在印度,男男性行为者(MSM)是面临艾滋病毒感染和传播风险的关键群体。他们也是极度边缘化和受污名化的人群,面对巨大的社会心理压力,包括,但不限于,污名,同性恋恐惧症,歧视,刑事定罪,低自尊,自我接受度低,苦恼,and,因此,心理健康问题的发生率很高。尽管这些多层次的社会心理问题可能会使MSM面临HIV感染和传播的高风险,目前,印度的艾滋病毒预防干预措施没有解决这些问题。本文介绍了一种心理社会干预措施的设计,以降低印度MSM的HIV风险。
由国家精神卫生研究所资助,这项研究是一项基于自我接受的社会心理HIV预防干预的双臂随机临床疗效试验,在少数群体压力模型和辛迪加理论的指导下,这是通过广泛的基于社区的形成工作以及印度MSM社区和主要线人的投入而开发的,这些线人了解印度MSM所面临的经验。参与者是金奈和孟买的MSM,他们认可最近的性行为,使他们处于艾滋病毒/性传播感染(STI)获取和传播的高风险中。登记的参与者同样被随机分配到1)实验条件,其中包括四个小组和六个个人咨询会议,包括标准护理艾滋病毒/性传播感染检测和咨询,或2)护理条件的标准,其中包括单独的艾滋病毒/性传播感染检测和咨询。主要结果是无套式肛交行为的频率和STI发生率的变化(梅毒血清阳性和尿道,直肠,咽部淋病和衣原体感染。主要研究评估访视发生在基线,4-,8-,和12个月。
需要针对印度MSM面临的社会心理压力的HIV预防干预措施;这项研究将检查这种干预的有效性。如果干预成功,它也许能够减轻印度的国家艾滋病毒/艾滋病负担,同时赋予边缘化和高度污名化的群体权力。
ClinicalTrials.gov标识符:NCT02556294,2015年9月22日注册
Men who have sex with men (MSM) in India are a key group at risk for HIV acquisition and transmission. They are also an extremely marginalized and stigmatized population, facing immense psychosocial stressors including, but not limited to, stigma, homophobia, discrimination, criminalization, low self-esteem, low self-acceptance, distress, and, as a result, high rates of mental health problems. Although these multi-level psychosocial problems may put MSM at high risk for HIV acquisition and transmission, currently HIV prevention interventions in India do not address them. This paper describes the design of a psychosocial intervention to reduce HIV risk for MSM in India.
Funded by the National Institute of Mental Health, this
study is a two-arm randomized clinical efficacy
trial of a self-acceptance based psychosocial HIV prevention intervention, informed by the minority stress model and syndemic theory, that was developed with extensive community-based formative work and input from the Indian MSM community and key informants who are knowledgeable about the experiences faced by MSM in India. Participants are MSM in Chennai and Mumbai who endorsed recent sexual behaviors placing them at high risk for HIV/sexually transmitted infection (STI) acquisition and transmission. Enrolled participants are equally randomized to either 1) the experimental condition, which consists of four group and six individual counseling sessions and includes standard of care HIV/STI testing and counseling, or 2) the standard of care condition, which includes HIV/STI testing and counseling alone. The primary outcomes are changes in the frequency of condomless anal sex acts and STI incidence (syphilis seropositivity and urethral, rectal, and pharyngeal gonorrhea and chlamydia infection. Major
study assessment visits occur at baseline, 4-, 8-, and 12-months.
HIV prevention interventions that address the psychosocial stressors faced by MSM in India are needed; this
study will examine the efficacy of such an intervention. If the intervention is successful, it may be able to reduce the national HIV/AIDS burden in India while empowering a marginalized and highly stigmatized group.
ClinicalTrials.gov Identifier: NCT02556294 , registered 22 September 2015.