Developing an HIV prevention intervention for young MSM through improved parent-child communication

项目摘要 在美国，男男性行为者(MSM)感染艾滋病毒的风险很高，这代表了 80%的感染发生在14-24岁的青年中，92%的感染发生在14-19岁的男孩中。尽管如此 在风险方面，该领域甚至没有一项艾滋病毒预防干预措施被证明在降低性风险或 增加青少年男男性接触者(AMSM)中的艾滋病毒检测。从历史上看，达成预防艾滋病毒的AMSM已经 考虑到他们相对地理上的隔绝和无法进入传统的同性恋集会，这是具有挑战性的 空间(例如，酒吧和许多与同性恋有关的社交网站)。然而，我们的团队开发了一种小说 为LGB青少年的父母提供干预的在线平台，目前每个人都有数千名访问者 年。艾滋病毒预防倡导者将AMSM的父母确定为降低艾滋病毒风险的未开发资源 在这群人中。亲子之间关于性的交流与青少年有很好的联系 危险行为和对异性恋青少年父母的干预在#年被证明是有效的。 加强父母与青少年之间的沟通，从而减少青少年的健康风险。因此，目标是 建议的研究是开发一种在线干预，以增加和改善父母与 AMSM关于性和艾滋病毒，最终目标是降低青春期性风险和增加艾滋病毒 测试。为了实现这一目标，我们提出了四个具体目标：(1)确定最好的教育、激励、 并通过进行访谈和指导父母与他们的儿子就性和艾滋病毒进行沟通 与AMSM及其家长组成的焦点小组，(2)开发基于网络的多媒体干预，以激励 并教父母如何有效地与儿子就艾滋病毒相关话题进行沟通，(3)试点测试 干预的可接受性和系统的功能，以及(4)进行随机、受控的试点 对干预措施的审判。通过从AMSM和AMSM收集访谈和焦点小组数据来实现目标1-3 他们的父母，然后与父母和青少年组成的团队合作，合成现有的数据，设计 并对其可接受性和功能性进行测试。目标4将通过随机选择符合以下条件的父母实现 来我们现有的网站上寻求资源以接受我们新的干预或控制，然后 在2-4个月的时间内从两个学习部门的父母和他们的AMSM儿子那里收集纵向在线数据 句号。重要的是，我们的研究团队已经证明了(A)招募家长-AMSM的可行性 将双亲纳入定性研究，以及(B)利用我们的网站将父母-AMSM双亲纳入纵向研究 定量研究。因此，我们的建议是创新的，因为它使用了我们现有的、经过验证的资源来解决 许多历史上困扰着对AMSM及其父母的研究的障碍，以及 对这群人进行干预。如果被证明是有效的，这将是有史以来第一次艾滋病毒预防干预 显示对AMSM有效，AMSM是艾滋病毒感染风险最高的青少年群体。

Project Summary Young men who have sex with men (MSM) are at high risk for HIV infection in the United States, representing 80% of all infections among youth ages 14-24, and 92% of infections among boys ages 14-19. Despite these risks, the field has not even one HIV prevention intervention shown to be effective in decreasing sexual risks or increasing HIV testing among adolescent MSM (AMSM). Historically, reaching AMSM for HIV prevention has been challenging, given their relative geographic isolation and lack of access to traditional gay congregating spaces (e.g., bars and many gay-related social networking websites). However, our team has developed a novel online platform for delivering interventions to parents of LGB youth that currently sees thousands of visitors each year. HIV prevention advocates have identified parents of AMSM as an untapped resource for reducing HIV risk in this population. Parent-child communication about sex has well-demonstrated associations with adolescent risk behaviors, and interventions with parents of heterosexual youth have been shown to be effective in increasing parent-adolescent communication, and thereby, reducing adolescent health risks. Thus, the goal of the proposed study is to develop an online intervention to increase and improve parent communication with AMSM about sexuality and HIV, with the ultimate goal of decreasing adolescent sexual risk and increasing HIV testing. To achieve this goal, we proposed four specific aims: (1) Identify the ways to best educate, motivate, and guide parents in communicating about sexuality and HIV with their sons by conducting interviews and focus groups with AMSM and their parents, (2) Develop a web-based, multimedia, intervention that motivates and teaches parents how to communicate effectively with their sons about HIV-related topics, (3) Pilot test the acceptability of the intervention and functionality of the system, and (4) Conduct a pilot randomized, controlled trial of the intervention. Aims 1-3 will be achieved by collecting interview and focus group data from AMSM and their parents, and then collaborating with a team of parents and adolescent to synthesize existing data, design the intervention, and test its acceptability and functionality. Aim 4 will be achieved by randomizing parents who come to seek resources on our existing website to receive either our new intervention or control, and then gathering longitudinal, online data from parents in both study arms and their AMSM sons over a 2-4 month period. Importantly, our study team has already demonstrated the feasibility of (a) recruiting parent-AMSM dyads into qualitative research, and (b) utilizing our website to enroll parent-AMSM dyads into longitudinal quantitative research. Thus, our proposal is innovative in that it uses our existing, proven resources to address many of the barriers that have historically plagued research on AMSM and their parents, as well as efforts to intervene with this population. If found to be effective, this would be the first ever HIV prevention intervention shown to work for AMSM – the population of adolescents who are at highest risk for HIV infection.