Videotape-based HIV Prevention Intervention

描述(申请人提供)：艾滋病干预计划源于社会认知理论，基于认知-行为原则，在改变艾滋病毒高危行为方面展示了最大的希望。不幸的是，由于社区组织依赖于在认知行为技能技术方面有专长的专业干预者，认知行为干预还不能转移到社区组织以实现成本效益。相比之下，依靠录像带促进技能培养的干预措施为指导艾滋病毒预防干预措施的提供提供了一种负担得起且易于实施的机制。到目前为止，基于录像带的降低风险的技能培养方法只在男性身上进行了测试，还没有被独立复制。这项申请要求四年的研究支持，以适应、实施和评估在低收入非裔美国人男性和女性中使用录像带进行的艾滋病毒减少风险技能培训干预的有效性，以努力增加基于视频的技能培训的普及性。400名符合高危行为标准的非裔美国人男性(N=200)和女性(N=200)将被随机分配到两个实验条件之一：(1)由社区组织工作人员通过录像带提供的基于认知行为原则的全面减少艾滋病毒风险干预，并提供最少的咨询和促进者技能培训；或(2)仅接受时间和接触匹配的标准艾滋病毒教育控制条件。因此，本研究将使用2(干预)条件×2性别因素设计来检验以下假设：(1)相对于对照组，HIV预防干预预期会导致HIV相关知识的增加、对HIV风险的敏感化，以及改变危险行为的意图；(2)HIV预防干预主义预期会导致对减少行为的自我效能感的提高，以及在与性伴侣的沟通方式中降低风险的有效性的提高；(3)与对照组相比，艾滋病毒预防干预的参与者在无保护的性行为中的行为改变、性伴侣数量的减少和避孕套的使用方面预计将经历更大的减少和更长时间的维持。如果通过录像带和社区促进者提供技能指导被证明是成功的，我们将确立基于录像带的艾滋病毒预防干预的普适性，作为在非裔美国人男性和妇女中预防艾滋病毒的一种可行且具有成本效益的方法。

DESCRIPTION (provided by applicant): AIDS Intervention Programs that are derived from social cognitive theory and based on cognitive-behavioral principles have demonstrated the greatest promise in changing HIV high-risk behaviors. Unfortunately, cognitive behavioral interventions have not been transferable to community-based organizations for cost effective implementation due to their dependence on professional interventionists with expertise in cognitive behavioral skills techniques. In contrast, interventions that rely on videotapes to facilitate skills building provide an affordable and easily implemented mechanism for guiding the delivery of HIV prevention interventions. To date, videotape-based skills building approach to risk reductions has only been tested with men and has not been independently replicated. This application requests four years of support of research to adapt, implement, and evaluate the efficacy of an HIV-risk reduction skills training intervention conducted with videotapes among low income African American men and women in an effort to increase the generalizability of video-based skills training. Four hundred African American men (N=200) and women (N=200) who meet high-risk behavior criteria will be randomly assigned to one of two experimental conditions: (1) A comprehensive HIV-risk reduction intervention based on cognitive behavioral principles delivered by videotape and facilitated by community organization staff with minimal training in counseling and facilitator skills techniques; or (2) A time- and contact- matched standard HIV education only control condition. The study will therefore use 2 (intervention) conditions X 2 gender factor designs to test the following hypotheses: (1) The HIV prevention intervention is expected to result in increased HIV-related knowledge, sensitization to HIV-risk, and intentions to change risk behaviors relative to the control group; (2) The HIV prevention interventionism expected to result in increased self-efficacy for reducing behaviors and increased effectiveness in communicating ways to reduce risk with sexual partners; (3) Participants in the HIV prevention intervention are expected to experience significantly greater reductions and longer-lasting maintenance of behavior change in unprotected sexual intercourse, decreased numbers of sexual partners, and increased use of condoms relative to the control group. If the delivery of skills instruction via videotape and community facilitators proves successful, we will have established the generalizability of videotape-based HIV prevention intervention as a feasible and cost effective method of HIV prevention among African American men and women.