Experimental Analysis of HIV Risk Assessment Reactivity in South African Clinics

描述（由申请人提供）：此修订后的申请，提交了响应程序公告05-090“行为科学的方法和测量”，提出了行为评估反应性的实验分析，同时生成关于南非性传播疾病（STD）诊所患者有希望的HIV预防干预的额外疗效数据。我们的主要目的是研究公共卫生的影响和机制的影响，艾滋病毒的风险行为评估艾滋病毒的风险行为和艾滋病毒预防干预的结果在样本的性病门诊患者在开普敦，南非，一个严重影响艾滋病毒和艾滋病毒相关的耻辱。将1500名患者（50%）随机分配至所罗门四组实验设计扩展的条件。通过额外类型的基线评估，实验是2（HIV风险降低干预：增强与标准护理咨询）x 3（基线行为访谈：无与一般与详细）析因设计。这两个实验性基线行为访谈类似于目前主要的艾滋病预防试验中使用的访谈，并且在要求参与者关注特定风险行为实例的数量上有所不同。我们预期详细访谈会比一般访谈导致更多的评估反应，并且单独的详细访谈会导致风险行为的减少。我们还将测试假设的基础上的变体的自我意识理论的机制，调解和适度的评估反应。这项研究的结果将与预防科学领域以及南非的艾滋病毒预防有关。这项研究将是第一个通过实验将基线评估的影响与有效促进安全性行为的艾滋病毒预防干预的影响分开的研究。该研究也将是健康领域中第一个探索评估反应发生的认知和人际过程以及自我报告风险行为后适度行为变化的因素的研究。关于公共卫生的好处，这些结果将有助于确定如何最大限度地提高预防干预措施的效果传播到社区组织，并可能有助于制定简短的，动机增强艾滋病毒风险降低干预措施，利用评估的反应。结果也将与杀微生物剂试验有关，这些试验通常使用重复的详细行为评估，这可能会改变参与者使用杀微生物剂的意愿并扭曲结果。

DESCRIPTION (provided by applicant): This revised application, submitted in response to Program Announcement 05-090 "Methodology and Measurement in the Behavioral Sciences," proposes an experimental analysis of behavioral assessment reactivity, while generating additional efficacy data on a promising HIV prevention intervention for South African sexually transmitted disease (STD) clinic patients. Our primary aim is to examine the public health impact and mechanisms underlying the effects of HIV risk behavior assessment on HIV risk behavior and on HIV prevention intervention outcomes in a sample of STD clinic patients in Cape Town, South Africa, an area severely affected by HIV and HIV-related stigma. 1500 patients (50%) women will be randomly assigned to condition in a extension of the Solomon Four Group experimental design. With an additional type of baseline assessment, the experiment is a 2 (HIV risk reduction intervention: enhanced vs. standard of care counseling) x 3 (baseline behavioral interview: none vs. general vs. detailed) factorial design. The two experimental baseline behavioral interviews are analogous to those currently used in major HIV prevention trials, and differ in the amount they require participants to focus on specific instances of risk behavior. We expect that the detailed interview will lead to more assessment reactivity than the general interview and that the detailed interview alone will lead to reductions in risk behavior. We will also test hypotheses based on variants of self-awareness theory regarding the mechanisms that mediate and moderate assessment reactivity. Results of this study will be relevant to the field of prevention science as well as to HIV prevention in South Africa. This study will be the first to experimentally disentangle the influence of baseline assessments from that of an HIV prevention intervention effective at promoting safer sexual behaviors. The study will also be the first in the health domain to explore the cognitive and interpersonal processes by which assessment reactivity occurs and the factors that moderate behavior change following self-reports of risk behavior. Regarding public health benefits, these results will help to determine how to maximize the effects of prevention interventions disseminated to community based organizations, and may help to develop brief, motivation-enhancing HIV risk-reduction interventions that capitalize on assessment reactivity. Results will also be relevant to microbicide trials that often use repeated detailed behavioral assessments, which may alter participants' willingness to use the microbicide and distort the outcomes.