NATIONAL HIV BEHAVIORAL SURVEILLANCE SYSTEM

描述（由申请人提供）：马里兰州卫生和精神卫生部门（DHMD），艾滋病管理局向美国卫生和人类服务部疾病控制和预防中心（CDC）申请三年内1,417,943美元，用于在马里兰州巴尔的摩市大都会区实施国家艾滋病毒行为监测系统（NHBS）。NHBS是一项匿名研究，其重点是招募三种艾滋病毒感染风险人群：男男性行为者（MSM）、注射吸毒者（IDU）和艾滋病毒感染风险增加的异性恋者（HET）。这项研究将包括一系列的三个横断面调查，使用相同的访谈工具，将招募上述每一个风险人群。男同性恋者的招募将于2008年12月完成，IDU的招募将于2009年12月完成，HET的招募将于2010年12月完成。每个目标人群的建议样本量至少为500名参与者。拟议的研究将包括一份详细的调查问卷，以收集人口统计、性和药物使用行为、艾滋病毒检测和利用当地艾滋病毒预防计划服务的信息。问卷将在全国范围内标准化，并增加巴尔的摩特定的有限数量的问题。该研究还将提供HIV检测，利用FDA批准的HIV诊断测试和近期HIV血清转换的血清学检测算法（STARHS）来识别近期感染。抽样和招募方法将根据每个目标人群（男男性行为者、注射吸毒者和高性变态者）的情况适当选择，并将与疾病预防控制中心合作制定。男男性接触者的招募将以场地为基础。巴尔的摩市的公共场所（如酒吧、俱乐部等）将被随机抽样，符合条件的男性将被要求接受抽血和问卷调查。IDU招聘将采用受访者驱动抽样（RDS）。最初的注射吸毒者参与者将通过主要的社区线人招募，在同意抽血和填写问卷后，将接受培训以招募更多的注射吸毒者。连续几波的注射吸毒者新兵将招募更多的注射吸毒者。连续几波的注射吸毒者新兵将招募更多的注射吸毒者。HET的招募将通过基于场所的招募（如男男性接触者）或受访者驱动的抽样（如注射吸毒者）进行，并将与疾病预防控制中心合作选择。NHBS在巴尔的摩大都市区的活动将为衡量艾滋病毒风险行为以及规划和针对马里兰州的艾滋病毒预防活动提供有价值的信息。美国疾病控制与预防中心已提议在全国25个艾滋病毒高流行的大都市地区实施国家卫生服务体系，合并后的数据将产生全国范围内受影响最严重地区高危人群的艾滋病毒风险行为估计。

DESCRIPTION (provided by applicant): The Maryland Department to of Health and Mental Hygiene (DHMD), AIDS Administration is requesting $1,417,943 over three years from the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC) to implement the National HIV Behavioral Surveillance System (NHBS) in the Baltimore, Maryland metropolitan area. The NHBS is an anonymous research study which focuses on recruiting three populations at risk for HIV infection: Men who have sex with men (MSM), injection drug users (IDU), and heterosexuals at increased risk for HIV infection (HET). This study will consist of a series of three cross-sectional surveys using the same interview instrument, which will recruit each of the above risk populations. MSM recruitment will be completed by December 2008, IDU recruitment by December 2009, and HET recruitment by December 2010. The proposed sample size for each of the target population is a minimum of 500 participants. The proposed study will include a detailed questionnaire to gather information on demographics, sexual and drug use behaviors, HIV testing, and utilization of local HIV prevention program services. The questionnaire will be standardized nationally, with the addition of a limited number of questions specific to Baltimore. The study will also offer HIV testing, utilizing both FDA approved HIV diagnostic tests and the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) for the identification of recent infections. The sampling and recruitment methodologies will be selected as appropriate for each of the target populations (MSM, IDU, and HET) and will be developed in collaboration with the CDC. MSM recruitment will be venue-based. Public venues (e.g., bars, clubs, etc) in Baltimore City will be randomly sampled and eligible men will be requested to consent to a blood draw and a questionnaire. IDU recruitment will utilize respondent driven sampling (RDS). Initial IDU participants will be recruited through key community informants and after consenting to a blood draw and a questionnaire will then be trained to recruit additional IDUs. Successive waves of IDU recruits will recruit additional IDUs. Successive waves of IDU recruits will recruit additional IDUs. HET recruitment will be either through venue-based recruitment, as with MSM, or respondent driven sampling, as with IDUs, and will be selected in collaboration with the CDC. The NHBS activities in the Baltimore metropolitan area will produce valuable information for measuring HIV risk behaviors and for planning and targeting HIV prevention activities in Maryland. The CDC has proposed performing NHBS in 25 high HIV prevalence metropolitan areas nationwide, and the combined data will produce national estimates of HIV risk behaviors in high-risk populations in the most affected regions of the country.