Ethno-Epidemiology in an Emergent MSM Risk Environment

描述(由申请人提供)：本申请提出了一种混合方法，对纽约市的MSM POZ派对进行民族流行病学研究。POZ派对是一种新兴的性风险环境，正在美国各地复制，并明确为HIV和MSM之间不受限制的性行为编写脚本。拟议研究的具体目标包括：1.描述MSM POZ派对，包括物理环境、参与者和社会互动的特征，这些特征共同定义了这种新兴的MSM风险环境；2.描述HIV+MSM在这些环境中的性行为所赋予的复杂的个人和社会意义，特别是明确地为不使用避孕套的性行为和/或与多个同时发生性伴的性行为编写脚本的互动；3.描述这种环境中的药物使用情况，以及POZ派对在促进接触和启动HIV+MSM之间的新型药物和性互动方面可能起到的作用；4.审查HIV+MSM参加POZ派对的理由和动机，并比较POZ派对和POZ派对以外的性行为，有兴趣探索血清分类和血清披露的动态。将使用结构化调查和人种学方法：在两年的数据收集期间，将对参加POZ党估计30次活动之一的400名受试者进行结构化筛查调查，并对参加多项活动的受试者进行另外800次访谈。筛选调查将被用来为随后的一系列人种学访谈(N=75)选择对象，这些访谈将成为关于5个主题领域的密集叙事数据的来源，包括生活史、药物启动实践、性派对启动/实践、无保护的性行为(赤身裸体)和非POZ党性接触中血清状态披露的动态。这项研究将使我们了解HIV+MSM的性行为，包括与HIV-或血清状态不明的性伴侣的性行为，性传播疾病的风险，新药物和性行为的启动，以及HIV重叠感染。

DESCRIPTION (provided by applicant): This application proposes a mixed method, ethno-epidemiological study of MSM Poz Parties in NYC. Poz Parties are an emerging type of sexual risk environment that are being replicated throughout the US and explicitly scripted for unrestricted sexual exchanges between HIV+ MSM. Specific aims of the proposed study include the following: 1. To describe MSM Poz Parties, including characteristics of the physical settings, participants, and social interactions, that collectively define this emerging MSM risk environment; 2. To describe the complex personal and social meanings that HIV+ MSM attach to sexual interactions in these environments, notably interactions that are explicitly scripted for sex without condoms and/or sex with multiple concurrent partners; 3. To describe the use of drugs within this environment, and the role that Poz Parties may have in facilitating exposure to, and initiation of, new types of drug and sexual interactions among HIV+ MSM; 4. To examine HIV+ MSM's rationales and motivations for participating in Poz Parties, and to compare sexual exchanges at Poz Parties with those outside Poz parties, with an interest in exploring sero-sorting and sero-disclosure dynamics. Both structured survey and ethnographic methodologies will be used: Structured screener survey will be conducted among 400 subjects attending one of an estimated 30 Poz Party events over the two years of data collection, with an additional 800 interviews among subjects attending multiple events. Screener surveys will be used to select subjects for a series of subsequent ethnographic interviews (N=75) that will be the source of intensive narrative data about 5 thematic domains, including Life History, Drug Initiation Practices, Sex Party Initiation/Practices, Unprotected Sex (Barebacking), and Dynamics of Sero-Status Disclosure in Non Poz Party sexual encounters. The study will inform our understanding of the sexual practices of HIV+ MSM, including sex with HIV- or serostatus unknown partners, risk for STD's, initiation of new drug and sexual practices, and HIV superinfection.