Feasibility of recruiting nondisclosing Black MSM/W for drug use /HIV research

描述（由申请人提供）：本项目将调查对吸毒的黑人男性进行艾滋病毒风险人种学研究的可行性，这些黑人男性与男性和女性发生性关系，但不确定为同性恋或同性恋，也不向女性伴侣透露他们的同性活动。由于这些人不认为自己是同性恋或同性恋，人们担心他们没有被针对同性恋社区的计划所覆盖。具体目标是：1）寻找和招募与男性和女性发生性关系（MSM/W）但不向女性伴侣透露其同性活动的吸毒黑人男性进行面谈。2)初步了解黑人男男性接触者（MSM/W）如何决定是否以及如何披露他们的艾滋病毒风险行为，包括吸毒和高风险性行为。由于男性间的性接触是男性中最常见的艾滋病毒/艾滋病传播类别，因此对男男性接触者（包括黑人男男性接触者/妇女）的研究越来越多。然而，似乎没有对黑人男男性接触者/女同性恋者之间的吸毒模式或向女性伴侣披露同性活动的问题进行系统的调查。有人猜测，黑人男男性接触者/西裔构成了促进黑人妇女感染艾滋病毒的“桥梁”人口，但没有足够的经验证据证实这一说法。该项目的广泛目标是促进对成年黑人吸毒与艾滋病毒风险之间关系的进一步研究，以便更好地了解艾滋病毒/艾滋病感染方面的严重种族差异。黑人男子感染的可能性是白色男子的6倍，黑人妇女感染的可能性是白色妇女的19倍。该项目将聘请两名人种学家通过四个来源招募男性：1）我们以前在低收入，高艾滋病毒社区的研究中建立的现有社交网络; 2）已知的MSM场所，如俱乐部，酒吧，公园和街道位置; 3）互联网网站和4）为吸毒者和前罪犯服务的团体和组织。在研究的两个点上，五个小型焦点小组将有助于加强我们的招聘策略，并就隐瞒或披露行为的决定形成调查路线。人种学家还将与30名男子建立关系，并进行个别访谈，以获得对吸毒和男男性行为活动，艾滋病毒风险的知识和管理以及影响披露决定的因素的初步见解。如果拟议的可行性研究产生了一个成功的战略，招聘和采访黑人男男性接触者/女，它可以被纳入一个后续的更大的努力（R 01），旨在收集更广泛的数据，可以告知适当的风险降低干预措施。公共卫生相关性：这项可行性研究的目的是改进关于与男性和女性发生性关系的吸毒男子中艾滋病毒风险和保护因素的研究。这项研究的重点是黑人男子谁不确定为同性恋或同性恋，并没有透露他们的同性活动，他们的女性伴侣。因为这些人不认为自己是同性恋或同性恋，他们可能无法通过针对同性恋社区的预防计划获得。这项研究将确定成功的战略，招聘和采访这些人，与长期目标的知识，可以有助于更有效的干预措施，可能最终减少艾滋病毒/艾滋病的种族差异。

DESCRIPTION (provided by applicant): This project will investigate the feasibility of conducting ethnographic research on HIV risk among drug-using Black men who have sex with men and women but do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, there is concern that they are not being reached by programs aimed at gay-identified communities. The specific aims are: 1) To locate and recruit for interviewing drug-using Black men who have sex with men and women (MSM/W) but do not disclose their same-sex activity to their female partners. 2) To gain a preliminary understanding of how Black MSM/W decide whether and what to disclose about their HIV risk behaviors including drug use and high risk sexual practices. Because male-to-male sexual contact is the most commonly reported HIV/AIDS transmission category among men, there is a growing body of research on MSM, including Black MSM/W. However, there appear to be no systematic investigations of patterns of drug use among Black MSM/W or on the issue of disclosing same-sex activity to female partners. There is speculation that Black MSM/W constitute a "bridge" population facilitating HIV infection among Black women but there is insufficient empirical evidence to substantiate the claim. The broad goal of this project is to foster further research on the relationship between drug use and HIV risk among Black adults, in order to develop a better understanding of the severe racial disparities in HIV/AIDS infection. Black men are six times more likely than White men to be infected, and Black women are 19 times as likely as White women to be infected. This project will employ two ethnographers to recruit men through four sources: 1) existing social networks established in our previous research in low-income, high-HIV neighborhoods; 2) known MSM venues such as clubs, bars, parks and street locations; 3) Internet sites and 4) groups and organizations serving drug users and ex-offenders. Five small focus groups at two points in the study will help to enhance our recruitment strategy and shape lines of inquiry regarding decisions to conceal or disclose behavior. Ethnographers will also cultivate relationships with and conduct individual interviews with 30 men to obtain preliminary insights into drug use and MSM activity, knowledge and management of HIV risk and factors influencing disclosure decisions. If the proposed feasibility study yields a successful strategy for recruiting and interviewing Black MSM/W, it can be incorporated into a subsequent larger effort (an R01) designed to collect more extensive data that can inform appropriate risk-reduction interventions. PUBLIC HEALTH RELEVANCE: This feasibility study is designed to improve research on HIV risk and protective factors among drug-involved men who have sex with men and women. The study is focused on Black men who do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, they may not be reached by prevention programs aimed at gay-identified communities. This study will identify successful strategies for recruiting and interviewing these men, with the longer-term goals of generating knowledge that can contribute to more effective interventions that may ultimately reduce racial disparities in HIV/AIDS.