Health Empowerment for MSM in South Africa

描述（由申请人提供）：行为和流行病学数据表明，南非男男性行为者（MSM）具有高水平的艾滋病毒风险行为和高艾滋病毒流行率，并在他们生活的资源紧张的社区中经历高水平的耻辱，歧视和暴力。南非男男性接触者所面临的不利的社会环境导致了他们的艾滋病风险行为和不良的性健康结果。一个多层次的干预，这将有助于南非男男性接触者减少他们的风险行为，减少社会环境中的同性恋负面影响的影响，提高个人和集体的能力，以影响他们的社区积极的变化是迫切需要的。拟议的研究项目将测试对男男性接触者的健康赋权的有效性，这是一种多层次的干预措施，旨在降低南非男男性接触者感染艾滋病毒的风险。建立在一个社区发展和授权模式，发现是有效的风险降低与男男性接触在美国，干预措施将包括密集的小团体行为讲习班，以加强个人的自我效能和建立安全性行为的社会规范，并将通过男男性接触社交网络传播这些规范，通过文化上适当的同伴教育计划，注入艾滋病毒预防内容的男男性接触社区活动。我们提出了一个两个社区，多基线比较的MSM社区接受干预的MSM社区类似的规模和社会结构，艾滋病毒预防服务主要是通过当地和省级公共卫生诊所提供。我们假设，经过18个月的干预，我们将观察到更大的艾滋病毒预防成果，在我们的干预社区，相对于比较社区，关于三个具体目标：（1）更高水平的社会凝聚力之间的MSM社区成员;（2）更高水平的感知集体权力的MSM社区;（3）促进性健康的行为增加，包括与男性伴侣持续使用安全套和水基润滑剂，对HIV阴性的MSM每6个月定期进行HIV检测，对HIV阳性的MSM每6个月定期进行HIV疾病监测。 公共卫生相关性：南非男男性行为者健康赋权项目旨在帮助南非城镇社区的年轻黑人男男性行为者减少感染艾滋病毒的风险，并克服社区中的耻辱和歧视的影响。该干预措施结合了关于安全性行为的小组研讨会，同伴教育活动和Facebook等社交网络工具，以促进MSM社区的安全性行为，包括不直接参与干预的MSM。

DESCRIPTION (provided by applicant): Behavioral and epidemiological data indicate that men who have sex with men (MSM) in South Africa have high levels of HIV risk behavior and high HIV prevalence, and experience high levels of stigma, discrimination, and violence in the resource-challenged communities in which they live. The disadvantageous social environment that South African MSM face contributes to their HIV risk behavior and poor sexual health outcomes. A multi-level intervention that will help South African MSM reduce their risk behavior by reducing the impact of homonegative influences in the social environment and increasing individual and collective capacity to effect positive change in their communities is urgently needed. The proposed research project will test the efficacy of Health Empowerment for MSM, a multilevel intervention to reduce MSM's risk for HIV infection in South Africa. Building on a community development and empowerment model found to be effective at risk reduction with MSM in the United States, the intervention will incorporate intensive small-group behavioral workshops to strengthen individual self-efficacy and build social norms for safer sex, and will diffuse these norms through MSM social networks by means of a culturally appropriate peer education program that infuses MSM community events with HIV prevention content. We propose a two-community, multiple baseline comparison of an MSM community receiving the intervention to an MSM community similar in size and social structure where HIV prevention services are primarily provided through local and provincial public health clinics. We hypothesize that after 18 months of intervention, we will observe greater HIV prevention outcomes in our intervention community, relative to the comparison community, with respect to three specific aims: (1) greater levels of social cohesion between members of the MSM community; (2) greater levels of perceived collective power in the MSM community; and (3) greater increases in sexual health-promoting behaviors, including consistent condom and water-based lubrication use with male partners, regular HIV testing among HIV-negative MSM every 6 months, and regular monitoring of HIV disease among HIV-positive MSM every 6 months. PUBLIC HEALTH RELEVANCE: Health Empowerment for MSM in South Africa aims to help young, black MSM in South African township communities reduce their risk for HIV infection and overcome the effects of stigma and discrimination in their communities. The intervention combines small-group workshops on safer sex, peer education events, and social networking tools like Facebook to promote safer sexual behavior in MSM communities, including among MSM who do not participate directly in the intervention.