Testing an Intervention to Increase HIV Self-Testing among Young, Black MSM

测试一种干预措施，以增加年轻黑人男男性接触者的艾滋病毒自我检测

• 批准号: 9116808
• 负责人: Victoria Frye
• 金额: $ 63.08万
• 依托单位: NEW YORK BLOOD CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9116808
• 关键词: AIDS prevention; Address; African American; Caring; Cognitive; Communication; Communities; Complex; Counseling; Couples; Development; Diffuse; Discrimination; Drug usage; Drug user; Education; Face; Generic Drugs; HIV; HIV Infections; HIV diagnosis; HIV risk; Health; Homophobia; Human immunodeficiency virus test; Incidence; Intervention; Interview; Knowledge; Maintenance; Maps; Medical; Methods; Modeling; Motivation; Participant; Patient Self-Report; Perception; Phase; Preventive Intervention; Privacy; Provider; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Design; Risk Behaviors; Risk Reduction; Sex Behavior; Sexual Health; Site; Social Network; Structure; System; Techniques; Technology; Testing; Text; Time; Training; Treatment Efficacy; United States; aged; alcohol and other drug; arm; base; behavior influence; behavior test; black men who have sex with men; brief intervention; burden of illness; condoms; design; empowered; experience; improved; innovation; men who have sex with men; motivational enhancement therapy; novel; peer; peer support; preference; prevent; programs; resilience; screening; skills; skills training; social; social stigma; success; theories; uptake; web app

DESCRIPTION (provided by applicant): Increasing HIV testing rates among young, African American or Black men who have sex with men (YBMSM) is critical to reducing the disproportionate disease burden in the African American/Black community. Rates of new HIV infections increased 48% between 2006 and 2009 among YBMSM; a recent study reported a nearly 6% annual HIV incidence among YBMSM. A significant portion of YBMSM has not tested in the prior year and YBMSM are 7 times more likely to be unaware of their HIV infection, as compared to other young MSM. The stigma associated with accessing fixed site HIV testing prevents many YBMSM from testing. In addition, alcohol and other drug (AOD) use represent a significant barrier to HIV prevention, including testing, among YBMSM, reflecting complex social structures, enhancing the impact of stigma and discrimination. We propose a study to design and test a brief intervention to increase uptake of consistent HIV self-testing among YBMSM using a novel and culturally-relevant "buddy system" approach. In our model, peer educators train pairs of YBMSM (or "buddies") to initiate self-testing and support each other in consistent self-testing (every 3 months) and sexual and AOD use risk reduction. The self-test is a promising new method that reduces several barriers to testing for YBMSM, such as HIV testing stigma, homophobia, mistrust of medical care providers/system, limited access, and confidentiality/privacy concerns. The intervention, which is brief, focused and tailored, has three primary components. First, buddies will receive a 25-minute self-testing skills-building, motivation- enhancing and peer support-focused session, rapid HIV testing and free self-test kits at our fixed site or on our mobile testing unit. Second, additional self-tests will be deliverd (or accessed) as needed, using the delivery method of their choice. Third, booster messages, based on personalized testing plans developed during the initial session, will be delivered using preferred type of communication technology (e.g., texts, e-mail, calls). A peer educator will deliver the intervention and on-demand technical support will be available from the study team using the full range of communication technology. As part of the study, we propose to conduct 30 in- depth interviews to identify barriers to, facilitators of, perceptions of and preferences fo regular HIV self- testing, describe how AOD use and sexual behavior influence HIV self-testing behaviors, and assess participant perspectives on the proposed buddy intervention. Next, based on the formative research, we will use intervention mapping to adapt couples testing, integrating enhanced motivational interviewing techniques to create a brief, peer educator-delivered, face-to-face intervention. Finally, we will use web- and app-based approaches to recruit 376 HIV-negative, BMSM aged 18 to 24 who will be randomized as pairs to either the intervention arm (skills training; free test kits on demand; tailored booster messages) or the control arm (generic health screening information; free test kits on demand) and followed for 12 months to estimate the intervention's efficacy in increasing regular self-reported HIV self-testing

描述（由申请人提供）：提高年轻的非裔美国人或男男性行为黑人 (YBMSM) 的艾滋病毒检测率对于减少非裔美国人/黑人社区不成比例的疾病负担至关重要。 2006 年至 2009 年间，YBMSM 中新发艾滋病毒感染率增加了 48%；最近的一项研究报告称，YBMSM 中的艾滋病毒年发病率接近 6%。很大一部分 YBMSM 在上一年没有接受过检测，与其他年轻 MSM 相比，YBMSM 不知道自己感染 HIV 的可能性高出 7 倍。与获得固定地点 HIV 检测相关的耻辱阻止了许多 YBMSM 进行检测。此外，酒精和其他药物（AOD）的使用是 YBMSM 中艾滋病毒预防（包括检测）的重大障碍，反映了复杂的社会结构，加剧了耻辱和歧视的影响。我们提出了一项研究，旨在设计和测试一项简短的干预措施，以使用一种新颖且与文化相关的“伙伴系统”方法来提高 YBMSM 中一致的艾滋病毒自我检测的采用率。在我们的模型中，同伴教育者训练成对的 YBMSM（或“伙伴”）启动自我测试，并在一致的自我测试（每 3 个月）以及降低性和 AOD 使用风险方面相互支持。自检是一种很有前途的新方法，可以减少 YBMSM 检测的一些障碍，例如 HIV 检测耻辱、恐同症、对医疗保健提供者/系统的不信任、访问受限以及保密/隐私问题。干预措施简短、重点突出、量身定制，分为三个部分： 主要成分。首先，好友将在我们的固定地点或移动检测设备上接受 25 分钟的自我测试技能培养、激励增强和同伴支持重点课程、快速艾滋病毒检测和免费自测套件。其次，将根据需要使用他们选择的交付方法交付（或访问）额外的自测。第三，基于在初始会议期间制定的个性化测试计划的增强消息将使用首选类型的通信技术（例如短信、电子邮件、电话）来传递。同伴教育者将进行干预，研究团队将使用全方位的通信技术提供按需技术支持。作为研究的一部分，我们建议进行 30 次深度访谈，以确定定期 HIV 自我检测的障碍、促进因素、看法和偏好，描述 AOD 的使用和性行为如何影响 HIV 自我检测行为，并评估参与者对拟议的伙伴干预的看法。接下来，基于形成性研究，我们将使用干预映射来调整夫妻测试，整合增强的动机访谈技术来创建简短的、由同伴教育者提供的面对面干预。最后，我们将使用基于网络和应用程序的方法招募 376 名年龄在 18 至 24 岁的 HIV 阴性 BMSM，他们将被随机分组​​到干预组（技能培训；按需提供免费检测试剂盒；量身定制的加强信息）或对照组（通用健康筛查信息；按需提供免费检测试剂盒），并随访 12 个月，以评估干预措施在增加定期自我报告的 HIV 自我检测方面的功效