HIV Risk in African MSM is South African Townships

南非男男性行为者(MSM)是艾滋病毒/艾滋病研究不足的人群 流行病学和社会科学研究。然而，不断发展的证据表明，性危险行为 在这些男性中是很常见的，并且与酒精的使用密切相关。自我报告数据表明 艾滋病毒在这一人群中的流行率相当于或高于 南非的普通人口。由于艾滋病毒/艾滋病与贫困的联系，非洲城镇的男男性接触者 似乎特别容易感染艾滋病毒。由于我们知识上的这些差距，我们缺乏 有针对性的、文化上适当的、以证据为基础的干预措施，以应对该人群和 有效预防的资源是有限的。 拟议研究的目的是(1)评估居住在非洲的男男性接触者中艾滋病毒的流行率。 并确定哪些行为、心理和网络特征区别于 (2)确认性风险的结构性和心理社会相关因素 这些男性的行为，特别关注饮酒的作用；以及(3)描述社交 组织这些男性的同性性行为，并确定结构性和心理社会因素， 影响人们如何体验这些做法； 为了实现这些目标，这项拟议的研究结合了艾滋病毒检测、调查和民族志。vbl.使用 人种学观察、人种学绘图、深入访谈和对20名关键信息提供人和80名 来自目标人群的成员，我们将首先研究非洲MSM在四个城镇的生活，这四个城镇是 Tshwane市(包括比勒陀利亚在内的大都市地区)。人种志将阐明 男性同性性行为和风险是如何在习俗、身份、网络和 并为预防战略的未来发展或调整提供信息。建立在 在人种学阶段，我们将调查居住在茨瓦内的500名从事同性性行为的男性 与男性(完全与女性发生性关系或与女性发生性关系)通过 受访者驱动的抽样。这项调查将确定结构性和心理社会相关性，特别是 酒精和其他物质的使用在性危险行为中的作用。对调查参与者进行艾滋病毒检测将 使我们能够确定艾滋病毒感染的风险因素，使我们能够针对特定的艾滋病毒预防工作 行为、MSM的子群或他们的女性伴侣，并确定 研究参与者的推定和实际血清状态。 在拟议研究的最后阶段，并根据研究结果，研究小组将在 与社区合作伙伴合作设计干预措施；该干预措施的可行性和有效性 将在随后的研究中进行测试。 1

South African men who have sex with men (MSM) are an understudied population in HIV/AIDS epidemiological and social science research. However, evolving evidence indicates that sexual risk behavior among these men is common, and strongly associated with the use of alcohol. Self-report data suggest that HIV prevalence in this population is as high as or higher than the overall high rate of infection among the general South African population. Due to the association of HIV/AIDS with poverty, African MSM in townships seem to be at particular risk for HIV infection. As a result of these gaps in our knowledge, there is a lack of targeted, culturally appropriate, evidence-based interventions addressing HIV risk in this population and the resources for effective prevention are limited. The aims of the proposed study are (1) to assess the prevalence of HIV among African MSM living in South African townships and identify which behavioral, psychosocial, and network characteristics distinguish infected MSM from non-infected MSM; (2) to identify the structural and psychosocial correlates of sexual risk behavior in these men, with a particular focus on the role of alcohol use; and (3) to describe the social organization of same-sex sexual practices of these men and identify structural and psychosocial factors that affect how these practices are experienced; To accomplish these aims, the proposed study combines HIV testing, a survey, and ethnography. Using ethnographic observations, ethnographic mapping, in-depth interviewing and of 20 key informants and 80 members from the target population, we will first study the lives of African MSM in four townships that are part of the Tshwane Municipality (the greater metropolitan area that includes Pretoria). Ethnography will elucidate how male same-sex sexuality and risk is structured in terms of practices, identities, networks, and communities, and inform future development or adaptation of prevention strategies. Building on the ethnographic phase, we will survey 500 men residing in Tshwane who engage in same-sex sexual practices with men (either exclusively of or in conjunction with sexual interactions with women) recruited via Respondent-Driven Sampling. The survey will identify structural and psychosocial correlates, particularly the role of the use of alcohol and other substances in sexual risk behavior. HIV testing of survey participants will allow us to identify risk factors of HIV infection, enabling us to target HIV prevention efforts to specific behaviors, subgroups of MSM, or their female partners, and to determine the correspondence between the study participant's presumed and actual serostatus. In the final phase of the proposed study and based on the study's outcomes, the research team will in collaboration with community partners design an intervention; feasibility and effectiveness of this intervention will be tested in a subsequent study. 1