Using CBPR to Reduce HIV Risk Among Immigrant Latino MSM

描述（由申请人提供）：东南部拥有美国增长最快的拉丁裔人口，同时承担着不成比例的艾滋病毒负担。对于拉丁美洲人或男男性行为者（MSM）来说，几乎没有有效的艾滋病毒预防干预措施，对于最近到达的、讲西班牙语的、文化适应程度较低的拉丁美洲男男性行为者来说，也没有有效的艾滋病毒预防干预措施。 为了响应PA-08-074“社区参与研究”，我们的社区-大学合作伙伴关系建议共同进行一项为期5年的准实验研究（R 01），以完善，全面实施和严格评估非专业健康顾问（LHA）干预措施，旨在增加安全套的使用和艾滋病毒检测，其中最近抵达，讲西班牙语，文化适应程度较低的拉丁美洲男男性接触者正在东南部农村定居。干预措施是基于社会认知理论和赋权教育理论，并利用基于社区的参与性研究（CBPR）开发的。这项研究是长期社区-大学合作的结果，该合作伙伴关系已经并将继续在研究的所有阶段使用CBPR。 将对NC农村地区的20名拉丁裔男男性行为者进行筛选，并招募他们担任LHA。我们的伙伴关系将选择LHA的基础上的素质的自然助手和非正式领导人，并有现有的社交网络的其他拉丁美洲男男性接触者。每个LHA的社交网络的12名成员也将被筛选和招募参加。LHA及其社交网络将被随机分配到干预组或延迟干预组。干预组中的LHA（n=10）将接受培训，并在第2年在其社交网络中担任LHA。延迟干预的LHA（n=10）将接受相同的LHA培训，并在第3年在其社交网络中担任LHA。将从每个LHA（n=20）及其社交网络的12名成员（n=240）纵向收集定量评估数据：（1）基线，（2）干预后即刻，和（3）12个月随访。这是一项“意向治疗”研究，其中参与者数据基于其随机分组进行分析。 我们假设，与延迟干预对照组相比，HIV预防干预组的参与者将证明（1）性交期间自我报告的避孕套使用增加和（2）自我报告的HIV检测增加。 这项研究的结果和产品将被传播，以告知公共卫生实践，研究和政策。结果和产品将包括：（1）西班牙语干预，这是：文化相关和性别特异性;旨在减少拉丁美洲男男性行为者的艾滋病毒风险;并准备传播和适应;（2）艾滋病毒风险和拉丁美洲男男性行为者的干预有更深入的了解;和（3）深入了解CBPR过程，包括社区成员，组织代表和学术研究人员。

DESCRIPTION (provided by applicant): The Southeast has the fastest-growing Latino population in the United States and at the same time carries a disproportionate HIV burden. Few efficacious HIV prevention interventions exist for either Latinos or men who have sex with men (MSM), and none exists for recently arrived, Spanish-speaking, less-acculturated Latino MSM. In response to PA-08-074 "Community Participation in Research," our community-university partnership proposes to jointly conduct a 5-year quasi-experimental study (R01) to refine, fully implement, and rigorously evaluate a lay health advisor (LHA) intervention designed to increase condom use and HIV testing among recently arrived, Spanish-speaking, less-acculturated Latino MSM who are settling in the rural Southeast. The intervention is based on social cognitive theory and theory of empowerment education and was developed using community-based participatory research (CBPR). This study is a result of a long-term community- university partnership that has used and will continue to use CBPR throughout all phases of research. A total of 20 Latino MSM in rural NC will be screened and recruited to serve as LHAs. Our partnership will select LHAs based on qualities of natural helpers and informal leaders and having existing social networks of other Latino MSM. Twelve members of each LHA's social network will be screened and recruited to participate as well. The LHAs, coupled with their social networks, will be randomized to intervention or delayed- intervention groups. LHAs (n=10) in the intervention group will be trained and serve as LHAs within their social networks in Year 2. Delayed-intervention LHAs (n=10) will receive the same LHA training and serve as LHAs within their social networks in Year 3. Quantitative assessment data will be collected from each LHA (n=20) and the 12 members of his social network (n=240) longitudinally at: (1) baseline, (2) immediate post- intervention, and (3) 12-month follow-up. This is an "intent-to-treat" study, in which participant data are analyzed based on their randomization group. We hypothesize that participants in the HIV prevention intervention, relative to those in the delayed- intervention comparison group, will demonstrate (1) increased self-reported use of condoms during sexual intercourse and (2) increased self-reported HIV testing. The results and products from this study will be disseminated to inform public health practice, research, and policy. Results and products will include: (1) a Spanish-language intervention that is: culturally relevant and gender-specific; designed to reduce HIV risk among Latino MSM; and ready for dissemination and adaptation; (2) a deeper understanding of HIV risk and intervention among Latino MSM; and (3) insight into a CBPR process that includes community members, organizational representatives, and academic researchers.