Men of Asia Testing for HIV (MATH)

描述（由申请人提供）：许多亚裔美国人和太平洋岛民（AAPI）男性在美国艾滋病毒高风险从未经历过血清学检测。 在最近的一项研究中，62%的艾滋病毒阳性的AAPI男性在检测时不知道自己的艾滋病毒状况。 此外，根据最近的另一项研究，45.6%被诊断为艾滋病的AAPI将疾病列为接受艾滋病毒检测的主要原因，与白人同行相比，这一比例明显较高。 然而，人们对影响AAPI男性测试的因素知之甚少。 由于延迟检测通常与晚期疾病的初始表现，较高的医疗保健费用和疾病发病率有关，因此对检测行为的研究至关重要。 在AAPI的累积艾滋病病例中，有艾滋病毒性风险的男性比例更高（71%），而所有有艾滋病毒性风险的男性占美国男性累积艾滋病病例的56%，这一事实强调了了解AAPI男性艾滋病毒相关风险的重要性。 据估计，在美国的1090万AAPI中，6.7有700万（61.4%）5岁及以上的人在家里说亚太裔语言。 在亚洲及太平洋区域，估计有720万人感染艾滋病毒或艾滋病。有证据表明，人口统计学和社会文化，包括种族认同，是艾滋病毒相关风险行为的主要决定因素--在亚洲，在美国的外国出生的AAPI男性，在美国-天生的亚太裔男人 鉴于亚太区域艾滋病疫情的爆发，了解新出现的风险模式（包括移徙、文化污名化和性旅游）变得比以往任何时候都更加重要。 此外，对社交网络和规范的影响仍然研究不足。 据我们所知，只有一项已发表的关于向社交网络成员披露艾滋病毒状况的AAPI男性研究。 尽管对社交网络的更大开放程度与艾滋病毒状况的了解呈正相关，但由于文化限制，艾滋病毒感染者可能面临更大的披露挑战。 更大的结构和网络层面的因素的积累有助于个人心理和风险行为，最终决定是否寻求艾滋病毒检测的决定。 因此，乔治城大学护理与健康研究学院与美国一个全国性的AAPI健康倡导组织和八（8）个AAPI社区组织（CBO）一起提出了一项为期五年的全国性研究：（1）估计AAPI MSM中HIV感染的患病率和发病率;（2）描述AAPI MSM的HIV检测和HIV感染状况知识的社会文化和个体水平的相关性：（3）检验AAPI MSM的HIV风险的社会文化和个体水平的相关性;以及（4）评估一个用于开展科学的、以社区为基础的艾滋病毒研究的联盟模型框架。

DESCRIPTION (provided by applicant): Many Asian American and Pacific Islander (AAPI) men in the U.S. at high risk for HIV have never undergone serological testing. In one recent study, 62% of HIV-positive AAPI men were unaware of their HIV status at the time of testing. Moreover, according to another recent study 45.6% of AAPIs with an AIDS diagnosis cite illness as the primary reason for being tested for HIV, a significantly higher proportion in comparison to their Caucasian counterparts. However, little is known about factors that influence testing among AAPI men. Because delayed testing is often associated with an initial presentation of advanced disease, higher health care costs, and disease morbidity, studies of testing behaviors are vital. Among cumulative AIDS cases in AAPIs, proportionately more are men at sexual risk for HIV (71%) whereas all men at sexual risk for HIV make up 56% of cumulative AIDS cases among men in the U.S., a fact that underscores the significance of understanding the HIV-related risks of AAPI men. It is estimated that of the 10.9 million AAPIs in the U.S., 6.7 million (61.4%) are foreign-born and 7 million (63.7%) ages 5 and above speak an AAPI language at home. In the Asia and Pacific region, it is estimated that 7.2 million people are living with HIV or AIDS. Evidence suggests that demographic and socio-cultural, including ethnic identification, are major determinants of HIV-related risk behavior -- in Asia, in foreign-born AAPI men in the U.S., and in U.S.-born AAPI men. Given the explosion of the AIDS epidemic in the Asia and Pacific region, understanding emerging patterns of risk (including migration, cultural stigmatization, and sex tourism) become more important than ever. Furthermore, the impact of social networks and norms remains understudied. To our knowledge there is only one published study among AAPI men on the disclosure of HIV status to social network members. AAPIs may face greater challenges to disclosure due to cultural constraints, despite the fact that greater openness to social networks is positively associated with knowledge of HIV status. The accretion of larger structural and network level factors contributes to individual psychology and risk behaviors that ultimately determine the decision of whether or not to seek HIV testing. Therefore, the Georgetown University's School of Nursing and Health Studies, together with one national AAPI health advocacy organization and eight (8)AAPI community-based organizations (CBOs) in the U.S. propose a national five-year study: (1) to estimate the prevalence and incidence of HIV infection among AAPI MSM; (2) to describe the socio-cultural and individual-level correlates of HIV testing and knowledge of HIV infection status among AAPI MSM; (3) to examine the socio-cultural and individual level correlates of HIV risk among AAPI MSM; and (4) to evaluate a consortium model framework for conducting scientific, community-based HIV research.