HIV risk and venues for meeting sex partners

描述（由申请人提供）：尽管美国艾滋病毒传播总体下降，但男男性行为者（MSM）中的艾滋病毒/艾滋病诊断从2001-06年开始增加。MSM聚集的场所继续作为卫生和社区服务提供者让MSM参与艾滋病毒检测、教育和预防的不可或缺的场所。与此同时，这些提供者面临着更多的挑战，既要确定目标人群，又要将干预措施转化为非传统环境（例如，互联网）。虽然已经在MSM与性伴侣会面的场所内进行了研究，但很少有跨场所分析，因此很少有场所级别特征（例如，酒吧里的酒精/毒品、网上匿名聊天、浴室里黑暗/安静的空间）可以创造社会规范，这些规范可以显著影响MSM如何协商与艾滋病毒相关的风险行为（例如，血清状况披露、使用避孕套）。 与SC2机制一致，拟议的试点研究将使用基于概率的招募方法来识别和纵向跟踪（6个月）性活跃的MSM（N = 150）的三个不同的样本：一个样本通过浴室招募（n = 50），一个在酒吧招募（n = 50），一个从互联网上招募（n = 50）。这些措施将是定性和定量的。 除了确定场所级别的模式和艾滋病毒相关风险行为的流行率（即，特定于伴侣见面的场所的性行为），本研究将集中于识别场所级别的特征（例如，照明;声音;对不安全性行为、毒品或酒精使用的社会规范的感知;对匿名的感知），以确定它们对参与者的性行为和性决策的影响。额外的注意将支付交叉作用，酒精和俱乐部药物可能发挥的场地和随后的性行为与合作伙伴通过场地满足。最后，采用纵向设计，本研究将跟踪参与者的性行为，物质使用行为和场所频繁的变化，以确定特定场所的合作伙伴和随后的性行为，艾滋病毒风险，毒品和酒精使用之间的联系。 与SC2机制一致，这项试点研究将作为开发和测试基于场所的干预措施的基础，以减少MSM中的艾滋病毒传播风险。鉴于研究的结果和SC2机制的目标（长期发展新的研究方向），这将保证开发PI发起的R34和/或R 01赠款。为了实现这些目标，Christian Grov博士（PI）与Jeffrey Parsons博士（Mentor）合作，Jeffrey Parsons博士是一位成功的NIH资助的研究人员，擅长将形成性研究结果转化为干预措施。他们共同创建了一个全面的PI开发计划，该计划配备了4个阶段的时间轴和可衡量的成功指标。 公共卫生相关性：这项研究的结果将有助于更细致入微地了解与艾滋病毒相关的风险行为的社会环境（场所），男性与男性发生性关系（MSM）遇到他们的性伴侣。这些数据将反过来为基于场所的艾滋病毒预防和干预工作以及旨在减少MSM艾滋病毒相关风险行为的治疗提供信息。与SC2机制一致，本研究产生的试点数据将作为开发和测试基于场所的干预措施的基础，以降低MSM中的艾滋病毒传播风险。

DESCRIPTION (provided by applicant): Despite overall declines in HIV transmission in the US, HIV/AIDS diagnoses among men who have sex with men (MSM) has increased from 2001-06. Venues where MSM gather continue to serve as integral locations where health and community service providers engage MSM for HIV testing, education, and prevention. Meanwhile, these providers face added challenges both with locating target populations and in translating interventions to non-traditional settings (e.g., Internet). While there have been studies conducted within venues where MSM meet sex partners, there is little cross-venue analyses, thus little contextualization of how venue-level characteristics (e.g., alcohol/drugs in bars, anonymous chat online, dark/quiet spaces in bathhouses) can create social norms that can significantly impact how MSM negotiate HIV-associated risk behavior (e.g., serostatus disclosure, condom use). Consistent with the SC2 mechanism, the proposed pilot study will use probability-based recruitment methods to identify and longitudinally follow (for 6 months) three diverse samples of sexually active MSM (N = 150): one sample recruited via bathhouses (n = 50), one recruited at bars (n = 50), and one recruited off the Internet (n = 50). Measures will be both qualitative and quantitative in nature. In addition to identifying venue-level patterns and the prevalence of HIV-associated risk behavior (i.e., sexual behavior specific to the venues where partners were met), this study will focus on identifying venue- level characteristics (e.g., lighting; sound; perceived social norms around unsafe sex, drug, or alcohol use; perception of anonymity) in an effort to determine their impact on participant's sexual behavior and sexual decision making. Additional attention will be paid to intersecting roles that alcohol and club drugs may play in venues and subsequent sexual behaviors with partners met via venues. Finally, using a longitudinal design, this study will track changes in participant's sexual behaviors, substance use behaviors, and venue frequenting to identify connections between venue-specific partners and subsequent sexual behaviors, HIV-risk, drug, and alcohol use. Consistent with the SC2 mechanism, this pilot study will serve as the basis for developing and testing a venue-based intervention to reduce HIV transmission risks among MSM. Given the study's findings, and the SC2 mechanism's objective (long-term development of a new line of research), this will warrant developing PI- initiated R34 and/or R01 grants. To accomplish these goals, Dr. Christian Grov (PI) has partnered with Dr. Jeffrey Parsons (Mentor), who is an accomplished NIH-funded investigator with expertise in translating formative research findings into interventions. Together, they have created a comprehensive PI development plan that is equipped with a 4-phase timeline and measurable indicators of success. PUBLIC HEALTH RELEVANCE: The findings of this study will facilitate a more nuanced understanding of HIV-associated risk behaviors contextualized within social atmospheres (venues) that men who have sex with men (MSM) encounter their sex partners. These data will, in turn, inform venue-based HIV prevention and intervention efforts, and treatments designed to reduce MSM's HIV associated risk behaviors. Consistent with the SC2 mechanism, the pilot data generated from this study will serve as the basis for developing and testing a venue-based intervention to reduce HIV transmission risks among MSM.