PS09-007 Evaluating Locally-Developed Homegrown HIV Prevention Interventions

描述(申请人提供)：美国33个有艾滋病毒报告的州报告的艾滋病毒病例的数据表明，与其他种族/民族相比，艾滋病毒/艾滋病的负担最集中在非裔美国人人口中。在2001至2004年间被诊断感染艾滋病毒的49,704名非洲裔美国男性中，54%的病例发生在男男性行为者(MSM)中。在洛杉矶县(LAC)，非裔美国人男性中艾滋病毒/艾滋病病例可归因于男性与男性之间的性传播的比例更高(75%)。在缺乏有效疫苗的情况下，行为干预是降低非裔美国MSM(AAMSM)艾滋病毒高发病率的为数不多的方法之一。虽然美国各地的AAMSM组织已经创建了许多个人和群体层面的艾滋病毒干预措施，但几乎不存在记录这些计划有效性的评估数据。鉴于1)基于证据的艾滋病毒干预措施和2)现有AAMSM项目的“最佳实践”结果评估都明显缺乏，我们的合作团队打算通过对为18-29岁的AAMSM开发的未充分评估的“本土”HIV预防计划进行科学严格的评估来解决一个明显的研究差距。这项申请直接回应了RFA-PS-09-007的资助机会公告，同时建议对男子团体(ITMT)在当地开发的“MyLife MyStyle”小组干预进行系统的计划评估。MyLife MyStyle是由洛杉矶县的AAMSM在2005-2006年间设计的，旨在满足18至29岁的AAMSM的关键艾滋病毒预防需求，AAMSM是美国艾滋病毒发病率最高的人群。在MyLife MyStyle评估项目中，合作团队将检验这样一个假设，即MyLife MyStyle计划的参与者在干预后三个月报告与男性伴侣发生无保护肛交的频率将至少减少15%。为了验证我们的研究假设并了解针对面临艾滋病毒感染和传播风险的年轻AAMSM而设计的干预的关键因素，我们为5年的项目期确定了以下具体目标：1)对至少300名18-29岁的AAMSM实施随机对照试验，以测试MyLife MyStyle与等待名单控制条件相比，在干预后3个月减少与男性伴侣的无保护肛交(UAS)的有效性；2)进行全面的计划评估，以确定与计划成功相关的干预因素，例如：a)干预组件、过程和特征；b)招募和保留策略；C)提供干预措施所需的组织基础设施要求；d)成本效益分析。

DESCRIPTION (provided by applicant): Data on HIV cases reported in 33 U.S. states with HIV reporting indicate the burden of HIV/AIDS is most concentrated in the African American population compared to other racial/ethnic groups. Of the 49,704 African American males diagnosed with HIV between 2001 and 2004, 54% of these cases were among men who have sex with men (MSM). In Los Angeles County (LAC), the proportion of HIV/AIDS cases among African American males attributable to male-to-male sexual transmission is even greater (75%). In the absence of an effective vaccine, behavioral interventions represent one of the few methods for reducing high HIV incidence rates among African American MSM (AAMSM). While a number of individual- and group-level HIV interventions have been created by and for a variety of AAMSM organizations across the U.S., evaluation data to document the effectiveness of these programs are practically non-existent. Given the conspicuous absence of both 1) evidence-based HIV interventions and 2) "best practices" outcome evaluations of existing AAMSM programs, our collaborative team intends to address a glaring research gap by implementing a scientifically rigorous evaluation of an insufficiently evaluated "homegrown" HIV prevention program developed for AAMSM ages 18-29 years. This application responds directly to the funding opportunity announcement RFA-PS-09-007 by proposing a systematic program evaluation of In The Meantime Men's Group's (ITMT) locally developed "MyLife MyStyle" small-group intervention. MyLife MyStyle was designed by AAMSM in Los Angeles County in 2005-2006 to address the crucial HIV prevention needs of 18- to 29-year-old AAMSM, a population experiencing the highest rate of HIV incidence in the U.S. In the MyLife MyStyle Evaluation Project, the collaborative team will test the hypothesis that participants of the MyLife MyStyle program will report at least a 15% absolute decrease in frequency of unprotected anal sex with male partners at three months post-intervention. To test our research hypothesis and to understand critical elements of an intervention designed for young AAMSM at risk of HIV acquisition and transmission, we have identified the following Specific Aims for the 5-year project period: 1) Implement a randomized controlled trial for a minimum of 300 AAMSM, ages 18-29 years, to test the effectiveness of MyLife MyStyle to reduce unprotected anal sex (UAS) with male partners at three months post-intervention compared to a wait-list control condition; 2) Conduct a comprehensive program evaluation to identify intervention elements associated with program success, such as: a) intervention components, processes, and characteristics; b) recruitment and retention strategies; c) requirements of the organization's infrastructure necessary to deliver the intervention; and d) a cost-effectiveness analysis.