Reducing Risk of HIV/STD Infection Among African American Men

描述(由申请人提供)：居住在城市地区的非裔美国人(AA)男性的性传播疾病(STD)，包括艾滋病毒的高发病率是一个主要的公共卫生问题。此外，再生障碍性贫血妇女中最常见的艾滋病毒传播途径是异性接触。然而，很少有研究专注于针对性别的策略，以劝阻异性活跃的AA男性从事高HIV/STD传播风险的行为。因此，这项研究的广泛和长期目标是开发这样的策略。具体目标包括测试以理论为基础的、针对具体性别的适当的艾滋病毒/性传播疾病风险降低干预措施在增加避孕套持续使用方面的有效性，确定解释干预效果的理论中介因素，以及测试增加干预效果寿命的策略。这项研究将利用随机对照试验设计，对360名18至45岁的市中心AA男性进行调查，他们报告最近与女性发生了无保护措施的阴道或肛交。男性将被随机分配到两个专门为再生障碍性贫血男性设计的小组干预措施中：(A)艾滋病毒/性传播疾病风险降低干预措施或(B)关于健康饮食和体力活动的健康促进控制干预措施。为了评估增加干预效果寿命的策略，这些男性还将被随机接收或不接收个性化定制的邮件，以强化干预的信息。该方法借鉴了社会认知理论、计划行为理论和申请者与AA男性的初步研究。主要结果是通过音频计算机辅助自访(ACASI)收集在基线和干预后6个月和12个月前3个月的阴道和异性肛交中自我报告的持续使用安全套的情况。次要结果包括其他性行为和假设的调节干预效果的理论变量。将使用广义估计方程(GEE)和随机效应模型来解决具体目标。

DESCRIPTION (provided by the applicant): The high rates of sexually transmitted disease (STD), including HIV, among African American (AA) men who reside in urban areas are a major public health problem. In addition, the most common route of HIV transmission among AA women is heterosexual exposure. Yet, little research has focused on gender-specific strategies to dissuade heterosexually active AA men from engaging in high HIV/STD transmission risk behaviors. Accordingly, the broad, long-term objective of this research is to develop such strategies. The Specific Aims include testing the efficacy of a theory-based, gender-specific contextually appropriate HIV/STD risk-reduction intervention in increasing consistent condom use, identifying theoretical mediators that account for the intervention's effects, and testing a strategy to increase the longevity of the intervention's effects. This research will utilize a randomized controlled trial design with 360 inner-city AA men 18 to 45 years who report recent unprotected vaginal or anal intercourse with a woman. Men will be randomly allocated to one of two small-group interventions specially designed for AA men: (a) a HIV/STD risk-reduction intervention or (b) a health promotion control intervention on healthful diet and physical activity. To evaluate a strategy to increase the longevity of intervention effects, the men also will be randomized to receive or not receive individually tailored mailings to reinforce the intervention's message. The approach draws on social cognitive theory, the theory of planned behavior, and the applicant's Preliminary Studies with AA men. The primary outcome is self-reported consistent condom use during vaginal and heterosexual anal intercourse in the previous 3 months collected at baseline and 6 and 12 months post-intervention via audio-computer-assisted self-interviewing (ACASI). Secondary outcomes include other sexual behaviors and theoretical variables hypothesized to mediate intervention efficacy. Generalized estimating equations (GEE) and random effects models will be employed to address the Specific Aims.