Culturally-Tailored HIV Risk Reduction for African-American MSM

描述（由申请人提供）：与男性发生性关系的有色人种男性，特别是非洲裔美国男男性接触者（AA-MSM），在威斯康星州的全国和当地男男性接触者中，继续占总艾滋病毒/艾滋病和性传播感染病例的不成比例。在威斯康星州，2005年在非洲裔美国人中新诊断的艾滋病毒病例中，几乎三分之二可归因于男性对男性的性接触。为了响应CDC RFA-PS 06 -006，威斯康星州艾滋病干预研究中心/医学院与三个为AA-MSM- Diverse and Resilient，Inc.服务的社区组织合作，密尔沃基同性恋、双性恋和变性者社区中心和Charles 'D' Productions-建议：（1）制定一项基于理论和文化定制的群体层面干预措施，旨在减少AA-MSM中的艾滋病毒和性传播感染风险行为。(2)在220名AA-MSM中进行一项随机III期临床试验，比较快速HIV检测和咨询降低风险干预（仅HCT）与增强干预的有效性，增强干预包括HCT干预加上基于理论和文化定制的小组干预，旨在减少AA-MSM中的HIV和STI风险行为。(3)确定关键人口统计数据（例如，年龄）和理论变量（例如，自我效能）中度或中度观察到的干预效果。(4)比较增强的HCT-plus小组干预措施与仅HCT-plus干预措施的成本效益，以确定HCT-plus干预措施更大的艾滋病毒预防有效性是否足以证明其更高的成本是合理的。(5)通过当地社区和公共卫生论坛以及为提供者和社区倡导者举办的培训讲习班，以及通过科学报告和出版物，传播研究结果。 迫切需要对AA-MSM进行艾滋病毒和性传播感染预防干预。我们提出的研究将通过开展和评价一项随机对照试验来解决这一差距，以评估旨在减少AA-MSM中艾滋病毒和性传播感染风险行为的文化定制的群体水平干预措施的有效性。如果证明有效，干预措施将传播给社区机构使用，这些机构正在努力减少AA-MSM中艾滋病毒和性传播感染的新病例，AA-MSM是一个受传染病负担影响不成比例的群体。这些预防计划将改善AA-MSM的性健康。

DESCRIPTION (provided by applicant): Men of Color who have sex with men, and in particular African-American MSM (AA-MSM), continue to account for a disproportionate percentage of the total HIV/AIDS and STI cases among MSM, both nationally and locally in Wisconsin. In Wisconsin, almost two-thirds of newly diagnosed HIV cases in 2005 among African-Americans were attributable to male-to-male sex contact. In response to CDC RFA-PS06-006, the Center for AIDS Intervention Research/Medical College of Wisconsin in collaboration with three community- based organizations who serve AA-MSM- Diverse and Resilient, Inc., the Milwaukee LGBT Community Center, and Charles 'D' Productions- proposes to: (1) Manualize a theory-based and culturally tailored group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. (2) Conduct a randomized phase 3 clinical trial with 220 AA-MSM to compare the effectiveness of a rapid HIV testing and counseling risk reduction intervention (HCT-only) to an enhanced intervention that includes the HCT intervention plus a theory-based and culturally tailored small group intervention designed to reduce HIV and STI risk behavior among AA-MSM. (3) Determine whether key demographic (e.g., age) and theoretical variables (e.g., self-efficacy) moderate or mediate observed intervention effects. (4) Compare the cost- effectiveness of the enhanced HCT-plus small-group intervention relative to the HCT-only intervention to determine whether the greater HIV prevention effectiveness of the HCT-plus intervention is sufficient to justify its greater cost. (5) Disseminate study findings through local community and public health forums and training workshops for providers and community advocates, as well as through scientific presentations and publications. There is an urgent need for HIV and STI prevention interventions for AA-MSM. Our proposed study will address this gap through the conduct and evaluation of an RCT to assess the effectiveness of a culturally- tailored, group-level intervention designed to reduce HIV and STI risk behavior among AA-MSM. If demonstrated efficacious, the intervention will be disseminated for use by community agencies who are working to reduce new cases of HIV and STI infection among AA-MSM, a group disproportionately affected infectious disease burden. Such prevention programs will result in improved sexual health among AA-MSM.