A Community-level HIV Prevention Intervention for Young Black Men

描述(由申请人提供)：在年轻的黑人男男性行为者(YBMSM)中，艾滋病毒血清阳性率和血清发病率已达到灾难性的水平。黑人男男性接触者接受艾滋病毒检测的频率也较低，与其他男男性接触者相比，他们不太可能意识到自己的艾滋病毒阳性血清状态。显然，目前用来接触青年男童子军的艾滋病毒预防方法并不有效。赋权项目是专门为年轻男同性恋者/双性恋者制定的唯一社区一级艾滋病毒预防干预措施，已被证明在减少报告无保护肛交的男子比例方面有效。然而，黑人社区组织不愿实施赋权项目，直到它已经适应了基督教青年会的生活背景，以及它在降低无保护性行为比率和提高艾滋病毒抗体检测率方面的有效性已经确定。因此，赋权项目的开发者花了五年时间，通过对艾滋病毒阳性和HIV阴性的基督教青年会进行形成性的定性研究，并通过与三个黑人社区组织和两个文化专家委员会的合作研究，针对青年男女同性恋者的社会经济、文化和社会背景进行干预。该项目的主要目标是测试定制赋权项目在减少性危险行为和增加青壮年男男性行为检测方面的有效性。这项研究的具体目标是：(1)在一个社区(佐治亚州亚特兰大)实施为期两年的定制赋权项目，并使用第二个社区(德克萨斯州休斯顿)作为对照，不接受干预；(2)在两个社区使用基于场地的时空抽样对干预前后的YBMSM进行横断面调查，以确定干预的效果：(A)减少可能传播HIV的性行为的比例和频率，包括减少性伴侣的数量；(B)增加知道其HIV血清状态的男性比例；(C)修改可能与减少艾滋病毒风险有因果关系的心理社会中介变量；(D)改变作为积极心理健康和福祉指标的心理社会因素；(3)对干预措施进行程序评价，以评估如何实施有针对性的赋权项目，并在个人和社区两级评估对该项目的看法。我们还将寻找这两个社区性传播感染率的变化。

DESCRIPTION (provided by applicant): HIV seroprevalence and seroincidence rates have reached catastrophic levels among young Black men who have sex with men (YBMSM). Black MSM are also tested less frequently for HIV and are less likely to be aware of their HIV-positive serostatus than other MSM. Clearly, HIV prevention methods currently used to reach YBMSM are not effective. The Mpowerment Project is the only community-level HIV prevention intervention developed specifically for young gay/bisexual men that has been shown to have evidence of effectiveness in reducing the proportion of men reporting unprotected anal sex. However, Black CBOs are reluctant to implement the Mpowerment Project until it has been adapted to the context of YBMSM's lives and its efficacy in reducing rates of unprotected sex and increasing HIV antibody testing rates have been established Therefore, the developers of the Mpowerment Project have spent five years tailoring the intervention to the socioeconomic, cultural, and social context of YBMSM's lives through formative, qualitative research with HIV-positive and HIV-negative YBMSM and through collaborative research with three Black CBOs and two Boards of Cultural Experts, comprised of Black gay/same gender-loving men. The primary goal of this project is to test the efficacy of the tailored Mpowerment Project in reducing sexual risk behavior and increasing testing among YBMSM. The specific aims of this study are: (1) To implement the tailored Mpowerment Project for two years in one community (Atlanta, GA), and use a second community (Houston, TX) as a control that will not receive the intervention; (2) To conduct cross-sectional surveys of YBMSM before and after the intervention in both communities using venue-based day-time-space sampling to determine the efficacy of the intervention in: (a) reducing the proportion and frequency of sexual behaviors that are likely to transmit HIV, including reducing the number of sex partners; (b) increasing the proportion of men who know their HIV serostatus; (c) modifying psychosocial mediating variables that may be causally related to HIV risk reduction; and (d) changing psychosocial factors that are indicators of positive mental health and well-being; (3) To conduct process evaluations of the intervention to assess how the tailored Mpowerment Project is implemented and to assess the perceptions of the project at both the individual- and community-level. We will also look for changes in sexually transmitted infection rates in both communities.