Motivating Changes in Condom, Methamphetamine Use During MSM Sexual Encounters

描述(由申请人提供)：男男性行为者(MSM)中使用甲基苯丙胺与参与各种高危性行为和艾滋病毒发病率增加有关。然而，针对男男性同性恋者中使用甲基苯丙胺的有效干预措施即使有，也很少，并在这一人群中进行了测试。在MSM中使用甲基苯丙胺最初被认为是一个主要在旧金山和洛杉矶等西部大城市存在的问题，大多数关于MSM中使用甲基苯丙胺的研究都是在这些地区进行的。最近，甲基苯丙胺的使用在小城市和该国其他地区已经成为一个严重的问题。然而，关于男男性接触者中甲基苯丙胺的使用及其与这些其他地区艾滋病毒风险的关联，人们知之甚少。这项拟议的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。研究将分两个阶段进行。第一年将包括一个形成阶段，以(A)增加我们对使用甲基苯丙胺与男男性接触者危险性行为之间关系的了解，(B)评估招募使用甲基苯丙胺的不同战略，(C)确定在使用甲基苯丙胺的男男性接触者中实现更安全性行为的障碍，以及(D)评估减少使用甲基苯丙胺的男男性接触者中艾滋病毒危险行为的一系列行为改变目标的可接受性。将使用干预映射方法来开发基于动机访谈(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，测试80名使用甲基苯丙胺的男男性接触者的干预，分析结果，并传播研究结果。具体目的是(1)开展形成性工作，以了解使用甲基苯丙胺的男男性行为者艾滋病毒风险的背景，评估行为改变目标在使用甲基苯丙胺的男男性接触者中降低艾滋病毒风险的可行性(例如，招募和保留战略)和可接受性，并确定改变的障碍(例如，技能缺陷、感知风险、感知的自我效能)；我们还将对现有数据集进行文献回顾和二级数据分析，以更好地了解围绕甲基苯丙胺使用和危险性行为的问题；(2)根据形成阶段的调查结果，制定和预测动机访谈艾滋病毒预防干预措施；以及(3)通过一组前测-后测设计对干预进行预试，以确定干预的有效性，以增加改变和减少性危险行为的意愿。

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.