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 干预措施的有效性，这是针对异性恋黑人男性的 HIV 干预和预防计划。 MEN Count 模型通过同行案例经理在 60-90 天内提供的多次一对一会议，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。 MEN Count 是通过马萨诸塞州波士顿 NIH R21 的资助，使用 CBPR 方法开发和试点测试的。类似的 CBPR 方法加上更严格的评估设计（即随机对照试验 - RCT）将用于测试费城黑人就业培训社区服务机构 (NCCF) 的 MEN 计数。研究参与者 (N=504) 将是报告艾滋病毒异性恋风险的黑人男性 [过去 30 天内与一名女性发生无保护性行为，过去 6 个月内与 2 名女性性伴侣发生性行为]，以及当前失业或在过去 6 个月内无家可归。为了评估 MEN Count 的有效性，将进行一项双臂随机对照试验，参与者将被随机接受 MEN Count 或结构上类似于 MEN Count 的注意力比较计划，但重点关注一般男性健康——营养、运动和初级卫生保健利用。我们将分别在基线和 6 个月及 12 个月的随访中通过调查和 STI 检测来评估该计划对减少无保护性行为和 STI（衣原体、淋病、梅毒）病例数量的影响。此外，还将开展质量保证和流程评估工作，以确保高质量的计划遵守和交付，并在模型证明有效时支持计划复制。 公共卫生相关性：本研究的目的是评估 MEN Count 干预措施的有效性，这是一项针对异性恋黑人男性的 HIV 干预和预防计划。 MEN Count 模型通过同行案例经理在 60-90 天内提供的 3 场一对一会议，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。将使用两项随机对照试验来评估 MEN Count 相对于以饮食和运动为重点的注意力比较条件，对减少无保护性行为和性传播感染事件的影响，通过基线和 6 个月和 12 个月随访时的计算机化调查和 STI 测试进行测量。

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.