Strategies for Identifying At-Risk African American MSM

描述(由申请人提供)：非裔美国男男性接触者群体中感染率的飙升使得有必要确定专门针对这一群体的有效艾滋病毒检测战略。一项聚焦于五个大城市--包括纽约--的流行病学研究显示，几乎一半被检测的非裔美国男男性接触者是艾滋病毒阳性(McKeller等人，2006年)。此外，67%的男性在检测前并不知道自己的血清状态。纽约市最近的流行病学数据表明，黑人男性所有新感染病例中有41%是由不安全的同性性行为引起的(NYCDHMH 2005)。这一消息来源表明，感染艾滋病毒的MSM人数不成比例地生活在哈莱姆区和南布朗克斯区，这两个地区的流行率仍然是该市最高的。因此，我们调查的主要目标是启动一项前瞻性研究计划，以填补在像我们这样的高危社区为非裔美国人MSM制定有效干预策略方面的知识空白。具体地说，我们的目标是： 1)比较三种策略--伙伴咨询和转介服务(PCRS)、社交网络和替代检测场所--用于识别和检测先前未诊断的18岁非裔美国人MSM的有效性，方法是确定每种策略检测的总人数、每种策略检测的人群报告的危险行为以及每种策略关联到适当的医疗和预防服务的先前未诊断的、HIV阳性的非裔美国MSM的总数； 2)进行成本/资源分析，以评估每种策略识别每一名以前未被诊断为艾滋病毒阳性的非洲裔美国男男性接触者的相对成本；以及 3)确定与非裔美国人MSM中艾滋病毒检测的抵抗力和障碍相关的关键变量，这将结合每种招募战略的成本效益。 本次调查将采用定性和定量两种研究方法。量化工作将侧重于从研究参与者的项目记录中提取社会人口统计、风险评估、测试和医学数据，这些参与者将自我选择进入每一项招募战略。还将跟踪这些计划的成本数据。这些数据将用于生成每个策略的单位成本。定性研究以正式焦点小组的形式，随机挑选通过这一举措接受服务的目标人群成员，将审查服务质量和客户的观点以及对招聘战略的感受，通过这种战略，他们接受艾滋病毒检测并与护理有关。参与者的反馈还将确定改善检测和护理服务的方法。

DESCRIPTION (provided by applicant): Soaring rates of infection within the African-American MSM community make it necessary to identify effective HIV testing strategies specifically for this population. An epidemiological study focusing on five large cities-including New York-revealed that almost half of all African American MSM tested were HIV- positive (McKeller, et al 2006). In addition, 67% of these men were unaware of their sero-status prior to testing. Recent NYC epidemiological data indicate that 41% of all new infections among black men resulted from unsafe same sex behaviors (NYCDHMH 2005). This same source suggests that a disproportionate number of HIV infected MSM live in Central Harlem and the South Bronx, areas that continue to have some of the highest prevalence rates in the city. The major objective of our investigation, then, is to initiate a prospective program of research to fill gaps in knowledge concerning effective intervention strategies for African American MSM in high-risk communities such as ours. More specifically, our aims are: 1) to compare the efficacy of three strategies-Partner Counseling and Referral Services (PCRS), social networking, and alternative testing venues-for identifying and testing previously-undiagnosed, 18-64 year old, African American MSM by determining the total number tested by each strategy, the risk behaviors reported for persons tested by each strategy, and the total number of previously undiagnosed, HIV-positive African American MSM who are linked to appropriate medical care and prevention services by each strategy; 2) to conduct a cost/resource analysis to evaluate the relative cost of identifying each previously undiagnosed, HIV-positive African American MSM for each of these strategies; and 3) 3) to determine the key variables associated with resistance and barriers to HIV testing in African American MSM, which will contextualize the cost efficacy of each recruitment strategy. This investigation will employ both qualitative and quantitative research methodologies. Quantitative work will focus on extracting socio-demographic, risk-assessment, testing, and medical data, from program records for study participants, who will have self-selected into each recruitment strategy. Cost data will also be tracked for these programs. These data will be used to generate a unit cost for each strategy. Qualitative research, in the form of formal focus groups with randomly selected members of the target population who have received services through this initiative, will examine service quality and client perspective and feelings about the recruitment strategy through which they came to be tested for HIV and connected to care. Feedback from participants will also identify ways of improving testing and care services.