Gender Violence and HIV Risk Reduction in South Africa

说明(由申请人提供)：这份修订后的提案要求提供4年的支持，以开展发展研究，为南非开普敦有对妇女实施暴力行为的风险以及感染和传播艾滋病毒的风险的男性设计和实地测试基于性别和理论的行为风险减少干预措施。多达五分之一的南非人艾滋病毒呈阳性，据估计，南非每天有1600名新的艾滋病毒感染者。南非对妇女的暴力发生率也是世界上最高的，性胁迫与妇女感染艾滋病毒的风险增加有关。在社会建构主义的性别理论和健康促进行为的信息-动机-行为技能模型的指导下，我们将进行三个阶段的干预发展研究：(第一阶段)在开普敦一个乡镇的社区中心对男性和女性进行初步访谈、焦点小组和定量调查。根据快速形成研究获得的信息，这项研究的第一阶段将制定以理论为基础的基于性别的暴力和减少艾滋病毒相关风险的干预措施；(第二阶段)在小样本男性中测试新制定的干预措施的可行性，并从社区妇女那里获得对干预内容的反馈。第二阶段还将测试在社区中心进行音频计算机辅助访谈以收集数据的可行性；以及(第三阶段)进行随机实地测试，以确定降低风险干预措施对面临基于性别的暴力和艾滋病毒风险的南非男子的潜在效果。现场测试的参与者将被随机分配到接受新开发的干预或时间匹配的注意力比较条件。在6个月的随访期后，我们将评估不同组之间行为结果的差异。我们还将测试基于性别的态度和信念对艾滋病毒风险降低结构和干预结果的缓和作用。拟议的研究结果还将提供有关性别力量差异、对妇女的态度和艾滋病污名在南非艾滋病毒传播风险中的作用的关键信息，并将为改善南非的艾滋病毒预防干预措施提供迫切需要的战略。

DESCRIPTION (provided by applicant): This revised proposal requests 4 years of support to conduct developmental research to design and field-test a gender and theory-based behavioral risk reduction intervention for men who are at risk for perpetrating violence against women and at risk for contracting and transmitting HIV in Cape Town, South Africa. As many as one in five South Africans is HIV positive and there are an estimated 1,600 new HIV infections in South Africa each day. South Africa also has the world's highest rates of violence against women and sexual coercion is associated with women's increased risks for HIV infection. Guided by the social constructionist theory of gender and the Information-Motivation-Behavioral Skills model of health promoting behaviors we will conduct 3 stages of intervention development research: (Stage 1) initial interviews, focus groups, and quantitative surveys with men and women in a community center in a Cape Town township. Based on information gained from rapid formative studies, this first phase of research will develop a theory-based gender-based violence and HIV-related risk reduction intervention; (Stage 2) Test the feasibility of the newly developed intervention with a small sample of men and receive feedback on the intervention content from women in the community. Stage 2 will also test the feasibility of an audio-computer assisted interview for data collection in the community center; and (Stage 3) Conduct a randomized field test to determine the potential efficacy of the risk reduction intervention for South African men at risk for gender-based violence and HIV. Participants in the field test will be randomly assigned to either receive the newly developed intervention or a time matched attention comparison condition. Following a 6-month follow-up period, we will assess differences between groups on behavioral outcomes. We will also test the moderating effects of gender-based attitudes and beliefs on HIV risk reduction constructs and intervention outcomes. Results of the proposed research will also provide critical information about the role of gender power differentials, attitudes toward women, and AIDS stigmas in HIV transmission risks in South Africa and will offer urgently needed strategies for improving HIV prevention interventions in South Africa.