POSSE Project: A Community-Level Intervention for Black YMSM

POSSE 项目：针对黑人 YMSM 的社区级干预

• 批准号: 9037710
• 负责人: Sybil Hosek
• 金额: $ 66.68万
• 依托单位: HEKTOEN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9037710
• 关键词: AIDS prevention; AIDS/HIV problem; Affect; Age; Anus; Area; Beauty; Behavior; Behavioral; Biological; Characteristics; Chicago; Cities; Communities; Contracts; Coupled; Data; Discrimination; Education; Education Projects; Educational Intervention; Effectiveness; Epidemic; Evaluation; Event; Family; Gays; Gender Identity; HIV; HIV Infections; HIV risk; HIV/STD; Health; House Call; Housing; Hybrids; Intervention; Intervention Studies; Interview; Knowledge; Leadership; Methods; Modeling; Participant; Performance; Philadelphia; Population; Prevalence; Prevention; Preventive Intervention; Process; Public Health; Recruitment Activity; Reporting; Research; Research Project Grants; Risk; Risk Behaviors; Risk Reduction; Safe Sex; Schools; Sexual Partners; Social Network; Structure; Testing; TimeLine; Training; United States; Use Effectiveness; Work; base; behavior change; community based participatory research; design; effective intervention; experience; follow-up; high risk men; improved; innovation; metropolitan; peer; pilot trial; post intervention; programs; research to practice; sex; sex risk; social norm; social stigma; success; theories; transmission process; trend; trial design; young men who have sex with men

 DESCRIPTION (provided by applicant): Black young men who have sex with men (BYMSM) are at high risk for contracting and transmitting HIV, and represent a priority population for developing effective interventions. Within the House Ball community (HBC), a clandestine subculture of the Black gay community, HIV is highly stigmatized. This stigma, coupled with high HIV prevalence rates and elevated levels of undiagnosed/untreated HIV infection, places BYMSM in HBCs at incredible risk for HIV infection. Community-level interventions that target social norms, behavior, and stigma in the HBC are sorely needed in order to make a broader impact among BYMSM. Building on prior work in the community, this study proposes to launch an innovative Effectiveness-Implementation Hybrid Type 2 trial to examine the effectiveness and implementation of a community-level HIV prevention intervention (called POSSE) based on popular opinion leader (POL) models across two cities with similar HBCs, Chicago and Philadelphia. The proposed study has two specific aims: 1) To determine the effectiveness of a POL intervention, POSSE, to decrease sexual risk behavior (UAI), STIs and HIV stigma among BYMSM in the HBC; and 2) To evaluate the processes, strategies, barriers and facilitators for the implementation of POSSE delivered across two distinct metropolitan areas with high HIV prevalence among BYMSM and similar House Ball Communities. To examine these aims, we will first use social network strategies to identify, screen, and recruit POLs (n=75) from the Philadelphia HBC. We will then gather baseline behavioral and biological (HIV/STI testing) data in both Chicago and Philadelphia (n=100 BYMSM per city) and train the Philadelphia POLs to implement the POSSE intervention. We will conduct an implementation-focused process evaluation to assess fidelity to the POSSE intervention; number, content, spread, and acceptability of risk reduction messages; age appropriateness of the messages; acceptability of the overall intervention; and barriers/facilitators to implementation. Next, we will complete follo-up assessments every 6 months post- intervention in both cities (n=100 BYMSM per city at each assessment point). We will also assess behavior change in those delivering the intervention (POLs) at each assessment point. We will conduct implementation- focused qualitative interviews with POLs (n=15) and community participants (n=30) from Philadelphia. Last, we will implement POSSE in Chicago by repeating the steps outlined above, continuing assessments in both cities, and conducting qualitative interviews in Chicago. This study is significant and innovative in that it proposes to simultaneously evaluate the effectiveness and implementation of a community-level intervention for BYMSM, a group disproportionately impacted by the HIV epidemic, in order to expeditiously move effective public health programming into the community.

 描述(由申请人提供)：男男性行为者(BYMSM)是感染和传播艾滋病毒的高风险人群，是制定有效干预措施的优先人群。在黑人同性恋社区的秘密亚文化House Ball社区(HBC)内，艾滋病毒被高度污蔑。这一耻辱，加上艾滋病毒的高流行率和未诊断/未治疗的艾滋病毒感染水平上升，使HBCS中的BYMSM面临令人难以置信的艾滋病毒感染风险。为了在BYMSM中产生更广泛的影响，迫切需要针对HBC中的社会规范、行为和耻辱进行社区层面的干预。在社区先前工作的基础上，这项研究建议启动一项创新的有效性-实施混合类型2试验，以检查基于民意领袖(POL)模式的社区层面艾滋病毒预防干预(称为POSE)的有效性和实施情况，这两个城市具有相似的HBC，芝加哥和费城。这项拟议的研究有两个具体目标：1)确定POL干预(POSE)的有效性，以减少HBC中BYMSM的性危险行为(UAI)、性传播感染和艾滋病毒污名；以及2)评估在BYMSM和类似的House Ball社区中艾滋病毒感染率较高的两个不同的大都市地区实施POSE的过程、战略、障碍和促进者。为了检验这些目标，我们将首先使用社交网络战略来识别、筛选和招募费城HBC的Pols(n=75)。然后，我们将在芝加哥和费城(每个城市n=100名BYMSM)收集基线行为和生物(HIV/STI测试)数据，并培训费城警察实施Posse干预。我们将进行以实施为重点的过程评估，以评估Posse干预措施的忠诚度；降低风险信息的数量、内容、传播范围和可接受性；信息的年龄适宜性；整体干预措施的可接受性；以及实施的障碍/促进者。接下来，我们将在两个城市的干预后每6个月完成一次跟踪评估(每个评估点每个城市100名BYMSM)。我们还将在每个评估点评估那些提供干预(POP)的人的行为变化。我们将对来自费城的POL(n=15)和社区参与者(n=30)进行以实施为重点的定性访谈。最后，我们将在芝加哥实施Posse，重复上述步骤，在两个城市继续评估，并在芝加哥进行定性访谈。这项研究具有重要意义和创新性，因为它建议同时评估对BYMSM的社区一级干预的有效性和实施情况，BYMSM是一个受艾滋病毒疫情影响不成比例的群体，以便迅速将有效的公共卫生方案纳入社区。