Internet-Based HIV Prevention for Methamphetamine-Using MSM: Formative Research

描述（由申请人提供）：本申请是为了响应RFA-MH-11-081：重振男男性行为者的艾滋病毒预防（R21）。使用冰毒的男男性行为者（MUMSM），其中许多是多种物质使用者，即使偶尔使用，也有两到三倍的可能性进行无保护的肛交。当与不接受传统避孕套预防信息的男性一起工作时，减少伤害的方法有可能重振艾滋病毒预防。如果我们能为高风险男性提供符合他们特定需求的干预措施，我们就有更大的机会看到危险行为的显著减少。这项研究的长期目标是为MUMSM和为这一人群服务的教育工作者开发一个移动在线工具，通过支持制定减少危害战略，包括增加避孕套的使用，促进减少艾滋病毒的传播。基于信息-动机-行为技能（IMB）模型，本R21的四个目标允许收集和分析开发在线工具所需的形成性数据。目的1比较在线遇到男性性伴侣的MUMSM中多物质使用模式和危害减少，以确定IMB和风险行为预测因素的差异。目标2确定不同减少危害分类的MUMSM对在线艾滋病毒预防需求的看法如何不同，包括偏爱的内容和设计特征。目标3确定艾滋病毒预防教育工作者认为的在线艾滋病毒预防需求，包括首选的内容和设计特征，这些教育工作者定期为MUMSM开展外展和教育。目标4整合了定量和定性数据，以确定针对MUMSM的在线艾滋病毒干预的IMB内容和设计特征。除了接触到可能忽视当前预防信息的高危男同性恋者之外，这个应用程序意义重大，因为移动在线干预将预防带到危险环境中，在这些环境中，男同性恋者正在与男性进行药物使用和性接触。该工具还为教育工作者和病例管理人员提供了一种与难以接触的男男性行为者保持联系的机制。这个应用程序是创新的，因为它提出了一种有效的方法来收集、分析和综合定量和定性数据，因为它通过开发一个移动在线工具，包括对MUMSM和预防教育工作者/病例管理人员的同伴支持，将IMB和减少伤害模型扩展到结构性干预。这个应用程序的一个优势是，它结合了明尼苏达大学艾滋病毒/性传播感染干预和预防研究的专业知识，这是基于互联网的艾滋病毒预防的领导者，以及来自旧金山卫生部的著名研究人员在预防MUMSM方面的专业知识。

DESCRIPTION (provided by applicant): This application is in response to RFA-MH-11-081: Reinvigorating HIV Prevention for Men who have Sex with Men (R21). Meth-using MSM (MUMSM), many of whom are polysubstance users, have double to triple the probability of engaging in unprotected anal intercourse, even with episodic use. When working with men not receptive to traditional condom-based prevention messages, a harm reduction approach has the potential to reinvigorate HIV prevention. If we can provide high-risk men with an intervention that meets their specific needs, we have a much greater chance of seeing measurable reductions in risky behavior. The long-term objective of this research is to develop a mobile online tool for MUMSM and educators serving this population that will facilitate a reduction in HIV transmission by supporting the enactment of harm reduction strategies, including increased condom use. Grounded in the Information- Motivation-Behavioral Skills (IMB) Model, the four aims of this R21 allow for the collection and analysis of formative data needed to develop the online tool. Aim 1 compares patterns of polysubstance use and harm reduction in MUMSM who meet male sexual partners online to identify differences in IMB and predictors of risk behavior. Aim 2 identifies how MUMSM in different harm reduction classifications vary in their perception of online HIV prevention needs, including preferred content and design features. Aim 3 identifies perceived online HIV- prevention needs, including preferred content and design features, of HIV-prevention educators who regularly conduct outreach and education for MUMSM. Aim 4 integrates quantitative and qualitative data to identify the IMB content and design features of an online HIV intervention for MUMSM. In addition to reaching high-risk MSM who might ignore current prevention messages, this application is significant because a mobile online intervention brings prevention to the risk environment where MUMSM are meeting men for substance use and sexual encounters. This tool also provides educators and case managers a mechanism to stay in contact with hard-to- reach MSM. This application is innovate because it proposes an efficient method to collect, analyze, and synthesize quantitative and qualitative data, and because it extends both the IMB and harm reduction models to a structural intervention by developing a mobile online tool that includes peer support for both MUMSM and prevention educators/case managers. A strength of this application is that it combines the expertise of the University of Minnesota HV/STI Intervention and Prevention Studies, a leader in Internet-based HIV prevention, with the expertise of a well- known researcher in prevention for MUMSM from the San Francisco Department of Health.