A Community-level HIV Prevention Intervention for Young Black Men

描述（由申请人提供）：艾滋病毒血清阳性率和血清发病率已达到灾难性的水平，在年轻的黑人男子谁与男性发生性关系（YBMSM）。黑人男男性行为者也不太经常接受艾滋病毒检测，而且不太可能意识到他们的艾滋病毒阳性血清状态比其他男男性行为者。显然，目前用于接触YBMSM的艾滋病毒预防方法并不有效。赋权项目是唯一一个专门为年轻男同性恋/双性恋男子制定的社区一级艾滋病毒预防干预措施，有证据表明，该项目在减少报告无保护肛交的男子比例方面具有效力。然而，黑人社区组织不愿意实施赋权项目，直到它适应了YBMSM的生活环境，并且它在降低无保护性行为率和提高艾滋病毒抗体检测率方面的有效性已经建立。定性研究与艾滋病毒阳性和艾滋病毒阴性YBMSM，并通过与三个黑人社区组织和两个文化专家委员会的合作研究，由黑人同性恋/同性恋男子组成。该项目的主要目标是测试量身定制的赋权项目在减少YBMSM中的性风险行为和增加测试方面的功效。本研究的具体目的是：（1）在一个社区实施为期两年的量身定制增能项目（Atlanta，GA），并使用第二个社区（Houston，TX）作为不接受干预的对照;（2）在两个社区中使用基于场所的日-时-空抽样在干预之前和之后对YBMSM进行横断面调查，以确定干预在以下方面的功效：（a）减少可能传播艾滋病毒的性行为的比例和频率，包括减少性伴侣的数量;（B）增加了解其艾滋病毒血清状况的男子的比例;（c）修改可能与减少艾滋病毒风险有因果关系的心理社会中介变量;（d）改变作为积极心理健康和福祉指标的心理社会因素;（3）对干预措施进行过程评价，以评估量身定制的增强能力项目是如何实施的，并评估个人和社区对项目的看法。我们还将观察两个社区性传播感染率的变化。

DESCRIPTION (provided by applicant): HIV seroprevalence and seroincidence rates have reached catastrophic levels among young Black men who have sex with men (YBMSM). Black MSM are also tested less frequently for HIV and are less likely to be aware of their HIV-positive serostatus than other MSM. Clearly, HIV prevention methods currently used to reach YBMSM are not effective. The Mpowerment Project is the only community-level HIV prevention intervention developed specifically for young gay/bisexual men that has been shown to have evidence of effectiveness in reducing the proportion of men reporting unprotected anal sex. However, Black CBOs are reluctant to implement the Mpowerment Project until it has been adapted to the context of YBMSM's lives and its efficacy in reducing rates of unprotected sex and increasing HIV antibody testing rates have been established Therefore, the developers of the Mpowerment Project have spent five years tailoring the intervention to the socioeconomic, cultural, and social context of YBMSM's lives through formative, qualitative research with HIV-positive and HIV-negative YBMSM and through collaborative research with three Black CBOs and two Boards of Cultural Experts, comprised of Black gay/same gender-loving men. The primary goal of this project is to test the efficacy of the tailored Mpowerment Project in reducing sexual risk behavior and increasing testing among YBMSM. The specific aims of this study are: (1) To implement the tailored Mpowerment Project for two years in one community (Atlanta, GA), and use a second community (Houston, TX) as a control that will not receive the intervention; (2) To conduct cross-sectional surveys of YBMSM before and after the intervention in both communities using venue-based day-time-space sampling to determine the efficacy of the intervention in: (a) reducing the proportion and frequency of sexual behaviors that are likely to transmit HIV, including reducing the number of sex partners; (b) increasing the proportion of men who know their HIV serostatus; (c) modifying psychosocial mediating variables that may be causally related to HIV risk reduction; and (d) changing psychosocial factors that are indicators of positive mental health and well-being; (3) To conduct process evaluations of the intervention to assess how the tailored Mpowerment Project is implemented and to assess the perceptions of the project at both the individual- and community-level. We will also look for changes in sexually transmitted infection rates in both communities.