Culturally-Tailored HIV Risk Reduction for African-American MSM

描述(由申请人提供)：与男性发生性行为的有色人种男子，特别是非裔美国男男性接触者(AA-MSM)，在威斯康星州全国和地方MSM中艾滋病毒/艾滋病和性传播感染病例总数中继续占不成比例的比例。在威斯康星州，2005年非洲裔美国人中几乎三分之二的新诊断艾滋病毒病例可归因于男性对男性的性接触。作为对CDC RFA-PS06-006的回应，威斯康星州医学院艾滋病干预研究中心与三个为AA-MSM提供服务的社区组织--多元化和弹性公司、密尔沃基LGBT社区中心和Charles‘D’Productions-建议：(1)制定基于理论和文化定制的群体水平干预措施，旨在减少AA-MSM中的HIV和STI危险行为。(2)对220名AA-MSM进行随机第三阶段临床试验，比较快速HIV检测和咨询降低风险干预(仅限HCT)和强化干预的有效性，其中包括HCT干预和旨在减少AA-MSM中HIV和STI风险行为的基于理论和文化定制的小组干预。(3)确定关键的人口统计学变量(如年龄)和理论变量(如自我效能感)是否适中或调节观察到的干预效果。(4)比较强化的HCT加小组干预与单纯的HCT干预的成本-效果，以确定HCT加干预的更大的艾滋病毒预防效果是否足以证明其更高的成本。(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成果。 迫切需要对AA-MSM进行艾滋病毒和性传播感染预防干预。我们拟议的研究将通过进行和评估随机对照试验来解决这一差距，以评估旨在减少AA-MSM中HIV和STI危险行为的文化定制的群体水平干预的有效性。如果证明有效，干预措施将被传播，供社区机构使用，这些机构正在努力减少AA-MSM中艾滋病毒和性传播感染的新病例，AA-MSM是一组受到不成比例影响的传染病负担。这样的预防计划将改善AA-MSM的性健康。

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.