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加拿大安大略省黑人男性的艾滋病毒应对代际参与干预:一项试点干预研究的方案

HIV-Response Intergenerational Participation Intervention Among Black Men in Ontario, Canada: Protocol for a Pilot Intervention Study.

作者信息

Etowa Egbe B, Boakye Priscilla N, Antabe Roger, Wong Josephine Pui-Hing

机构信息

Ontario HIV Treatment Network, Toronto, ON, Canada.

Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada.

出版信息

JMIR Res Protoc. 2023 Jul 11;12:e48829. doi: 10.2196/48829.

Abstract

BACKGROUND

Black men and their communities are more affected by HIV. Although they constitute less than 5% of the Ontarian population, they accounted for 26% of new HIV diagnoses in 2015, nearly half of which (48.6%) were attributed to heterosexual contact. HIV stigma and discrimination reinforce African, Caribbean, and Black men's HIV vulnerability by creating unsafe environments that deter them from testing and disclosure, resulting in isolation, depression, delayed diagnosis and linkage to treatment and care, and poor health outcomes. In response to these challenges, intergenerational strategies were identified from previous community-based participatory studies as best practices to reduce HIV vulnerabilities and promote resilience among heterosexual Black men and communities. The proposed intervention is premised on this recommendation of intergenerational intervention.

OBJECTIVE

The overarching objective is to engage heterosexual Black men and communities in cocreating a community centered, culturally safe intergenerational intervention to reduce HIV vulnerabilities and related health disparities.

METHODS

We will engage 12 diverse community stakeholders in Ontario, inclusive of heterosexual Black men, in 8 weekly sessions to evaluate existing evidence of effective HIV health literacy interventions, identify essential and relevant aspects, and work collaboratively to co-design the HIV-Response Intergenerational Participation (HIP) intervention for use with Black men and communities. Next, we will recruit 24 self-identified heterosexual Black men aged 18-29, 29-49, and ≥50 years. We will pilot and evaluate the HIP intervention with 24 heterosexual Black men from these 3 age groups (split as 2 events: a total of 12 participants in person in Toronto and 12 participants on the web in Windsor, London, and Ottawa). We will use the data obtained along with questionnaires from validated scales and focus groups to evaluate the effectiveness of HIP. The data will include HIV knowledge, perceived stigma toward people living with HIV, acceptance and uptake of HIV testing, preexposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and condom use. We will also collect data related to perceptions about system-level factors such as discrimination, socially misconstrued masculine identity, etc. Quantitative analysis will essentially be a univariate descriptive analysis. We will use thematic analysis to highlight the results of the focus group discussions. Finally, we will disseminate the evaluation results and engage researchers, leaders, Black men, and communities to expand the project team and scale up the intervention in Ontario and across Canada.

RESULTS

Implementation commences by May 2023, and by September 2023, we should have produced, among others, an evidence-informed HIP intervention that can be adapted for use by heterosexual Black men and communities beyond Ontario.

CONCLUSIONS

The pilot intervention will strengthen critical health literacy and build resilience against HIV through intergenerational dialogue among heterosexual Black men of all ages.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/48829.

摘要

背景

黑人男性及其社区受艾滋病毒影响更为严重。尽管他们在安大略省人口中所占比例不到5%,但在2015年新确诊的艾滋病毒病例中,他们占了26%,其中近一半(48.6%)是通过异性接触感染的。艾滋病毒污名化和歧视营造了不安全的环境,阻碍黑人男性进行检测和披露病情,导致他们被孤立、抑郁、诊断延迟以及无法获得治疗和护理,健康状况不佳,从而加剧了非洲、加勒比和黑人男性感染艾滋病毒的易感性。为应对这些挑战,在以往基于社区的参与性研究中确定了代际策略,作为减少艾滋病毒易感性和增强异性恋黑人男性及其社区恢复力的最佳做法。拟议的干预措施就是基于这一代际干预建议。

目的

总体目标是让异性恋黑人男性及其社区共同创建以社区为中心、具有文化安全性的代际干预措施,以减少艾滋病毒易感性和相关的健康差距。

方法

我们将邀请安大略省12个不同的社区利益相关者,包括异性恋黑人男性,参加为期8周的每周一次的会议,以评估有效的艾滋病毒健康素养干预措施的现有证据,确定关键和相关方面,并共同合作设计艾滋病毒应对代际参与(HIP)干预措施,供黑人男性及其社区使用。接下来,我们将招募24名自我认定的年龄在18 - 29岁、29 - 49岁和≥50岁的异性恋黑人男性。我们将对来自这3个年龄组的24名异性恋黑人男性进行HIP干预试点和评估(分为2个活动:在多伦多有12名参与者亲自参加,在温莎、伦敦和渥太华有12名参与者通过网络参加)。我们将使用获得的数据以及来自经过验证的量表和焦点小组的问卷来评估HIP的有效性。数据将包括艾滋病毒知识、对艾滋病毒感染者的污名认知、艾滋病毒检测的接受和采用情况、暴露前预防(PrEP)、暴露后预防(PEP)以及避孕套使用情况。我们还将收集与对诸如歧视、社会误解的男性身份等系统层面因素的认知相关的数据。定量分析基本上将是单变量描述性分析。我们将使用主题分析来突出焦点小组讨论的结果。最后,我们将传播评估结果,并邀请研究人员、领导者、黑人男性及其社区扩大项目团队,并在安大略省及加拿大全国扩大干预规模。

结果

实施工作于2023年5月开始,到2023年9月,我们应已制定出一项基于证据的HIP干预措施,该措施可适用于安大略省以外的异性恋黑人男性及其社区。

结论

试点干预将通过各年龄段异性恋黑人男性之间的代际对话,加强关键的健康素养,并增强抵御艾滋病毒的能力。

国际注册报告识别码(IRRID):PRR1 - 10.2196/48829。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/239b/10369308/1e3917ce83b5/resprot_v12i1e48829_fig1.jpg

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