Young Hispanic Men - Entre Culturas: Navigating Culture, Identity and HIV Risk

描述（由申请人提供）：即将成年的关键任务，即风险行为达到顶峰的生命阶段，是综合成人身份（职业、性和文化）的发展。对于那些正在与男性发生性关系的年轻西班牙男性（YHMSM）来说，在一个传统规范鄙视和排斥同性恋思想、情感和行为，并期望严格遵守文化规范的文化中，他们正在形成同性恋身份，这个过程可能特别具有挑战性和风险。这不仅需要参与主流西班牙文化普遍不接受的行为，而且他们在迈阿密这样做，在艾滋病毒在男男性接触者中的流行率很高。YHMSM迫切需要的是量身定制的干预措施，利用有效，灵活的方法，如动机增强干预（MEIs），可以通过互联网传递，这种方式被年轻人完全接受，并为干预研究提供了很大的希望。在这个1a/b阶段的研究中，我们将开发和试点测试一种适合文化和发展的MEI，以减少YHMSM之间的风风性行为（无保护的肛交和多伴侣），通过面对面（FtF）和互联网使用实时实施方法。在第1a阶段，我们将收集定量和定性数据，以确定与YHMSM高危性行为相关的文化、发展和个人因素，为两种分娩方式制定量身定制的MEI，以及在时间和次数上可比较的健康教育控制（health）。我们将从社区和互联网场所招募100名YHMSM的横断面样本来完成ACASI。我们将通过25个定性访谈、10个关键信息提供者访谈和6-8个焦点小组来补充这些数据，以指导干预措施的制定。在第1b阶段，我们将测试新开发的MEI的可接受性和可行性，获得干预措施减少危险性行为强度的效应量估计，并确定是否准备好进入第2阶段进行功效测试。我们将从社区和网络场所共招募90名YHMSM，并将他们随机分配到3个条件之一（MEI-FtF; mei - Internet； HEALTH）。参与者将在基线、干预后3个月和6个月使用ACASI完成评估。每次会议结束后，他们将完成可接受性和可行性评估。如果试点试验显示出希望，我们将很好地将干预措施推向全面的功效测试，并推进YHMSM的预防工作。

DESCRIPTION (provided by applicant): The critical task of emerging adulthood, the life period when risk-behaviors peak, is the development of an integrated adult identity (professional, sexual and cultural). For young Hispanic men who are having sex with men (YHMSM) developing a gay identity in a culture whose traditional norms stigmatize and reject homosexual thoughts, feelings and behaviors and that expects strong adherence to cultural norms, this process can be particularly challenging and risky. Not only does it entail participating in behaviors that are not generally accepted by mainstream Hispanic culture, but they are doing so in Miami, a context where HIV prevalence among MSM is high. Urgently needed for YHMSM are tailored interventions that utilize effective, flexible approaches such as Motivational Enhancement Interventions (MEIs) that can be delivered through the Internet, a modality thoroughly embraced by young adults and one that offers much promise for intervention research. In this Stage 1a/b study, we will develop and pilot test a culturally and developmentally tailored MEI to reduce risky sex (unprotected anal sex and multiple partners) among YHMSM to be delivered face-to-face (FtF) and through the Internet using a real-time implementation approach. In Stage 1a, we will collect quantitative and qualitative data to identify the cultural, developmental, and personal factors associated with risky sex in YHMSM, develop a tailored MEI for two delivery modalities, and a health education control (HEALTH) comparable in time and number of sessions. We will recruit across-sectional sample of 100 YHMSM from community and Internet venues to complete an ACASI. We will supplement these data with 25 qualitative interviews, 10 key informant interviews and 6-8 focus groups to guide intervention development. In Stage 1b, we will test the newly developed MEI's acceptability and feasibility, obtain effect size estimates of the intervention's strength to reduce risky sex, and determine if it is ready to be moved to Stage 2 for efficacy testing. We will recruit a total of 90 YHMSM from community and Internet venues and randomly assign them to one of the 3 conditions (MEI-FtF; MEI-lnternet; HEALTH). Participants will complete assessments using ACASI at baseline, 3 and 6 month post intervention. After each session, they will complete acceptability and feasibility assessments. If the pilot trial shows promise, we will be well positioned to move the intervention to full-scale efficacy testing and advance prevention efforts for YHMSM.