■哈萨克斯坦的艾滋病毒传播在男男性行为者(MSM)和变性者以及男男性行为者(TSM)中增加,受艾滋病毒检测率低的驱动。
■确定艾滋病毒护理干预措施中的PRIDE是否具有在哈萨克斯坦MSM和TSM中增加艾滋病毒检测的社区效应。
■我们采用了阶梯式楔形,从哈萨克斯坦的三个城市招募MSM和TSM社区成员的集群随机对照试验:阿拉木图,阿斯塔纳,还有Shymkent.我们收集了社区成员在2018年8月21日至2022年3月30日之间完成一项评估的连续横断面数据。
■我们从研究城市中的629个MSM和TSM收集了数据。社区受访者是从现实世界中招募的(例如,非政府组织,酒吧,俱乐部)或虚拟网站(例如,社交媒体,应用程序),已知这三个城市中的每个城市的MSM和TSM都很频繁。
■社区受访者的资格标准是:(1)≥18岁;(2)在生活的任何时候都被确定为男性或在出生时被分配为男性;(3)在过去12个月内与另一个男人自愿发生性关系;(4)从事暴饮暴食(即2小时内≥5杯),非法使用毒品,或两者在过去90天内;和(5)居住在三个学习城市之一。
■艾滋病毒护理干预中的骄傲是一种理论驱动的“众包和同伴驱动的网络干预”,旨在通过“影响者”扩大社区成员的成功和韧性,他们可以加强并为他们的网络和社区带来好处。
■在前六个月接受了HIV检测。
■在受访者所在城市实施干预措施后,最近HIV检测的几率在统计学上显着增加(AOR=1.08,95%CI=1.05-1.12;p<.001)。
■艾滋病毒护理干预中的骄傲似乎有效地实现了社区范围的增长-即在MSM和TSM的HIV检测中,在没有经过干预的人中促进HIV检测。
■该试验已在clinicaltrials.gov(NCT02786615)注册。
■国家药物滥用研究所(NIDA),授权号R01DA040513。
结论:问题:艾滋病毒护理干预中的PRIDE是否在哈萨克斯坦的男男性行为者(MSM),变性者和男男性行为者(TSM)中增加了艾滋病毒检测的社区效应?研究结果:我们采用了阶梯式,哈萨克斯坦三个城市的整群随机对照试验。在调查对象所在的城市实施干预措施后,每增加一个月,最近HIV检测的几率就会有统计学上的显著增加。意义:干预措施增加了哈萨克斯坦未直接接受干预措施的MSM和TSM的HIV检测,为整个社区的影响提供支持。
UNASSIGNED: HIV transmission in Kazakhstan has increased among men who have sex with men (MSM) and transgender and nonbinary people who have sex with men (TSM), driven by low HIV testing rates.
UNASSIGNED: To determine if the PRIDE in HIV Care intervention had a community effect of increasing HIV testing among MSM and TSM in Kazakhstan.
UNASSIGNED: We employed a stepped-wedge, cluster-randomized controlled trial with MSM and TSM community members recruited from three cities in Kazakhstan: Almaty, Astana, and Shymkent. We collected serial cross-sectional data where community members completed one assessment between 21 August 2018, and 30 March 2022.
UNASSIGNED: We collected data from 629 MSM and TSM among the study cities. Community respondents were recruited from real-world (e.g., NGOs, bars, clubs) or virtual sites (e.g., social media, apps) where MSM and TSM in each of the three cities were known to frequent.
UNASSIGNED: Eligibility criteria for community respondents were: (1) ≥18 years old; (2) identifying as male at any point in life or being assigned male at birth; (3) having consensual sex with another man in the past 12 months; (4) engaging in binge drinking (i.e., ≥5 drinks in a 2 hour period), illicit use of drugs, or both in the past 90 days; and (5) residing in one of the three study cities.
UNASSIGNED: The PRIDE in HIV Care intervention is a theory-driven \"crowdsourcing and peer-actuated network intervention\" designed to amplify community members\' successes and resilience via \"influencers\" who can strengthen and impart benefit to their networks and community.
UNASSIGNED: Received an HIV test in the prior six months.
UNASSIGNED: There was a statistically significant increase in odds of recent HIV testing for every additional month the intervention was implemented in a respondent\'s city (AOR=1.08, 95% CI=1.05-1.12; p<.001).
UNASSIGNED: The PRIDE in HIV Care intervention appears to be efficacious in enacting a community wide increase-i.e., promoted HIV testing among those who did not go through the intervention itself-in HIV testing among MSM and TSM.
UNASSIGNED: This trial is registered with clinicaltrials.gov (NCT02786615).
UNASSIGNED: National Institute on Drug Abuse (NIDA), grant number R01DA040513.