Feasibility of recruiting nondisclosing Black MSM/W for drug use /HIV research

描述(由申请者提供)：该项目将调查在吸毒的黑人男子中进行艾滋病毒风险的人种学研究的可行性，这些黑人男子与男性和女性发生性关系，但不认为自己是同性恋，也不向女性伴侣透露他们的同性活动。由于这些男性并不认为自己是同性恋或同性恋者，因此有人担心，针对同性恋社区的项目并没有触及到他们。具体目标是：1)寻找和招募与男性和女性发生性行为但不向女性伴侣披露其同性活动的吸毒黑人男性(MSM/W)进行面试。2)初步了解黑人MSM/W如何决定是否披露他们的HIV危险行为以及披露哪些信息，包括吸毒和高危性行为。由于男性与男性之间的性接触是男性中最常见的艾滋病毒/艾滋病传播类别，关于男男性接触者的研究越来越多，包括黑人MSM/W。然而，似乎没有系统地调查黑人MSM/W的吸毒模式或向女性伴侣披露同性活动的问题。有人猜测，黑人MSM/W是促进黑人妇女感染艾滋病毒的“桥梁”人群，但没有足够的经验证据来证实这一说法。该项目的广泛目标是促进对黑人成年人吸毒与艾滋病毒风险之间关系的进一步研究，以便更好地了解艾滋病毒/艾滋病感染方面的严重种族差异。黑人男性被感染的可能性是白人男性的6倍，黑人女性被感染的可能性是白人女性的19倍。该项目将雇佣两名人种学家通过四个来源招募男性：1)我们之前研究中在低收入、高艾滋病毒社区建立的现有社交网络；2)俱乐部、酒吧、公园和街道等已知的MSM场所；3)互联网网站；4)为吸毒者和有前科的人提供服务的团体和组织。研究中两点的五个小焦点小组将有助于加强我们的招聘战略，并形成关于隐瞒或披露行为的决定的调查路线。民族志专家还将与30名男性建立关系并进行个人访谈，以初步了解毒品使用和男男性接触者活动、艾滋病毒风险的知识和管理以及影响披露决定的因素。如果拟议的可行性研究产生了招聘和面试黑人MSM/W的成功战略，则可以将其纳入随后的更大规模的工作(R01)，旨在收集更广泛的数据，为适当的降低风险干预措施提供参考。公共卫生相关性：这项可行性研究旨在改进对与毒品有关的男男性和女性性行为中艾滋病毒风险和保护因素的研究。这项研究的重点是黑人男性，他们不认为自己是同性恋或同性恋，也不向女性伴侣透露他们的同性活动。由于这些男性不认为自己是同性恋或同性恋，针对同性恋社区的预防计划可能无法接触到他们。这项研究将确定招募和面试这些人的成功战略，长期目标是产生能够有助于更有效的干预措施的知识，最终可能减少艾滋病毒/艾滋病的种族差异。

DESCRIPTION (provided by applicant): This project will investigate the feasibility of conducting ethnographic research on HIV risk among drug-using Black men who have sex with men and women but do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, there is concern that they are not being reached by programs aimed at gay-identified communities. The specific aims are: 1) To locate and recruit for interviewing drug-using Black men who have sex with men and women (MSM/W) but do not disclose their same-sex activity to their female partners. 2) To gain a preliminary understanding of how Black MSM/W decide whether and what to disclose about their HIV risk behaviors including drug use and high risk sexual practices. Because male-to-male sexual contact is the most commonly reported HIV/AIDS transmission category among men, there is a growing body of research on MSM, including Black MSM/W. However, there appear to be no systematic investigations of patterns of drug use among Black MSM/W or on the issue of disclosing same-sex activity to female partners. There is speculation that Black MSM/W constitute a "bridge" population facilitating HIV infection among Black women but there is insufficient empirical evidence to substantiate the claim. The broad goal of this project is to foster further research on the relationship between drug use and HIV risk among Black adults, in order to develop a better understanding of the severe racial disparities in HIV/AIDS infection. Black men are six times more likely than White men to be infected, and Black women are 19 times as likely as White women to be infected. This project will employ two ethnographers to recruit men through four sources: 1) existing social networks established in our previous research in low-income, high-HIV neighborhoods; 2) known MSM venues such as clubs, bars, parks and street locations; 3) Internet sites and 4) groups and organizations serving drug users and ex-offenders. Five small focus groups at two points in the study will help to enhance our recruitment strategy and shape lines of inquiry regarding decisions to conceal or disclose behavior. Ethnographers will also cultivate relationships with and conduct individual interviews with 30 men to obtain preliminary insights into drug use and MSM activity, knowledge and management of HIV risk and factors influencing disclosure decisions. If the proposed feasibility study yields a successful strategy for recruiting and interviewing Black MSM/W, it can be incorporated into a subsequent larger effort (an R01) designed to collect more extensive data that can inform appropriate risk-reduction interventions. PUBLIC HEALTH RELEVANCE: This feasibility study is designed to improve research on HIV risk and protective factors among drug-involved men who have sex with men and women. The study is focused on Black men who do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, they may not be reached by prevention programs aimed at gay-identified communities. This study will identify successful strategies for recruiting and interviewing these men, with the longer-term goals of generating knowledge that can contribute to more effective interventions that may ultimately reduce racial disparities in HIV/AIDS.