HIV, Risk Behaviors, and Stigma in High Risk Tanzanian Men

坦桑尼亚高危男性的艾滋病毒、危险行为和耻辱

• 批准号: 8128462
• 负责人: MICHAEL W ROSS
• 金额: $ 15.46万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-13 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8128462
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Africa; Africa South of the Sahara; African; Applications Grants; Area; Behavior; Behavioral; Biological; Biological Markers; British; Characteristics; Chlamydia; Cities; Communities; Country; Data; Discrimination; Epidemic; Evidence based intervention; Female; Frequencies; Geography; Goals; Gonorrhea; HIV; HIV Infections; HIV Seroprevalence; HIV/STD; Health Care Seeking Behavior; Health Services; Health behavior; Healthcare; Heterosexuals; High Prevalence; Homosexuals; Hospitals; Human immunodeficiency virus test; Indigenous; Individual; Infection; Intervention; Interview; Kenya; Knowledge; Link; Low Prevalence; Maps; Methods; Modeling; National Institute of Mental Health; Pathway interactions; Pattern; Play; Population; Prevalence; Prevention; Preventive; Process; Publishing; Questionnaires; Recording of previous events; Recruitment Activity; Reporting; Research; Research Personnel; Respondent; Risk; Risk Behaviors; Role; Sex Behavior; Sex Orientation; Stigmata; Structure; Surveys; Syphilis; Tanzania; Testing; Translating; Uganda; United States National Institutes of Health; Urethra; Woman; base; demographics; design; experience; high risk; high risk men; improved; male; meetings; men; men who have sex with men; metropolitan; pandemic disease; preference; prevention service; programs; protective behavior; public health relevance; rectal; response; sex risk; social stigma; transmission process; treatment program; urban area

DESCRIPTION (provided by applicant): Recent research in East Africa has established the existence of significant indigenous MSM networks, characterized by apparently high HIV seroprevalence rates and high stigma. We propose a mixed methods study (qualitative, quantitative, and biological STI/HIV markers) to study 350 MSM in Dar es Salaam (high HIV prevalence) and Tanga (lower prevalence), Tanzania, where there are no available data on MSM. The study will map sexual meeting places for MSM, elicit information on the level and experience of stigma, the process by which stigma is translated into HIV risk behavior, and health care experiences and needs of MSM. Quantitative data on demographics, sexual pathways and risk behaviors, sexual contacts, internalized homophobia, and context of sexual behavior, will be collected using a modified version of the MSM questionnaire recently used in Kampala. Linked to this will be biological data on HIV, syphilis and urethral and rectal gonorrhea and Chlamydia. Respondents testing positive for treatable STIs will be treated immediately, and for HIV referred to the free treatment program at Muhimbili Hospital. We will assess demographic and behavioral predictors of HIV and STIs, sexual risk behaviors with males and females and their context, and the impact of stigma on risk (or protective) behaviors. The emerging description of sexual risk, stigma, and HIV/STI prevalence will be used to inform a subsequent R01 to intervene to reduce risk and provide culturally sensitive health care for MSM in Tanzania, and design and implement a model program that can be used more broadly in East Africa. PUBLIC HEALTH RELEVANCE: We will study HIV and SDI prevalence in high-risk men in Dar es Salaam and Tanga, Tanzania, to assess what behaviors are most closely associated with HIV and STI infection in both cities. We will also interview these men to determine what role stigma related to their sexual activities plays in reducing HIV testing, and how interventions to reduce HIV risk and improve health service access in this population might be structured.

描述（由申请人提供）：最近在东非的研究已经建立了重要的土著MSM网络的存在，其特征是明显的高艾滋病毒血清阳性率和高耻辱。我们提出了一个混合方法的研究（定性，定量和生物STI/HIV标志物），研究350男男性行为者在达累斯萨拉姆（艾滋病毒高流行率）和坦加（低流行率），坦桑尼亚，那里没有可用的数据对男男性行为者。这项研究将绘制男男性接触者的性聚会场所地图，了解污名化的程度和经历，污名化转化为艾滋病毒风险行为的过程，以及男男性接触者的医疗保健经历和需求。关于人口统计学、性途径和风险行为、性接触、内化的同性恋恐惧症和性行为背景的定量数据，将使用最近在坎帕拉使用的MSM问卷的修改版本收集。与此相关的将是关于艾滋病毒、梅毒、尿道和直肠淋病以及衣原体的生物数据。可治疗性传播感染检测呈阳性的受访者将立即接受治疗，艾滋病毒将被转介到Muhimbili医院的免费治疗方案。我们将评估艾滋病毒和性传播感染的人口统计学和行为预测因素，男性和女性的性风险行为及其背景，以及耻辱对风险（或保护）行为的影响。对性风险、污名和艾滋病毒/性传播感染流行率的新描述将用于为随后的R 01提供信息，以进行干预，降低风险，为坦桑尼亚的男男性行为者提供文化敏感的卫生保健，并设计和实施一个可在东非更广泛使用的示范方案。 公共卫生关系：我们将研究坦桑尼亚达累斯萨拉姆和坦加的高危男性中艾滋病毒和SDI的流行情况，以评估这两个城市中哪些行为与艾滋病毒和STI感染最密切相关。我们还将采访这些男性，以确定与他们的性活动有关的耻辱在减少艾滋病毒检测方面发挥的作用，以及如何采取干预措施，以减少艾滋病毒风险和改善这一人群的卫生服务可及性。