HIV PREVALENCE, SEXUAL BEHAVIOR, AND ATTITUDES TOWARD CIRCUMCISION AMONG COLOMBIA

哥伦比亚的艾滋病毒感染率、性行为和对包皮环切术的态度

• 批准号: 7810559
• 负责人: Maria Cecilia Zea
• 金额: $ 66.06万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7810559
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adult; Affect; Africa; Age; American; Area; Attention; Attitude; Behavior; Behavioral; Belief; Caribbean region; Characteristics; Cities; Colombia; Communities; Computer Assisted; Conflict (Psychology); Counseling; Country; Data; Demographic Factors; Development; Epidemic; Female; Focus Groups; Future; Gays; Gray unit of radiation dose; HIV; Health Knowledge, Attitudes, Practice; Heterosexuals; High Prevalence; Homosexuality; Human immunodeficiency virus test; Incidence; Individual; Internal Migrations; Intervention; Interview; Knowledge; Label; Latin America; Laws; Lead; Legal; Life; Link; Male Circumcision; Methods; Modeling; Outcome; Participant; Pattern; Perception; Persons; Phase; Plague; Policies; Population; Population Characteristics; Poverty; Prevalence; Prevention; Prostitution; Public Health; Public Policy; Qualitative Research; Reaction; Recommendation; Recording of previous events; Research; Research Methodology; Respondent; Rights; Risk; Risk Behaviors; Sample Size; Sampling; Sex Behavior; Sexual Partners; Shapes; Social Class; Social Conditions; Social Environment; Social Network; Stigmata; Surveys; Testing; Time; UNHCR; Urbanization; Violence; War; aged; demographics; design; displaced person; epidemiological model; experience; high risk; informant; information gathering; innovation; life history; male; men; men who have sex with men; migration; oral HIV; programs; protective effect; psychologic; public health relevance; residence; sex risk; social; social stigma; stem; surveillance data

DESCRIPTION (provided by applicant): This application describes a five-year research program that investigates individual, social, and structural influences on HIV risk and serostatus among men who have sex with men (MSM) in Bogota, Colombia. This study is of public health significance because it will contribute to knowledge concerning HIV prevalence and risk behavior in an understudied group at high risk for HIV. Moreover, it will evaluate the protection against HIV afforded by circumcision among MSM in Colombia. This application is innovative in its use of a conceptual framework that addresses HIV risk within the social and structural context. In Colombia, there are legal protections of the rights of all individuals, including gay men, while at the same time, there is ongoing civil unrest, forced displacement of large numbers of people, and homonegativity. This study investigates how such societal characteristics, as well as individuals' characteristics, influence vulnerability to HIV. The aims of the proposed study are 1) to examine structural, social, and individual factors relevant to HIV risk among MSM in Bogota; 2) to estimate prevalence of HIV among MSM in Bogota; 3) to explore the association between circumcision status and HIV serostatus and to investigate beliefs, knowledge, and attitudes concerning circumcision among Colombian MSM; and 4) to integrate information gained from the various research methods used and to draw conclusions that will guide the design of policies and interventions addressing HIV risk among MSM in Colombia. The research consists of three phases. Phase I involves qualitative research (12 key informant interviews, 10 focus groups, and 28 life history interviews) to explore the context of life for MSM in Bogota, including sexual behavior patterns, social networks, stigma associated with homosexuality and HIV, violence, migration, and displacement. Life history interviews will be conducted with MSM who have experienced displacement. Phase II involves quantitative research. Rapid oral HIV testing and a quantitative survey instrument will be administered with A-CASI to samples of MSM, aged 15 to 49. Social and structural data will reflect conditions in Bogota's19 localidades (localities) where participants live. Data will be used to test a model of HIV risk with both individual-level analyses and multi-level analyses (incorporating characteristics of the person and the locality of residence); to obtain estimates of HIV prevalence among MSM in the city; to examine protective effects of circumcision; and to describe attitudes and knowledge of circumcision. The pilot test includes 100 participants, and the full administration of the revised survey includes 1000 participants, all obtained through respondent-driven sampling. Phase III consists of triangulation of data and dissemination of findings. The contextualized information gained from this research will be useful in HIV prevention efforts for Colombian MSM at the societal, city, community, and individual levels. PUBLIC HEALTH RELEVANCE The proposed study will examine individual, social, and structural factors influencing HIV risk among Colombian MSM, and findings will be useful in designing targeted interventions. Elucidation of societal conditions that increase individuals' HIV vulnerability; identification of susceptible groups of people; and explication of the link between individual experiences, social/structural characteristics, and HIV risk will inform prevention efforts at multiple levels, including legal or policy changes and interventions aimed at the community or individuals.

描述（由申请人提供）：本申请描述了一项为期五年的研究计划，该计划调查了哥伦比亚波哥大男男性行为者（MSM）中艾滋病毒风险和血清状态的个人，社会和结构影响。这项研究具有公共卫生意义，因为它将有助于了解艾滋病毒感染率和高危人群的风险行为。此外，它还将评估在哥伦比亚的男男性接触者中包皮环切对艾滋病毒的保护作用。这一应用创新性地使用了一个概念框架，在社会和结构背景下解决艾滋病毒风险问题。在哥伦比亚，包括男同性恋者在内的所有人的权利都受到法律保护，但与此同时，国内动荡不断，大量人流离失所，同性恋现象层出不穷。这项研究调查了这些社会特征以及个人特征如何影响对艾滋病毒的易感性。该研究的目的是：1)研究波哥大MSM人群中与HIV风险相关的结构、社会和个人因素；2)估计波哥大MSM人群的艾滋病毒感染率；3)探讨包皮环切状况与HIV血清状态的关系，调查哥伦比亚MSM对包皮环切的信念、知识和态度；4)整合从使用的各种研究方法中获得的信息，并得出结论，这些结论将指导设计针对哥伦比亚男同性恋者艾滋病毒风险的政策和干预措施。本研究分为三个阶段。第一阶段包括定性研究（12个关键信息者访谈、10个焦点小组访谈和28个生活史访谈），以探索波哥大MSM的生活背景，包括性行为模式、社会网络、与同性恋和艾滋病毒相关的污名、暴力、移民和流离失所。将对经历过流离失所的男同性恋者进行生活史访谈。第二阶段涉及定量研究。将使用a - casi对15至49岁的男男性行为者进行快速口服艾滋病毒检测和定量调查。社会和结构数据将反映参与者居住的波哥大19个地方的情况。数据将用于测试艾滋病毒风险模型，包括个人层面的分析和多层次的分析（包括个人和居住地的特征）；获得该市男男性行为者中艾滋病毒流行情况的估计数；检查包皮环切术的保护作用；描述对割礼的态度和认识。试点测试包括100名参与者，修订调查的全面管理包括1000名参与者，所有参与者都通过受访者驱动的抽样获得。第三阶段包括数据的三角测量和结果的传播。从这项研究中获得的背景信息将有助于哥伦比亚男同性恋者在社会、城市、社区和个人层面上的艾滋病毒预防工作。