Motivating HIV Risk-Reduction

描述(申请人提供)：本申请是对PA的回应 “预防艾滋病传播的简要干预措施”(PA 95-070)和要求3 支持进行一项随机对照试验的百分比 基于理论的电话传递简短的激励性增强干预。 试点测试数据为此次干预的可行性和可行性提供了强有力的支持 功效。以信息-动机-行为为导向的“性体检” 技能(IMB)健康行为改变模型，专为MSM量身定做 由于不安全的性行为而处于艾滋病毒传播高危状态的人，但是 既不是自发的变化，也不是寻求降低风险的支持。三 将通过卫生部门招募156名16岁及以上的男男性接触者 诊所、当地媒体和社区外展工作，并随机分配到 两种通过电话传递的干预措施之一，这两种干预措施都将 由当地公共卫生部门的健康教育人员提供。这个 实验条件包括一次临床病史访谈和两次 后续会话。辅导员运用激励性的面试技巧 以及认知行为咨询技术，以增强参与者的 随时准备应对变化，提供有关艾滋病毒和性传播疾病的准确信息，协助 制定目标，并就实现降低风险的方法制定战略。这个 控制状况，代表了当前的护理标准，重点是 提供艾滋病毒和性传播疾病教育。所有参与者将在一周内接受重新评估 在他们的干预之后以及在4、7和13个月的周年纪念日 他们的基线评估。如果被证明是有效的，实验 干预措施有望对该计划的两个目标做出回应 公告：(1)必须制定艾滋病毒预防方案，使人们能够接触到 世卫组织可能不会主动寻求艾滋病毒预防计划来改变高风险 行为；和(2)需要艾滋病毒预防干预措施 在诊所和其他初级卫生保健机构实施。 考虑到技术的障碍，目标尤其重要 迄今经验性检验的艾滋病毒预防干预措施的转让。这 干预措施、实施方式、招募参与者的程序、 以及将开发的用户就绪协议，以促进技术转让 都旨在满足提供商在决定时可能使用的标准 如证实有效，是否采取干预措施：(1) 干预将产生积极的公共卫生影响，(2)它将是 有效地接触到高危人群，否则他们不太可能 (3)实施成本不会过高；(4) 实施干预的复杂性不会超出其能力范围 现有的健康教育人员。

DESCRIPTION (provided by applicant): This application is in response to the PA "Brief Interventions to Prevent the Spread of AIDS" (PA 95-070) and requests 3 percent years of support to conduct a randomized controlled trial of a theory-based telephone-delivered brief motivational enhancement intervention. Pilot test data offer strong support for this intervention's feasibility and efficacy. "The Sex Check-Up," guided by the Information-Motivation-Behavioral Skills (IMB) model of health behavior change, is tailored specifically for MSM who are at high risk of HIV transmission due to unsafe sexual behaviors, but are neither self- initiating change nor seeking risk-reduction support. Three hundred fifty-six MSM, age 16 and older, will be recruited through health clinics, local media, and community outreach efforts, and randomly assigned to one of two telephone- delivered interventions, both of which will be delivered by health educators with the local Department of Public Health. The experimental condition is comprised of a clinical history interview and two subsequent sessions. The counselor utilizes motivational interviewing skills and cognitive-behavioral counseling techniques to enhance the participant's readiness for change, provide accurate information about HIV and STDs, assist with goal-setting, and strategize about ways of achieving risk-reduction. The control condition, representing a current standard of care, focuses on the delivery of HIV and STD education. All participants will be reassessed one week following their intervention and at the 4, 7, and 13-month anniversaries of their baseline assessment. If shown to be effective, the experimental intervention holds promise of being responsive to two objectives in the Program Announcement: (1) HIV prevention programs "must be developed to reach people who may not proactively seek HIV prevention programs to change high risk behavior;" and (2) HIV prevention interventions are needed "that can be implemented in clinics and other primary health care facilities." The latter objective is of particular importance given the obstacles to technology transfer of HIV-prevention interventions empirically tested thus far. This intervention, its mode of delivery, the procedures for participant recruitment, and the user-ready protocols to be developed to facilitate technology transfer are all intended to meet criteria that providers are likely to use in deciding whether to adopt the intervention if it is shown to be efficacious: (1) the intervention will have a positive public health impact, (2) it will be efficacious in reaching individuals at high risk who otherwise would not likely be reached, (3) the costs for its implementation will not be excessive, and (4) the complexity in delivering the intervention will not be beyond the capacity of existing health education staff.