Internet Use and HIV Risk among Men in NYC

描述(由申请人提供)：纽约市男男性行为者(MSM)中艾滋病毒的高流行率和发病率要求进一步了解无保护性行为背后的个人和背景因素，特别是在有色人种MSM和那些可能倾向于危险性行为的文化利基中。我们为期三年的探索性研究将重点关注通过互联网结交性伴侣的男男性接触者，在有艾滋病毒传播风险的情况下故意进行无避孕套的高危性行为。这项研究的具体目的是(1)描述最流行的互联网环境，在这些环境中，导致纽约市男男性接触者发生无套性行为的虚拟相遇发生。这一描述将包括网站的特点、组织、治理模式、用户特征、言语和非言语交流，以及隐含和明确的规则。(2)描述故意的无公寓性行为及其相关的自我认同，其归属意义，以及在它之前、同时和之后的心理关联(潜在的动机、情感和理由)。(3)按族群(非洲裔、拉丁裔、亚太岛民、欧洲裔美国人)对比上述因素。(4)评估从事这些行为的互联网用户对不涉及避孕套的艾滋病毒预防创新的接受程度，如直肠杀菌剂或艾滋病毒疫苗。这项研究将包括三个主要部分：(1)互联网人种学探索，重点是居住在纽约大都市区的男男性接触者使用的六个较受欢迎的互联网网站，目的是为了进行无公寓的性行为；(2)对24个主要信息者进行面对面的深入访谈，例如当地互联网性网站的网站管理员、在线讨论主持人和经常使用互联网性网站的领导人；以及(3)对通过互联网招募的120名经常使用互联网同性恋性网站的用户(30名非洲裔美国人，30名拉丁裔，30名亚太岛民和30名欧洲裔美国人)在寻求与其他男性发生无避孕套的性行为(艾滋病毒阴性男性寻求与他们在互联网上认识的新伴侣进行无保护的接受性行为)进行面对面的个人评估，将对2：1的样本进行过度抽样，以便三分之二的样本将是HIV阴性)。调查人员将与艾滋病毒临床和行为研究中心(包括统计学、流行病学和数据管理核心中心)的专家以及两名在有色人种MSM方面具有专业知识的外部顾问协商，进行定性和定量的数据分析。

DESCRIPTION (provided by applicant): The high prevalence and incidence of HIV among men who have sex with men (MSM) in New York City requires further understanding of individual and contextual factors underlying unprotected sex, specifically among MSM of color and those in cultural niches that may favor risky sex. Our three-year exploratory study will focus on MSM who meet sexual partners through the Internet to intentionally engage in condomless high-risk sex in situations in which there is risk of HIV transmission. The specific aims of the study are (1) To describe the most popular Internet contexts in which the virtual encounters that lead to condomless sex among NYC's MSM take place. This description will include features of sites, organization, mode of governance, users' characteristics, verbal and non-verbal exchanges, and implicit and explicit rules. (2) To describe intentional condomless sex and its associated self-identity, its attributed meanings, and the psychological correlates (underlying motivations, emotions, and justifications) that precede, are concurrent with, and follow it. (3) To contrast the above-mentioned factors by ethnic group (African American, Latino, Asian Pacific Islander, and European American). (4) To assess the receptiveness of Internet users who engage in these behaviors to HIV-prevention innovations that do not involve condoms, such as rectal microbicides or HIV vaccines. The study will have three main components: (1) an Internet ethnographic exploration focusing on the six more popular Internet sites used by MSM residing in the New York metropolitan area to connect with other MSM with the intention of engaging in condomless sex; (2) in-depth face-to-face interviews of 24 key informants, e.g., webmasters of local Internet sex sites, on-line discussion moderators, and leaders identified by regular users of Internet sex sites; and (3) individual face-to-face assessments of 120 regular users of Internet gay sex sites (30 African American, 30 Latino, 30 Asian Pacific Islander, and 30 European American) recruited through the Internet among those seeking to engage in condomless sex with other men (HIV-negative men who seek to have unprotected receptive sex with new partners they meet over the Internet will be oversampled two to one so that two-thirds of the sample will be HIV-negative). Qualitative and quantitative data analysis will be undertaken by the investigators in consultation with experts at the HIV Center for Clinical and Behavioral Studies, including the Statistics, Epidemiology, and Data Management Core as well as two external consultants with expertise in MSM of color.