Dr. Cui Yang's long term career goal is to develop culturally appropriate interventions among high-risk populations. Dr. Yang's history as an individual who has been trained in behavioral and epidemiological sciences in the United States, yet who understands Chinese culture and languages, places her in a strong position to contribute to a growing field of global collaborative research in HIV prevention. Since 2007, heterosexual transmission has become the major transmission mode of all HIV infections in China. In addition, alcohol use in conjunction with sexual activity increases the probability of risky sexual behaviors. There is an urgent need for the development of culturally-tailored intervention designed to reduce HIV infections among heterosexual men who are daily drinkers and have high risk sex partners, a understudied and yet a critical bridge group who could dramatically facilitate the spread of HIV. Little is known about social network factors of heterosexual men who have high risk sex partners, and there is an insufficient research on high risk heterosexual men and their alcohol consumption. This K99/R00 application is therefore uniquely timed to contribute to a growing field of HIV prevention science. Results from this pilot intervention will inform the social and cultural considerations of peer-driven interventions among male daily drinkers who have high risk sex partners and the translation of such an intervention to other countries, including US, where alcohol and risky sexual behaviors often co-occur. Overseen by a team of mentors, Dr. Yang's training objectives include 1) To gain expertise in HIV risk-reduction interventions, 2) To enhance knowledge of alcohol use among high risk populations;and 3) To further develop skills in qualitative methods and application of advanced statistical methods. In the mentored phase research (K99), Dr. Yang will conduct in-depth interviews among 40 male daily drinkers who have high risk sex partners to explore the factors associated with alcohol use in the context of high risk sex behaviors, and to examine the feasibility of peer-driven intervention in Sichuan province China. The training objectives and mentored phase research are instrumental to the successful advancement to the R00 phase research which proposes to develop intervention materials and will compare outcomes between two study conditions: (1) standard individual voluntary counseling and testing (VCT) (n=80), and (2) experimental condition (n=80). In the experimental condition, male daily drinkers who have high risk sex partners will be trained in the reduction of alcohol use and sexual risks, peer outreach, and communication skills so that they can conduct HIV prevention outreach among their risk network members. Participants in the comparison group will receive the standard care of HIV testing and counseling. All participants will be assessed at baseline and 6-month follow up. Finding of this pilot peer-driven intervention will provide significant preliminary data for an R01 grant of a prevention intervention to address issues of sexual health and alcohol- related risks among male daily drinkers who have high risk sex partners.
8. PORJECT NARRATIVE Male daily drinkers who have high risk sex partners have been understudied, yet a critical bridge group who could dramatically facilitate the spread of HIV in China. The primary goal of the proposed pilot prevention intervention is to train male daily drinkers who have high risk sex partners as peer health educators to promote the reduction of alcohol use and risky sexual behaviors. Results from this pilot intervention will inform the social and cultural considerations of peer-driven interventions among male daily drinkers who have high risk sex partners and the translation of such an intervention to other countries, including US, where alcohol and risky sexual behaviors often co-occur.
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