LONG TERM ACCEPTABILITY OF HIV PREVENTION METHODS

在这项申请中，我们建议对完成父母研究的两组女性及其主要性伴进行为期12个月的纵向随访。家长研究是一项随机对照试验，我们正在评估为妇女提供多种预防选择的框架，并在三个月的时间内评估这些方法的可接受性。在家长研究中，队列1将接受多选项干预(MO)，其中3种预防方法(男性避孕套、女性避孕套、优势S)按安全性等级顺序提供，而队列2将接受以男性避孕套为重点的单一选项条件。目前的应用建立在家长研究的基础上：1)纵向检查方法的可接受性；2)对女性的主要性伴侣进行结构化评估；3)从关系的角度探讨个人、关系和社会文化因素如何影响女性及其伴侣的可接受性；以及4)进行定性访谈，以探索影响可接受性的复杂关系和社会文化过程。队列1女性将在月经周期干预后6个月和12个月接受评估，她们的主要性伴将在3个时间点接受访谈，以对应于女性3个月、6个月和12个月的评估。为了使两个群体对多个期权的风险敞口相等，队列2将被提供多个期权干预。队列2妇女和她们的伴侣将在基线以及干预后3、6和12个月进行评估。对纵向数据进行多变量增长曲线分析。定性访谈的目的是深入了解影响不同预防方案可接受性的复杂关系和社会文化进程。两个子样本将被有目的地选择。第一个样本将只包括处于稳定关系3个月或更长时间且符合以下标准之一的女性：1)采用男用或女用避孕套；2)仅使用优势S；或3)完全不使用任何方法。第二个有目的的样本将包括处于新关系中的女性(关系不超过三个月)。访谈的定性分析将使我们能够将影响性危险行为的静态风险和保护因素的知识扩展到更复杂的过程中，并使用预防方法。对风险和保护过程的了解可以指导制定干预措施，以提高可接受性。

In this application, we propose a 12-month longitudinal follow-up of two cohorts of women who have completed a parent study and their main sex partners. The parent study is a randomized control trial in which we are evaluating a framework for present women with multiple prevention options and assessing acceptability of these methods over a three month period. In the parent study, Cohort 1 will have receive a multiple option intervention (MO) in which 3 prevention methods (male condoms, female condom, Advantage S) were presented in a hierarchical order of safety and Cohort 2 will have received a single option condition focused on male condoms. The current application builds on the parent study by: 1) examining acceptability of methods longitudinally; 2) conducting structured assessments with women's main sex partners; 3) using a relational perspective to explore how individual, relationship, and socio- cultural factors influence acceptability for both women and their partners; and 4) conducting qualitative interviews to explore the complex relationship and socio-cultural processes that influence acceptability. Cohort 1 women will be assessed at 6 and at 12 months post MO intervention and their main sex partners will be interviewed at 3 time points to corresponds to the women's 3, 6, and 12 month assessments. To equalize exposure to the multiple options across the two cohorts, Cohort 2 will be offered the multiple option intervention. Cohort 2 women and their partners will be assessed at baseline, and at 3, 6, and 12 months post intervention. Multi-variate growth cure analyses will be applied to the longitudinal data. The goal of the qualitative interviews is to gain insight into the complex relationship and socio-cultural processes that influence acceptability of different prevention options. Two sub-samples will be purposively selected. The first sample will include only women have been in a stable relationship of 3 or more months and who meet one of the following criteria: 1) adopted male or female condoms; 2) only use Advantage S; or 3) do not use any method at all. The second purposive sample will include women who are in new relationships (a relationship of three months or less). The qualitative analysis of the interviews will allow us to extend our knowledge of static risk and protective factors that affect sexual risk behavior and use of prevention methods to more complex processes. Understanding of risk and protective processes can guide the development of interventions to improve acceptability.