Multilevel HIV Prevention Intervention for Young African American Men

针对年轻非洲裔美国男性的多层次艾滋病毒预防干预

基本信息

项目摘要

DESCRIPTION (provided by applicant): HIV prevalence and incidence rates have reached catastrophic levels among young black men who have sex with men (YBMSM), ages 18-29. The goal of this project is to determine the efficacy of a multilevel, theory- based intervention, calld United Black Element (UBE), in reducing YBMSM's sexual risk behavior and increasing the frequency of HIV testing. Although based on the Mpowerment Project, a cost-effective HIV prevention intervention that has been shown to be efficacious in reducing the rate of unprotected sex among young MSM, UBE has been extensively adapted to the socioeconomic, cultural, and social context of YBMSM's lives. Through the development of an empowered, mobilized YBMSM community, UBE creates positive social norms around HIV prevention that are diffused throughout diverse social networks. We began work to launch and begin testing the efficacy of UBE in Dallas and Houston, TX with CDC funding; Dallas was randomized to the intervention condition. Large cities were chosen since that is where the majority of YBMSM reside, and testing a community mobilization approach in such a setting is critical in considering how to translate it to practice. It took longer than anticipated to fully implement UBE because of community capacity issues, but UBE is now fully implemented and is reaching into diverse social networks of Dallas YBMSM. The CDC funding that supported the intervention and baseline assessments has ended, and the Texas State Health Department is now funding UBE at a local organization with which we are collaborating. In the proposed mixed methods project, we have an extraordinary opportunity to study the impact of this intervention without having to start up or cover the costs of the intervention. Thus, the aims of this mixed methods project are to: 1) Analyze public health data and conduct 3 additional annual cross-sectional surveys of YBMSM in Dallas and Houston using venue-based sampling to determine the efficacy of UBE in: (a) reducing unprotected anal sex; (b) increasing recent HIV testing; (c) modifying psychosocial mediating variables that may be causally related to HIV risk reduction; and (d) changing psychosocial factors related to positive mental health and well-being; 2) Determine how community changes occur during implementation of UBE by examining when changes in the psychosocial mediating variables, sexual risk behavior and HIV testing take place and if changes in sexual risk behavior and testing continue to improve, remain the same, or decrease over time; 3) Explore how UBE penetrates diverse YBMSM subcommunities in Dallas, and how this multilevel intervention impacts individual, interpersonal, and social level factors related t risk behavior and testing. Using ethnography, we will follow a longitudinal cohort while the intervention is being fully implemented. 4) Examine the potential integration of biomedical HIV prevention methods into UBE through administering and analyzing quantitative data from the survey and qualitative data from the interviews. PUBLIC HEALTH RELEVANCE: Young black men who have sex with men (YBMSM) are contracting HIV at alarmingly high rates that far exceed other ethnic/racial groups and need an HIV prevention intervention that is culturally grounded, and helps them to reduce unsafe sex and increase the frequency of HIV testing. This intervention, United Black Element, creates an empowered, mobilized community of men who support each other about safer sex and testing and reaches all YBMSM throughout the community, whether they seek help to change their behavior or not. Community-level HIV prevention interventions such as this have been found in other studies to be very cost-effective, and thus is an excellent approach to pursue in terms of public health.
描述(由申请人提供):在18-29岁的年轻黑人男男性行为者(YBMSM)中,艾滋病毒流行率和发病率已达到灾难性的水平。该项目的目标是确定一种多层次的、基于理论的干预措施--联合黑色元素(UBE)--在减少YBMSM的性危险行为和增加HIV检测频率方面的有效性。虽然基于赋权项目,这是一种成本效益高的艾滋病毒预防干预措施,已被证明在降低年轻男男性接触者中无保护的性行为比率方面是有效的,但UBE已广泛适应青年男男性接触者生活的社会经济、文化和社会背景。通过发展一个赋权的、动员起来的YBMSM社区,UBE围绕艾滋病毒预防创建了积极的社会规范,这些规范在不同的社会网络中传播。我们开始工作,在疾病预防控制中心的资助下,在德克萨斯州的达拉斯和休斯顿开始测试UBE的疗效;达拉斯被随机分配到干预条件下。之所以选择大城市,是因为那里是大多数YBMSM居住的地方,在这种情况下测试社区动员方法对于考虑如何将其转化为实践至关重要。由于社区容量问题,完全实施UBE花费的时间比预期的要长,但UBE现在已经完全实施,并正在进入达拉斯基督教青年会的各种社交网络。支持干预和基线评估的疾控中心资金已经结束,德克萨斯州卫生部现在正在为我们正在合作的一个当地组织的UBE提供资金。在拟议的混合方法项目中,我们有一个非同寻常的机会来研究这种干预的影响,而不必启动或支付干预的成本。因此,这一混合方法项目的目标是:1)分析公共卫生数据,并在达拉斯和休斯顿利用场地抽样对YBMSM进行另外3次年度横断面调查,以确定UBE在以下方面的有效性:(A)减少无保护的肛交;(B)增加最近的艾滋病毒检测;(C)修改可能与减少艾滋病毒风险有关的心理社会中介变量;以及(D)改变与积极心理健康和福祉相关的心理社会因素;2)通过检查心理社会中介变量、性风险行为和艾滋病毒检测的变化,以及性风险行为和检测的变化是否随着时间的推移继续改善、保持不变或减少,来确定UBE在实施UBE期间如何发生变化;3)探索UBE如何渗透到达拉斯的不同YBMSM次社区,以及这种多层次干预如何影响与风险行为和检测相关的个人、人际和社会层面的因素。利用人种学,我们将在干预措施全面实施的同时跟踪纵向队列。4)通过管理和分析调查中的定量数据和访谈中的定性数据,检查生物医学艾滋病毒预防方法是否有可能纳入UBE。 公共卫生相关性:男男性行为的年轻黑人男性(YBMSM)感染艾滋病毒的比率高得惊人,远远超过其他族裔/种族群体,需要有文化基础的艾滋病毒预防干预,帮助他们减少不安全的性行为,增加艾滋病毒检测的频率。这种干预,联合黑人元素,创造了一个授权的、动员的男性社区,他们在安全的性行为和检测方面相互支持,并接触到整个社区的所有YBMSM,无论他们是否寻求帮助来改变自己的行为。在其他研究中发现,像这样的社区一级艾滋病毒预防干预措施非常具有成本效益,因此是公共卫生方面的一种极好的方法。

