PS08-001, NATIONAL HIV BEHAVIORAL SURVEILLANCE

描述（由申请人提供）：行为监测，定义为持续的、系统的收集、分析和解释行为数据，以预防或控制疾病或伤害，对于艾滋病和许多慢性疾病，其发病与假定暴露时间相隔数年或数十年，是很重要的。需要建立一个国家监测系统，提供有关MSM、IDUs和HET的风险和预防行为的相关、及时和高质量数据，以帮助指导和评估地方和国家的艾滋病毒预防工作。在缺乏有效的艾滋病毒疫苗的情况下，减少已知的艾滋病毒感染风险因素对于减少艾滋病毒传播至关重要。艾滋病毒行为监测数据可用于针对艾滋病毒感染风险最高的人群中需要改变的已确定的危险行为开展预防工作。行为监测数据对于评估社区内的预防工作是否覆盖重要人群以及是否达到地方和国家艾滋病毒预防目标非常重要。需要对行为数据进行持续、系统的收集、解释和分析，以确定基线风险和预防服务利用结果，并量化实现计划目标的进展情况。对于那些确定有未满足预防需求的人群，行为监测数据可以在地方、州和联邦各级使用，以帮助改进或重新定向预防工作，或获得额外的预防资源。美国疾病控制与预防中心的艾滋病毒/艾滋病战略计划已经确定，监测使人们面临艾滋病毒感染风险的行为是综合监测系统的关键要素，特别是在男同性恋者、注射吸毒者和HRH中。该方案的目标是建立一个持续的监测系统，以确定艾滋病毒感染高危人群中艾滋病毒风险行为的流行情况，并用于发展和指导国家预防服务和方案；并评估各种预防措施的影响。这一数据对于执行战略和为波多黎各卫生部、社区卫生组织和其他团体提供当地相关的流行病学信息非常重要。为此，我们将与行为和临床监测处、艾滋病毒/艾滋病预防司以及其他参与的州和地方卫生部门合作，在男男性接触者、注射吸毒者和HET人群中开展全国艾滋病毒行为监测。HIV行为监测系统将分三个研究周期进行。每个周期将针对三个不同的人群：男男性行为者、注射吸毒者和heet，每个周期将持续一年。第一个周期是MSM，将从2008年1月到12月31日进行。第二个周期是IDU，将于2009年1月至12月31日进行。第三个也是最后一个周期将是HRH，从2010年1月到12月31日。将使用科学合理的方法招募来自非卫生保健社区环境的高风险个体，以建立一个持续监测与艾滋病毒感染相关行为的系统。我们将通过男性之间的性行为、注射毒品使用和异性性接触来评估18岁及以上成年人感染艾滋病毒的风险行为和行为趋势。除了艾滋病毒预防方案的获取和利用之外，还将评估艾滋病毒检测。我们每个周期将采访至少500人。通过社区规划过程和疾病预防控制中心直接资助的社区组织（CBO’s）或由州/市资助的社区组织（CBO’s）、艾滋病预防项目、公共卫生学院、大学、人种学家和行为科学家的合作，我们将进行形成性研究和问卷开发。

DESCRIPTION (provided by applicant): Behavioral surveillance, defined as an ongoing, systematic collection, analysis, and interpretation of behavioral data for preventing or controlling disease or injury, is important for AIDS and many chronic diseases whose onset is separated from their putative exposures by several years or decades. A national surveillance system that provides relevant, timely, and high-quality data on risk and prevention behaviors of MSM, IDUs and HET is needed to help direct and evaluate local and national HIV prevention efforts. In the absence of an effective vaccine against HIV, reducing known risk factors for HIV infection is essential for reducing HIV transmission. HIV behavioral surveillance data can be used to target prevention efforts on identified risk behaviors that need to be changed in populations at greatest risk for HIV infection. Behavioral surveillance data is important for evaluating whether prevention efforts within a community are reaching important population segments and in meeting local and national goals for HIV prevention. An ongoing, systematic collection, interpretation, and analysis of behavioral data are needed to identify baseline risk and prevention-service-utilization outcomes, and to quantify progress towards meeting the plan's objectives. For those populations that are identified with unmet prevention needs, behavioral surveillance data can be used at local, state, and federal levels to help improve or redirect prevention efforts, or to obtain additional prevention resources. CDC's HIV/AIDS strategic plan has identified that monitoring behaviors that place people at risk for HIV infection is a key element of an integrated surveillance system, particularly in MSM, IDU's, and HRH. This programs goal is to develop an ongoing surveillance system to ascertain the prevalence of HIV risk behaviors among groups at high risk for HIV infection to be used in the development and directing national prevention services and programs; and to evaluate the impact of a variety of prevention efforts. This data will be important to implement strategies and provide local relevant epidemiological information for the Puerto Rico Health Department, CBO's and other groups. For this reason and in collaboration with the Behavioral and Clinical Surveillance Branch, Division of HIV/AIDS Prevention, and other participating state and local health departments we will conduct the National HIV Behavioral Surveillance in MSM, IDU's, and HET populations. The HIV Behavioral Surveillance System will be conducted in three research cycles. Each cycle will approach three different populations: MSM, IDU's, and HET and each cycle will be of one year duration. The first cycle will be MSM and it will be conducted through from January to December 31, 2008. The second cycle will be the IDU's and it will be conducted from January to December 31st, 2009. The third and last cycle will be the HRH, starting from January to December 31, 2010. High-risk individuals from non-healthcare community settings will be recruited using a scientifically sound methodology to develop an ongoing system for surveillance of behaviors related to HIV acquisition. We will assess risk behaviors and trends in behaviors over time among adults 18 years old and older at high risk for HIV infection through sexual behavior between men, injection drug use and heterosexual contact. HIV testing will be assessed in addition to access and utilization of HIV prevention programs. We will interview at least 500 persons per cycle. Through the community planning process and the collaboration of CDC directly funded community-based organizations (CBO's) or CBO's funded by states/cities, HIV prevention programs, schools of public health, universities, ethnographers and behavioral scientist we will conduct a formative research, and questionnaire development.