Reducing Sexual Risk for HIV among African American & Latino MSM

描述（由申请人提供）：在威斯康辛州全国和当地，与男性发生性行为的有色人种男性，特别是非裔美国男男性行为者，在男男性行为者中继续占不成比例的艾滋病毒/艾滋病和性传播感染病例总数的百分比。在威斯康辛州，2005年非洲裔美国人中几乎三分之二的新诊断的艾滋病病例可归因于男性与男性的性接触。为了响应CDC RFA-PS06-006，威斯康星医学院艾滋病干预研究中心与三个社区组织合作，他们服务于AA-MSM——diversity and Resilient， Inc.，密尔沃基LGBT社区中心和Charles 'D' Productions——建议：(1)制定一项基于理论和文化定制的群体干预措施，旨在减少AA-MSM中的艾滋病毒和性传播感染风险行为。(2)对220名AA-MSM进行随机3期临床试验，比较快速艾滋病毒检测和咨询风险降低干预（仅HCT）与强化干预（包括HCT干预加上基于理论和文化定制的旨在降低AA-MSM中艾滋病毒和性传播感染风险行为的小组干预）的有效性。(3)确定关键人口统计学（如年龄）和理论变量（如自我效能）是否调节或调节观察到的干预效果。(4)比较增强hct +小群体干预与仅hct干预的成本-效果，以确定hct +干预更大的艾滋病预防效果是否足以证明其更高的成本是合理的。(5)通过当地社区和公共卫生论坛以及为提供者和社区倡导者举办的培训讲习班，以及通过科学报告和出版物传播研究结果。

DESCRIPTION (provided by applicant): Men of Color who have sex with men, and in particular African-American MSM (AA-MSM), continue to account for a disproportionate percentage of the total HIV/AIDS and STI cases among MSM, both nationally and locally in Wisconsin. In Wisconsin, almost two-thirds of newly diagnosed HIV cases in 2005 among African-Americans were attributable to male-to-male sex contact. In response to CDC RFA-PS06-006, the Center for AIDS Intervention Research/Medical College of Wisconsin in collaboration with three community- based organizations who serve AA-MSM- Diverse and Resilient, Inc., the Milwaukee LGBT Community Center, and Charles 'D' Productions- proposes to: (1) Manualize a theory-based and culturally tailored group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. (2) Conduct a randomized phase 3 clinical trial with 220 AA-MSM to compare the effectiveness of a rapid HIV testing and counseling risk reduction intervention (HCT-only) to an enhanced intervention that includes the HCT intervention plus a theory-based and culturally tailored small group intervention designed to reduce HIV and STI risk behavior among AA-MSM. (3) Determine whether key demographic (e.g., age) and theoretical variables (e.g., self-efficacy) moderate or mediate observed intervention effects. (4) Compare the cost- effectiveness of the enhanced HCT-plus small-group intervention relative to the HCT-only intervention to determine whether the greater HIV prevention effectiveness of the HCT-plus intervention is sufficient to justify its greater cost. (5) Disseminate study findings through local community and public health forums and training workshops for providers and community advocates, as well as through scientific presentations and publications. There is an urgent need for HIV and STI prevention interventions for AA-MSM. Our proposed study will address this gap through the conduct and evaluation of an RCT to assess the effectiveness of a culturally- tailored, group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. If demonstrated efficacious, the intervention will be disseminated for use by community agencies who are working to reduce new cases of HIV and STI infection among AA-MSM, a group disproportionately affected infectious disease burden. Such prevention programs will result in improved sexual health among AA-MSM.