Evaluating a Structural and Behavioral HIV Risk Reduction Program for Black Men

描述（由申请人提供）：本研究的目的是评估MEN Count干预的有效性，这是一项针对异性恋黑人男性的艾滋病干预和预防计划。MEN Count模式将艾滋病毒风险降低和性别平等咨询与住房和就业案例管理结合起来，由同行案例管理人员在60-90天的时间内提供多次一对一的会议。MEN Count是在马萨诸塞州波士顿的NIH R21资助下，使用CBPR方法开发和试点测试的。类似的CBPR方法伴随着更严格的评估设计（即随机对照试验- RCT）将被用于费城黑人男性就业培训社区服务机构（NCCF）的MEN Count。研究参与者（N=504）将是报告异性恋感染艾滋病毒风险的黑人男性（在过去30天内与一名女性发生无保护性行为，在过去6个月内与2名以上女性性伴侣发生性行为），在过去6个月内失业或无家可归。为了评估MEN Count的有效性，将进行一项双臂随机对照试验，其中参与者将随机接受MEN Count或结构类似于MEN Count的注意力比较计划，但侧重于一般男性健康-营养，运动和初级卫生保健利用。我们将通过调查和性病检测，分别在基线和6个月和12个月的随访中评估项目对减少无保护的性行为次数和性病（衣原体、淋病、梅毒）病例的影响。此外，质量保证和过程评估工作将被执行，以确保高质量的程序遵守和交付，以及支持程序复制，如果模型证明是有效的。

DESCRIPTION (provided by applicant): The purpose of this study is to evaluate the efficacy of the MEN Count intervention, an HIV intervention and prevention program for heterosexual Black men. The MEN Count model integrates HIV risk reduction and gender-equity counseling with housing and employment case management via multiple one-on-one sessions delivered by a peer case manager over 60-90 day period. MEN Count was developed and pilot tested using a CBPR approach via funding from an NIH R21, in Boston, MA. Similar CBPR methods accompanied by a more rigorous evaluation design (i.e., a randomized controlled trial- RCT) will be used to test MEN Count in an employment training community service agency for Black men in Philadelphia (NCCF). Study participants (N=504) will be Black men reporting heterosexual risk for HIV [unprotected sex with a woman in the past 30 days and 2+ female sex partners in the past 6 months] and either current unemployment or homeless in the past 6 months. To evaluate the effectiveness of MEN Count, a two-armed RCT will be conducted in which participants will be randomized to receive either MEN Count or an attention comparison program similar to MEN Count in structure but focused on general men's health- nutrition, exercise and primary health care utilization. We will assess program impact on reduction in number of unprotected sex episodes and incident cases of STI (Chlamydia, gonorrhea, syphilis) via survey and STI testing, respectively, at baseline and 6 and 12 month follow-ups. Additionally, quality assurance and process evaluation efforts will be conducted to ensure high quality program adherence and delivery, as well as to support program replication should the model prove effective. PUBLIC HEALTH RELEVANCE: The purpose of this study is to evaluate the efficacy of the MEN Count intervention, an HIV intervention and prevention program for heterosexual Black men. The MEN Count model integrates HIV risk reduction and gender-equity counseling with housing and employment case management via three one-on-one sessions delivered by a peer case manager over 60-90 day period. A two armed randomized controlled trial will be used to evaluate the impact of MEN Count, relative to an attention comparison condition focused on diet and exercise, on reduction in unprotected sex and incident STI, as measured via computerized survey and STI tests at baseline and 6 and 12 month follow-ups.