Motivating Changes in Condom, Methamphetamine Use During MSM Sexual Encounters

描述（由申请人提供）：与男性发生性行为的男性（MSM）使用甲基苯丙胺与参与各种高危性行为和增加艾滋病毒发病率有关。然而，针对男男性行为者使用甲基苯丙胺的有效干预措施很少，如果有的话，已经开发并在这一人群中进行了测试。男男性接触者中甲基苯丙胺的使用最初被认为主要是西方大城市的问题，如旧金山和洛杉矶，大多数关于男男性接触者使用甲基苯丙胺的研究都是在这些地区进行的。最近，甲基苯丙胺的使用已成为小城市和该国其他地区的一个严重问题。然而，人们对男男性行为者使用甲基苯丙胺及其与其他地区艾滋病毒风险的关系知之甚少。这项为期两年的研究将在北卡罗来纳州的罗利-达勒姆地区进行。这项研究将分两个阶段进行。第一年将包括一个形成阶段，以(a)增加我们对男男性行为者中使用甲基苯丙胺和危险性行为之间关系的理解，(b)评估招募使用甲基苯丙胺的男男性行为者的不同策略，(c)确定使用甲基苯丙胺的男男性行为者之间安全性行为的障碍，以及(d)评估一系列行为改变目标的可接受性，以减少使用甲基苯丙胺的男男性行为者的艾滋病毒风险行为。干预绘图方法将用于开发基于动机访谈（Ml）和测量结果的工具的干预。在第二年，我们将使用前后测试设计对80名使用甲基苯丙胺的男男性行为者进行干预测试，分析结果并传播研究结果。具体目标是：(1)开展形成性工作，了解使用甲基苯丙胺的男男性行为者的艾滋病毒风险背景，评估干预措施的可行性（例如，招募和保留策略）和行为改变目标的可接受性，以降低使用甲基苯丙胺的男男性行为者的艾滋病毒风险，并确定改变的障碍（例如，技能缺陷，感知风险，感知自我效能）；我们还将对现有数据集进行文献审查和二手数据分析，以更好地了解有关甲基苯丙胺使用和危险性行为的问题；(2)基于形成阶段的研究结果，开发并预测试一种动机性访谈HIV预防干预措施；(3)通过一组前测后测设计对干预措施进行试点测试，以确定干预措施在提高改变意愿和减少性危险行为方面的效果。

DESCRIPTION (provided by applicant): Methamphetamine use among men who have sex with men (MSM) has been associated with participation in a variety of high-risk sexual behaviors and increased HIV incidence rates. However, few, if any, effective interventions targeting methamphetamine use among MSM have been developed and tested with this population. Methamphetamine use among MSM was initially considered a problem primarily in large western cities, such as San Francisco and Los Angeles, and the majority of research on its use among MSM has been conducted in these areas. More recently, methamphetamine use has become a significant problem in smaller cities and in other parts of the country. Yet less is known about methamphetamine use among MSM and its association with HIV risk in these other areas. This proposed 2-year study will be conducted in the Raleigh-Durham area in North Carolina. The study will be conducted in two phases. Year 1 will consist of a formative phase to (a) increase our understanding of the relationship between methamphetamine use and risky sexual behavior among MSM, (b) evaluate different strategies for recruiting methamphetamine-using MSM, (c) identify barriers to safer sex among methamphetamine-using MSM, and (d) assess the acceptability of a range of behavioral change objectives for reducing HIV risk behaviors among methamphetamine-using MSM. An intervention mapping approach will be used to develop an intervention based on motivational interviewing (Ml) and instruments for measuring outcomes. In Year 2, we will test the intervention with 80 methamphetamine-using MSM using a pre-post test design, analyze the results, and disseminate findings. The specific aims are to (1) conduct formative work to understand the context of HIV risk for methamphetamine-using MSM, evaluate the feasibility (e.g., recruitment and retention strategies) and acceptability of behavioral change objectives for an intervention to reduce HIV risk among methamphetamine-using MSM, and identify barriers to change (e.g., skills deficits, perceived risk, perceived self-efficacy); we will also conduct a literature review and secondary data analysis of existing data sets to better understand the issues surrounding methamphetamine use and risky sexual behavior; (2) develop and pretest a motivational interviewing HIV prevention intervention based on the findings from the formative Phase; and (3) pilot test the intervention through a one-group pretest-posttest design to determine efficacy of he intervention to increase readiness to change and reduce sexual risk behaviors.