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

描述(申请人提供)：这项研究的目的是评估男性计数干预的效果，这是一项针对异性恋黑人男性的艾滋病毒干预和预防计划。男子计数模式将减少艾滋病毒风险和性别平等咨询与住房和就业案件管理相结合，由同行案件管理人员在60-90天期间提供多个一对一会议。男性计数是通过马萨诸塞州波士顿的NIH R21资助使用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)将用于测试费城黑人男性就业培训社区服务机构(NCCF)的男性人数。研究参与者(N=504)将是报告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措施的性行为，在过去6个月内与2名女性性伴侣发生性关系]，以及目前的失业或在过去6个月内无家可归。为了评估男性计数的有效性，将进行一项双臂随机随机对照试验，参与者将接受男性计数或关注比较计划，该计划在结构上类似于男性计数，但侧重于一般男性的健康--营养、锻炼和初级卫生保健利用。我们将分别在基线和6个月和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措施的性行为和STI(衣原体、淋病、梅毒)病例数量的影响。此外，将进行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，以及支持计划复制，如果该模式被证明有效的话。 公共卫生相关性：这项研究的目的是评估男性计数干预的效果，这是一项针对异性恋黑人男性的艾滋病毒干预和预防计划。男子计数模式将减少艾滋病毒风险和性别平等咨询与住房和就业案件管理结合在一起，由同行案件管理人员在60-90天期间提供三次一对一的会议。两个武装随机对照试验将被用来评估男性计数对减少无保护措施的性行为和事件性传播感染的影响，相对于专注于饮食和锻炼的注意力比较条件，这是通过基线和6个月和12个月的跟踪调查和STI测试来衡量的。

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.