Regular HIV Testing among At-Risk Latino Men

描述（由申请人提供）：在拉丁美洲高危男性中进行定期艾滋病毒检测这项R34申请提出了为期3年的研究，以试点干预措施，以促进拉丁美洲高危男性的社会中心网络中定期进行艾滋病毒检测和更安全的行为。在美国，110万艾滋病毒感染者中有20%不知道自己感染了艾滋病毒。未确诊的艾滋病毒阳性者不能从早期获得提高生活质量和降低传染性的治疗中获益。鼓励进行艾滋病毒检测并向检测呈阳性的人提供治疗，可改善艾滋病毒感染者的健康，减少艾滋病毒发病率。为了获得早期诊断的好处，疾病预防控制中心建议艾滋病毒感染风险较高的人每年定期进行两次检测。尽管有许多鼓励进行艾滋病毒检测的战略，但据我们所知，没有任何战略促进在任何艾滋病毒感染风险群体中进行定期艾滋病毒检测。在美国，艾滋病毒流行主要集中在艾滋病毒高流行率和未确诊感染的人群中。与男性发生性行为的拉丁裔男性（LMSM）构成了许多这样的群体。男同性恋者面临的挑战使他们难以参与预防保健，包括与服务脱节，规范而不是谴责同性恋，以及错误的风险评估，例如认为他们内部群体的性行为风险较小。男同性恋者依赖其他男同性恋者作为建议的来源，并在一定程度上保护他们免受性少数和少数民族的双重危险。网络方法可以利用这些关系来达到高风险的LMSM，并培养降低其集体风险的规范。该提案旨在利用网络促进男男性行为者定期进行艾滋病毒检测和降低风险。我们将招募LMSM的三环网络，并确定他们的关系。定位良好的LMSM将告知和激励他们的同伴减少风险，并培训他们成为预防资源的桥梁，为检测提供量身定制的提示，并奖励HIV检测行为以鼓励重复。本研究旨在(1)开展研究，为LMSM网络量身定制招募和干预程序；(2)证明招募LMSM三环社会中心网络的可行性，培训关键成员促进其网络的定期检测和风险降低，并在6个月和12个月的随访中评估网络特征和结果；(3)评估参与者对干预的接受程度。在形成性工作之后，我们将邀请社会中心的LMSM开始招募五个LMSM三环网络（nh150）。我们将对男性进行艾滋病毒检测，并建议他们定期进行检测。我们将邀请随机选择的三个网络的主要成员参加为期六期的培训，以促进其网络中的定期艾滋病毒检测和降低风险。我们将在6个月和12个月的随访中评估网络和干预结果。在最后的跟进中，我们将采访参与者，以获得他们的经验，并确定有效的沟通策略。这项研究将评估一项战略的可行性，以促进在产生大量新艾滋病毒病例的网络中进行定期检测和降低风险。如果成功，该项目将进行随机试验，随访18个月，以评估该方法的疗效。

DESCRIPTION (provided by applicant): Regular HIV Testing among At-risk Latino Men This R34 application proposes 3 years of research to pilot an intervention to promote regular HIV testing and safer behavior among sociocentric networks of Latino men at risk for HIV. In the US, 20% of the 1.1 million individuals living with HIV are unaware of their HIV status. Undiagnosed HIV positive persons cannot benefit from early access to treatments that increase quality of life and reduce infectivity. Encouraging HIV testing and providing treatment to those testing positive can improve the health of HIV infected persons and reduce HIV incidence. To obtain the benefits of early diagnosis, CDC suggest that persons at higher risk for HIV get tested regularly twice a year. Despite the many strategies to encourage HIV testing, to our knowledge, there are no strategies to promote regular HIV testing among any group at risk for HIV. In the US, the HIV epidemic is largely concentrated in clusters of individuals with high HIV prevalence and undiagnosed infections. Latino men who have sex with men (LMSM) comprise many of these clusters. LMSM experience challenges that make it difficult to engage them in preventive care, including disconnection from services, norms than condemn homosexuality, and erroneous risk assessments such as the belief that sex within their ingroup is less risky. LMSM rely on other LMSM who are sources of advice and partially shield them from the double jeopardy of being a sexual and ethnic minority. Network approaches can use these relationships to reach high risk LMSM and foster norms that reduce their collective risk. This proposal intends to use networks to promote regular HIV testing and risk reduction among LMSM. We will recruit three-ring networks of LMSM and identify their ties. Well positioned LMSM will inform and motivate their peers for risk reduction, and be trained to be bridges to prevention resources, provide tailored prompts to testing, and reward HIV testing behaviors to encourage repetition. This proposal seeks to (1) conduct research to tailor recruitment and intervention procedures to networks of LMSM, (2) demonstrate the feasibility of recruiting 3-ring sociocentric networks of LMSM, train key members to promote regular testing and risk reduction in their networks, and assess network characteristics and outcomes at six- and 12-month follow up; and (3) evaluate the acceptability of the intervention among participants. Following formative work, we will invite socially central LMSM to initiate recruitment of five three- ring networks of LMSM (N H 150). We will test men for HIV and recommend that they get tested regularly. We will invite key members of three randomly selected networks to a six-session training to promote regular HIV testing and risk reduction in their networks. We will assess networks and intervention outcomes at six- and 12- month follow-ups. At the last follow up, we will interview participants to elicit their experiences and identify effective communication strategies. This study will evaluate the feasibility of a strategy to promote regular testing and risk reduction among networks that account for a large number of new HIV cases. If successful, this project will inform a randomized trial with an 18-month follow up to evaluate the efficacy of this approach.