项目成果

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Susan M. KEGELES其他文献

Susan M. KEGELES的其他文献

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{{ truncateString('Susan M. KEGELES', 18)}}的其他基金

Traineeships in AIDS Prevention Studies
艾滋病预防研究实习
  • 批准号:
    9395342
  • 财政年份:
    2017
  • 资助金额:
    $ 66.13万
  • 项目类别:
Intervention and Implementation Science Core
干预和实施科学核心
  • 批准号:
    9343106
  • 财政年份:
    2016
  • 资助金额:
    $ 66.13万
  • 项目类别:
Community Mobilization to Improve the HIV/AIDS Continuum of Care Among Black Men
社区动员以改善黑人男性的艾滋病毒/艾滋病连续护理
  • 批准号:
    9332471
  • 财政年份:
    2013
  • 资助金额:
    $ 66.13万
  • 项目类别:
Community Mobilization to Improve the HIV/AIDS Continuum of Care Among Black Men
社区动员以改善黑人男性的艾滋病毒/艾滋病连续护理
  • 批准号:
    8604646
  • 财政年份:
    2013
  • 资助金额:
    $ 66.13万
  • 项目类别:
Community Mobilization to Improve the HIV/AIDS Continuum of Care Among Black Men
社区动员以改善黑人男性的艾滋病毒/艾滋病连续护理
  • 批准号:
    9144450
  • 财政年份:
    2013
  • 资助金额:
    $ 66.13万
  • 项目类别:
Multilevel HIV Prevention Intervention for Young African American Men
针对年轻非洲裔美国男性的多层次艾滋病毒预防干预
  • 批准号:
    8885899
  • 财政年份:
    2012
  • 资助金额:
    $ 66.13万
  • 项目类别:
Multilevel HIV Prevention Intervention for Young African American Men
针对年轻非洲裔美国男性的多层次艾滋病毒预防干预
  • 批准号:
    8700538
  • 财政年份:
    2012
  • 资助金额:
    $ 66.13万
  • 项目类别:
Multilevel HIV Prevention Intervention for Young African American Men
针对年轻非洲裔美国男性的多层次艾滋病毒预防干预
  • 批准号:
    8537971
  • 财政年份:
    2012
  • 资助金额:
    $ 66.13万
  • 项目类别:
Development of a Multilevel HIV Prevention for Latin American Men
为拉丁美洲男性制定多层次艾滋病毒预防方案
  • 批准号:
    8139720
  • 财政年份:
    2010
  • 资助金额:
    $ 66.13万
  • 项目类别:
Development of a Multilevel HIV Prevention for Latin American Men
为拉丁美洲男性制定多层次艾滋病毒预防方案
  • 批准号:
    8012322
  • 财政年份:
    2010
  • 资助金额:
    $ 66.13万
  • 项目类别:

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