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为与男性发生性关系的非裔美国青年开发艾滋病毒预防干预措施(Y2Prevent):研究方案。

Development of an HIV Prevention Intervention for African American Young Men Who Have Sex With Men (Y2Prevent): Study Protocol.

作者信息

Azucar Danny, Hidalgo Marco A, Wright Deja, Slay Lindsay, Kipke Michele D

机构信息

Division of Research on Children, Youth, and Families, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States.

Division of General Internal Medicine and Health Services Research, Department of Medicine, Medicine-Pediatrics Section, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

出版信息

JMIR Res Protoc. 2022 Sep 29;11(9):e36718. doi: 10.2196/36718.


DOI:10.2196/36718
PMID:36173675
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9562086/
Abstract

BACKGROUND: African American young men who have sex with men (YMSM) possess many intersecting identities that may increase their vulnerability to social stigmatization and discrimination, which yields a negative influence on their well-being and behaviors. These experiences often manifest as increased general and sexual risk-taking behaviors that place this particular group at an increased risk for HIV. This scenario is exacerbated by the lack of HIV prevention interventions specifically designed for African American YMSM. OBJECTIVE: In this paper, we discuss the development of research designed to refine, pilot, and evaluate the feasibility, acceptability, and preliminary efficacy of a behavioral intervention designed to build resilience and reduce substance use and HIV risk behaviors among African American YMSM. The overarching aim of this research, funded by the National Institutes of Health, is to further refine and pilot test an intervention called Young Men's Adult Identity Monitoring (YM-AIM). YM-AIM is a theory-driven, group-level intervention designed to help African American YMSM develop a healthy vision for their future (or possible future self) by defining a set of short-term and long-term goals in the areas of education, health, family, and intimate relationships. METHODS: Through partnerships with community members and community-based organizations, we will further strengthen and refine YM-AIM to include 3 new components: biomedical HIV prevention strategies (pre-exposure prophylaxis and postexposure prophylaxis); HIV and sexually transmitted infection (STI) testing and HIV care referral, drug screening, and drug treatment referral; and a youth mentoring component. We will recruit African American YMSM, aged 18 to 24 years, into 2 working groups; each group will consist of 6 to 8 members and will convene on a weekly basis, and each meeting will focus on one specific YM-AIM topic. This feedback will be used to further refine the intervention, which will then be evaluated for its feasibility and acceptability. Intervention outcomes include drug use in the past 30 days and 3 months, alcohol use, condomless sex, number of sex partners, and increasing condom use intention, condom use self-efficacy, HIV and STI testing recency and frequency, and linkage to care. RESULTS: As of June 2022, we completed phase 1 of Y2Prevent and launched phase 2 of Y2Prevent to begin recruitment for working group participants. Phase 3 of Y2Prevent is anticipated to be launched in September and is expected to be completed by the end of this project period in December 2022. CONCLUSIONS: Few youth-focused interventions have sought to help youth identify and develop the skills needed to navigate the social and structural factors that contribute to individual-level engagement in prevention among sexual minority youth. This research seeks to promote young men's adoption and maintenance of HIV-protective behaviors (eg, safer sex, pre-exposure prophylaxis use, HIV and STI testing, and health care use). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36718.

摘要

背景:与男性发生性行为的非裔美国青年(YMSM)具有多种相互交织的身份特征,这可能会增加他们遭受社会污名化和歧视的脆弱性,进而对其幸福感和行为产生负面影响。这些经历往往表现为普遍的和性方面的冒险行为增加,使这一特定群体感染艾滋病毒的风险升高。而专门针对非裔美国YMSM的艾滋病毒预防干预措施的缺乏,更是加剧了这种情况。 目的:在本文中,我们讨论了一项研究的开展情况,该研究旨在完善、试点并评估一种行为干预措施的可行性、可接受性和初步效果,该干预措施旨在增强非裔美国YMSM的复原力,减少物质使用以及艾滋病毒风险行为。这项由美国国立卫生研究院资助的研究的总体目标是进一步完善并试点测试一种名为“青年男性成人身份监测”(YM-AIM)的干预措施。YM-AIM是一种理论驱动的、群体层面的干预措施,旨在通过在教育、健康、家庭和亲密关系等领域设定一系列短期和长期目标,帮助非裔美国YMSM为自己的未来(或可能的未来自我)树立健康的愿景。 方法:通过与社区成员和社区组织建立伙伴关系,我们将进一步加强和完善YM-AIM,使其包括3个新的组成部分:生物医学艾滋病毒预防策略(暴露前预防和暴露后预防);艾滋病毒和性传播感染(STI)检测以及艾滋病毒护理转诊、药物筛查和药物治疗转诊;以及一个青年指导部分。我们将招募年龄在18至24岁之间的非裔美国YMSM加入2个工作组;每个组将由6至8名成员组成,每周召开会议,每次会议将聚焦一个特定的YM-AIM主题。这些反馈将用于进一步完善干预措施,然后对其可行性和可接受性进行评估。干预结果包括过去30天和3个月内的药物使用情况、酒精使用情况、无保护性行为、性伴侣数量,以及增加使用避孕套的意愿、使用避孕套的自我效能感、艾滋病毒和STI检测的近期情况和频率,以及与护理的联系。 结果:截至2022年6月,我们完成了Y2Prevent的第1阶段,并启动了Y2Prevent的第2阶段,开始招募工作组参与者。Y2Prevent的第3阶段预计将于9月启动,预计在2022年12月本项目期结束前完成。 结论:很少有以青年为重点的干预措施试图帮助青年识别并培养应对那些导致性少数青年个人层面参与预防工作的社会和结构因素所需的技能。本研究旨在促进青年采用并维持艾滋病毒防护行为(如更安全的性行为、使用暴露前预防药物、进行艾滋病毒和STI检测以及使用医疗保健服务)。 国际注册报告识别码(IRRID):DERR1-10.2196/36718

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b096/9562086/3edf947a13fd/resprot_v11i9e36718_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b096/9562086/3edf947a13fd/resprot_v11i9e36718_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b096/9562086/3edf947a13fd/resprot_v11i9e36718_fig1.jpg

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本文引用的文献

[1]
Positive Youth Development in 2020: Theory, Research, Programs, and the Promotion of Social Justice.

J Res Adolesc. 2021-12

[2]
Characterizing Racial Differences of Mental Health Burdens, Psychosocial Determinants, and Impacts on HIV Prevention Outcomes Among Young Men Who have Sex With Men: a Community-based Study in Two U.S. Cities.

J Racial Ethn Health Disparities. 2022-8

[3]
Mentoring Young African American Men and Transgender Women Who Have Sex With Men on Sexual Health: Formative Research for an HIV Mobile Health Intervention for Mentors.

JMIR Form Res. 2020-12-17

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Awakening to an Intersectional Reality: Ending the HIV Epidemic in the USA Starts with Reducing Inequities among Black MSM.

J Urban Health. 2020-10

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J Urban Health. 2020-10

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AIDS Behav. 2021-5

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