Help Us, Save Us! HIV/STI Prevention Intervention for High-Risk Black Men

描述(由申请人提供)：非裔美国男性男男性行为者(MSM)中艾滋病毒/艾滋病的发病率令人震惊，由于缺乏在这一人群中有效的性风险降低干预措施，公共卫生对这一紧急情况的反应受到阻碍。因此，这项拟议研究的广泛、长期目标是确定降低非裔美国MSM中性传播感染(STI)风险的干预措施。这是HIV/STI大学的研究人员和黑人性健康教育组织(Bebashi)的合作努力，Bebashi是费城最古老的社区组织(CBO)，它解决了包括男男性接触者在内的非裔美国人社区的艾滋病毒问题。这项申请寻求资金来开发和测试一种基于理论的、与背景相适应的行为干预的有效性，以减少非裔美国MSM中的性危险行为。干预发展将以社会认知理论、计划行为理论、来自焦点群体的定性信息以及对研究人群中男性的纵向调查结果为指导。将利用一对一干预来解决每个男性的具体预防需求，并缓解参与者对通过参加小组或研讨会干预而暴露其与男性的性关系的担忧。这项研究将采用随机对照试验设计，包括基线、干预后即刻以及干预后6个月和12个月的评估。参与者将是594名非裔美国MSM，他们将被随机分为一对一降低性风险干预或一对一健康促进干预，作为控制条件。主要结果是在肛交和阴道性交过程中始终使用避孕套。具体目标涉及干预在肛交期间增加安全套一致性使用的有效性，主要结果，以及测试干预对安全套一致性使用效果的中介作用。这项研究将提供迫切需要的干预措施，以降低美国最高风险人群之一的艾滋病毒和其他性传播疾病的风险。

DESCRIPTION (provided by applicant): The incidence of HIV/AIDS among African American men who have sex with men (MSM) is alarming, and the public health response to this urgent situation has been hampered by a lack of sexual risk reduction interventions with solid evidence of efficacy in this population. Accordingly, the broad, long-term objective of the proposed research is to identify interventions to reduce the risk of sexually transmitted infection (STI) among African American MSM. This is a collaborative effort by HIV/STI university-based researchers and Blacks Educating Blacks About Sexual Health Issues (BEBASHI), the oldest community-based organization (CBO) in the City of Philadelphia that has addressed HIV in the African American community, including MSM. This application seeks funds to develop and test the efficacy of a theory-based, contextually appropriate behavioral intervention to reduce sexual risk behavior among African American MSM. Intervention development will be guided by social cognitive theory, the theory of planned behavior, qualitative information from focus groups, and findings from a longitudinal survey of men from the study population. A one-on-one intervention will be utilized to address the specific prevention needs of each man and to allay participants' concerns about revealing their sexual involvement with men by virtue of participating in a group or workshop intervention. The study will utilize a randomized controlled trial design, with baseline, immediate post intervention, and 6 and 12 months post intervention assessments. The participants will be 594 African American MSM who will be randomized to a one-on-one sexual risk reduction intervention or a one-on-one health promotion intervention that will serve as the control condition. The primary outcome is consistent condom use during anal and vaginal intercourse. The specific aims concern the efficacy of the intervention in increasing consistent condom use during anal intercourse, the primary outcome, and testing the mediation of the effects of the intervention on consistent condom use. This study will provide an urgently needed intervention to reduce the risk of HIV and other STIs in one of the highest risk populations in the United States.