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

这个应用程序描述了一个为期五年的研究计划，调查个人，社会， 哥伦比亚四个最大城市（波哥大， Medell n，卡利，and巴兰基利亚）.这项研究具有公共卫生意义，因为它将有助于 了解HIV高危人群的HIV感染率和危险行为。 此外，它还将评估割礼在哥伦比亚男男性行为者中提供的艾滋病毒防护。这 该应用程序在使用概念框架方面具有创新性， 结构背景：在哥伦比亚，对所有个人的权利，包括男同性恋者的权利，都有法律的保护， 与此同时，国内动乱仍在继续，大批人被迫流离失所， 同负性本研究的目的是：（1）探讨结构、社会和个人因素 与哥伦比亚四个城市男男性行为者艾滋病毒风险有关; 2）估计哥伦比亚四个城市男男性行为者艾滋病毒流行率， 3）检验包皮环切术状态与HIV血清状态之间的关系，并调查信念， 哥伦比亚男男性行为者对割礼的认识和态度; 4）整合信息 从所使用的各种研究方法中获得并得出指导政策设计的结论 以及针对哥伦比亚男男性行为者艾滋病毒风险的干预措施。 研究分为三个阶段。第一阶段涉及定性研究（24名关键知情人 访谈，18个焦点小组和28个生活史访谈），以探索四个城市的生活背景， 男男性行为者，包括性行为模式、社交网络、与同性恋和艾滋病毒相关的污名， 暴力、移民和流离失所。生活史访谈将与男男性接触者进行， 经历了流离失所。第二阶段涉及定量研究。快速口服艾滋病毒检测和定量 调查工具（A-CASI）将在四个城市15 - 49岁的MSM样本中使用。 数据将被用来测试艾滋病毒风险模型，以获得艾滋病毒在男男性行为人群中的流行率估计， 四个城市，测试包皮环切术的保护作用，并描述态度和知识， 割礼试点测试包括160名参与者;修订后的调查的全面管理包括 1000名参与者，通过响应者驱动抽样获得。第三阶段包括数据的三角测量， 传播调查结果。从这项研究中获得的背景信息将在艾滋病毒 在社会、城市、社区和个人层面为哥伦比亚男男性接触者开展预防工作。这个应用程序是一个为期五年的研究计划，调查个人，社会， 艾滋病毒的风险和艾滋病毒流行率的结构性影响，在四个最大的 哥伦比亚的城市（波哥大、麦德林、卡利和巴兰基利亚）。此外，它还探讨了 目标样本对包皮环切术的态度。

This application describes a five-year research program that investigates individual, social, and structural influences on HIV risk and serostatus among MSM in the four largest cities in Colombia (Bogot¿, Medell¿n, Cali, and Barranquilla). 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. The aims of the proposed study are 1) to examine structural, social, and individual factors relevant to HIV risk among Colombian MSM in four cities; 2) to estimate prevalence of HIV among MSM in the cities; 3) to test 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 (24 key informant interviews, 18 focus groups, and 28 life history interviews) to explore the context of life in the four cities for MSM, 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 (using A-CASI) will be administered to samples of MSM, aged 15 to 49, in the four cities. Data will be used to test a model of HIV risk, to obtain estimates of HIV prevalence in the population of MSM in the four cities, to test for protective effects of circumcision, and to describe attitudes and knowledge of circumcision. The pilot test includes 160 participants; the full administration of the revised survey includes 1000 participants, 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. This application is a five-year research program that investigates individual, social, and structural influences on HIV risk and HIV prevalence among MSM in the four largest cities in Colombia (Bogot¿, Medell¿n, Cali, and Barranquilla). In addition, it explores attitudes towards circumcision in the targeted sample.