Health Promotion for South African University Students

描述(由申请者提供)：这份R34申请寻求3年的支持，以开发和进行针对南非大学生的艾滋病毒/性传播感染风险降低干预措施的初步试点测试。这项研究具有重大的公共卫生意义，因为包括南非在内的撒哈拉以南非洲国家普遍存在艾滋病毒流行，艾滋病毒/艾滋病的发病率是世界上最高的。与大多数撒哈拉以南非洲国家一样，南非的主要感染方式是异性接触。在普遍的艾滋病毒流行中，遏制艾滋病毒的性传播需要行为干预，以接触到所有从事危险行为的人群。很少有研究测试针对普遍流行的撒哈拉以南非洲国家的大学生的艾滋病毒性行为风险降低干预措施。因此，这项拟议研究的广泛、长期目标是确定干预措施，以劝阻撒哈拉以南非洲的大学生从事HIV性危险行为。具体目标是：(A)制定基于理论、与背景相关的减少艾滋病毒性行为风险的干预措施；(B)就与性行为无关的健康问题，对其效力与促进健康的控制干预措施进行试点测试；(C)探讨参与者的性别或国籍是否影响其效力；以及(D)确定其效力的中介因素。该方法借鉴了社会认知理论、理性行动理论、计划行为理论和对研究人群的形成性研究。主要结果是通过音频计算机辅助自我访谈(ACASI)收集干预前前3个月和6个月和12个月随访时的无保护性行为频率。次要结果包括禁欲发生率、多个性伴侣、持续使用避孕套和理论中介变量，包括意图、信念和自我效能。这项探索性研究将产生有价值的初步数据，以支持随后的R01实施全面的群集式随机对照试验，以测试在世界上一个普遍的艾滋病毒流行正在造成最具破坏性的人类伤亡的地区，针对大学生的HIV性风险降低干预的有效性。

DESCRIPTION (provided by applicant): This R34 application is seeks 3 years of support to develop and conduct a preliminary pilot test of an HIV/STI risk-reduction intervention for university students in South Africa. This research has great public health relevance because Sub-Saharan African countries, including South Africa, have a generalized HIV epidemic and the highest rates of HIV/AIDS in the world. The primary mode of infection in South Africa, as in most Sub-Saharan African countries, is heterosexual contact. In a generalized HIV epidemic, curbing sexual transmission of HIV requires behavioral interventions to reach all populations that engage in risk behavior. Few studies have tested HIV sexual risk-reduction interventions specific to university students in Sub-Saharan African countries with a generalized epidemic. Accordingly, the broad, long-term objective of the proposed research is to identify interventions to dissuade university students in Sub-Saharan Africa from engaging in HIV sexual risk behaviors. The Specific Aims are to; (a) develop a theory-based, contextually relevant HIV sexual risk-reduction intervention, (b) conduct a pilot test of its efficacy as compared with a health-promotion control intervention on health issues unrelated to sexual behavior, (c) explore whether participants' gender or nationality moderates its efficacy, and (d) determine the mediators of its efficacy. The approach draws on social cognitive theory, the theory of reasoned action, the theory of planned behavior, and formative research with the study population. The primary outcome is frequency of unprotected intercourse in the previous 3 months collected preintervention and at 6- and 12- month follow-up via audio-computer-assisted self-interviewing (ACASI). Secondary outcomes include incidence of abstinence, multiple sexual partners, and consistent condom use and theoretical mediator variables, including intentions, beliefs, and self-efficacy. This exploratory research will yield valuable preliminary data to support a subsequent R01 to implement a full-scale clustered randomized control trial to test the efficacy of a HIV sexual risk-reduction intervention for university students in a region of the world where a generalized HIV epidemic is taking a most devastating human toll.