Motivating HIV Risk-Reduction

描述（由申请人提供）：此申请是对PA的回应

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.