男性的艾滋病毒风险行为。这是设计减少这些因素并降低风险的程序之前的基本步骤。

DESCRIPTION (provided by applicant): Although the AIDS epidemic has not devastated Latin America to the degree seen in other parts of the world, there is concern that unless consistent prevention efforts are made now it can wreak havoc on the continent in the coming decade. In Argentina, it is estimated that there are 130,000 HIV-infected adults resulting in a prevalence rate of 0.7%, which matches Brazil's for highest in South America. Among high-risk men, HIV prevalence can reach as high as 13.8%. Yet, there is a dearth of knowledge concerning psychosocial and contextual factors associated with unsafe sex on which to base HIV-prevention programs. This gap in knowledge will be addressed by our study. Targeting high-risk men living in Buenos Aires, the Primary Aims of our study are to (1) assess cognitive, emotional, socio-cultural, and contextual predictors of HIV-related risk behavior; (2) assess patterns of HIV testing in the high-risk male population and factors that facilitate or hinder testing; and (3) assess prevalence and incidence of HIV and STI infections. Overall, the study seeks to foster a mutually enriching collaborative relationship between the US- and Argentina-based research partners on which to build a future intervention program to decrease risk behavior among men in Argentina. This will be a 4.5- year study consisting of two phases: a formative phase and an assessment phase. The formative phase, which will be qualitative in nature, will consist of: (a) individual in-depth interviews with System Representatives and Gatekeepers; (b) focus groups and individual interviews with high risk men; and (c) site observations of places where men meet. During the assessment phase, 500 systematically recruited men from the Buenos Aires metropolitan area will undergo (a) a theoretically-based assessment of risk behavior and its psychosocial and contextual predictors as well as barriers and facilitators of HIV testing, and (b) HIV and STI testing. During this assessment phase, we will use both Respondent Driven Sampling to recruit an unbiased sample and CASI technology to minimize respondent bias. Grounded theory will guide the qualitative data analysis, and quantitative data analysis will include GLM, GEE, and linear and logistic regression methods. By the end of the study, we will have solid data that will serve as the basis for the development of HIV prevention programs specifically designed for high-risk men in Buenos Aires. This study will contribute to identifying psychological, cultural, and environmental factors that encourage HIV-risk behavior among men in Argentina. This is a fundamental step prior to designing programs that mitigate those factors and result in decreased risk.