Changing Behavior in Repeat HIV Testers

描述(申请人提供)：来自加州大学旧金山分校艾滋病健康项目、加州大学旧金山分校艾滋病预防研究中心和旧金山分校的合作小组 旧金山公共卫生部提议一项为期三年的随机、 旨在改变的单次咨询干预的对照试验 感染艾滋病毒风险最高的男性的行为：那些继续从事 与男性发生高危性行为，并反复检测艾滋病毒。人群中艾滋病毒的发病率 这样的人--测试过三次或更多的人--几乎是这个数字的三倍 在旧金山的所有其他测试者中。干预措施帮助了个人 识别并重新评估他们的“自我辩解”，也就是思想， 当他们从事不受保护的行为时，他们头脑中出现的态度或信念 肛交。在对这种方法进行了成功的研究后，团队 聘请了心理健康专家进行干预，该团队现在 希望测试干预措施的效果 作为风险评估不可或缺的一部分的准专业顾问 艾滋病毒抗体咨询的组成部分(“检测前咨询”)。要完成 这，300名男性将被招募，当他们打电话来安排匿名HIV 抗体检测。参与者必须报告无保护肛门插入或接受 在过去12个月内与非主要性伴发生性关系，以及3个月或以上 之前的艾滋病毒检测。参与者将被随机分配到干预组 (强化的考前咨询)或对照组(标准的考前咨询) 并将在6个月和12个月时完成后续访谈。主要结果是 措施将改变无保护措施肛交的发作次数 非主要合作伙伴。参与者对考试前咨询的满意度将 也可以测量和比较组间的差异。这项研究将回答一个 实际问题：这种以理论为基础的单次咨询能否 由训练有素的准专业顾问进行的干预导致 降低一组高危男性的风险？一个肯定的回答将是 对提高艾滋病毒咨询有效性的直接影响 在全国范围内并有可能减少艾滋病毒的传播。

DESCRIPTION (provided by applicant): A collaborative team from the UCSF AIDS Health Project, the UCSF Center for AIDS Prevention Studies, and the San Francisco Department of Public Health proposes a three-year, randomized, controlled trial of a single-session counseling intervention designed to change the behavior of men at greatest risk of HIV: those who continue to engage in high-risk sex with men and who repeatedly test for HIV. HIV incidence among such men-individuals who had tested three or more times-was almost triple that of all other testers in San Francisco. The intervention helps individuals identify and re-evaluate their "self-justifications," that is, the thoughts, attitudes, or beliefs present in their minds when they engage in unprotected anal sex. Following a successful study of this approach, in which the team employed mental health professionals to conduct the intervention, the team now wishes to test the efficacy of the intervention when performed by paraprofessional counselors as an integral part of the risk assessment component of HIV antibody counseling ("pre-test counseling"). To accomplish this, 300 men will be recruited when they call to schedule an anonymous HIV antibody test. Participants must report unprotected anal insertive or receptive sex with a non-primary partner in the prior 12 months, and three or more previous HIV tests. Participants will be randomized to the intervention group (enhanced pre-test counseling) or control group (standard pre-test counseling) and will complete follow-up interviews at 6 and 12 months. The primary outcome measure will be change in the number of episodes of unprotected anal sex with non-primary partners. Participant satisfaction with pre-test counseling will also be measured and compared between the groups. This study will answer a practical question: can this theory-based, single-session counseling intervention, conducted by trained paraprofessional counselors, result in reduced risk among a group of high-risk men? An affirmative answer will have immediate implications for improving the effectiveness of HIV counseling nationwide and potentially reducing transmission of HIV.