HIV/AIDS Prevention for Men with Intellectual Disabilities

描述（由申请人提供）：此申请的目的是为有轻度和中度智力残疾（智商约为940至75）的成年男性开发一个完全互动的、多媒体计算机光盘的艾滋病毒/艾滋病预防课程。这个原型（即最初的第一阶段开发工作）将侧重于与性行为有关的艾滋病毒/艾滋病传播和预防。第一阶段项目“现在就尊重”将开发一个功能齐全的交互式CD-ROM原型，解决a)通过性接触传播艾滋病毒/艾滋病（即，艾滋病毒/艾滋病是什么，高危性液体，性行为），以及b)对避孕套的使用负责（即，避孕套是什么，在哪里购买，如何方便使用，如何将避孕套戴在阴茎上）。所有内容都将根据性行为、表达的性兴趣（异性恋、双性恋或同性恋）和对内容的掌握程度来定制。形成程序（即焦点小组和电话访谈）将用于识别具有身份的男性特有的艾滋病毒/艾滋病风险问题（例如，社会适当的回应；默许；缺乏识别剥削关系的能力，被动等），以告知节目内容，剧本编写和框架。为了证明我们的方法的可行性，我们对目标用户群体进行了一期项目的评估：具有轻度和中度身份识别的成年男性和服务提供商，他们将与客户一起购买和使用该项目。这种评估方法将使我们能够确定，该项目适用于患有轻度和中度性认知障碍的男性，有效地教会他们如何传播和避免艾滋病毒/艾滋病，以及如何使用避孕套，他们对基本的消费者满意度因素给予了很高的评价。此外，我们将确认服务提供者认为该程序适合他们的客户，它提供了重要信息，他们会使用它并将其推荐给他们的同事。这两项评估活动的积极结果将验证第二阶段产品的进展。在第二阶段，该方案将扩大到解决基于关系的艾滋病毒/艾滋病预防策略和艾滋病毒/艾滋病检测。为了评估这一扩大的项目，我们将对至少150名有身份证的男性和40名专业评估人员进行随机等候名单对照现场测试。

DESCRIPTION (provided by applicant): The purpose of this application is to develop a fully interactive, multimedia computer-based CD-ROM HIV/AIDS prevention curriculum for adult men with mild and moderate intellectual disabilities (I.Q. approximately 940 through 75). This prototype (i.e., initial Phase I development effort) will focus on HIV/AIDS transmission and prevention related to sexual behavior. The Phase I program, "Respect Now" will develop a fully functional interactive CD-ROM prototype that addresses a) transmission of HIV/AIDS through sexual contact (i.e., what HIV/AIDS is, high-risk sexual fluids, sexual behavior), and b) taking responsibility for condom usage (i.e., what a condom is, where to purchase them, keeping them handy, how to put a condom on a penis). All content will be tailored by sexual behavior, by expressed sexual interest (heterosexual, bisexual or homosexual), and content mastery. Formative procedures (i.e., focus groups and telephone interviews) will be used to identify HIV/AIDS risk issues unique to men with ID (e.g., socially-appropriate responding; acquiescing; lack of ability to identify exploitative relationships, passivity, etc.) to inform program content, scriptwriting, and framing. To demonstrate the feasibility of our approach by evaluating the Phase I program with both of our targeted user groups: adult men with mild and moderate ID and service providers who would purchase and use the program with their clients. This evaluative approach will allow us to establish that the program is useable by men with mild and moderate ID, effective at teaching them about the transmission and avoidance of HIV/AIDS, and condom use, and that they rate it highly on essential consumer satisfaction factors. In addition, we will confirm that the program is seen by service providers as appropriate for their clients, that it provides vital information and that they would use it and recommend it to their colleagues. Positive outcomes on both these evaluative activities will validate moving forward with a Phase II product. At Phase II, the program will be expanded to address relationship-based HIV/AIDS avoidance strategies and getting tested for HIV/AIDS. To evaluate this expanded program, we will conduct a randomized wait-list control field test with at least 150 men with ID and 40 professional evaluators. PUBLIC HEALTH RELEVANCE: While there continues to be little research on the prevalence of HIV/AIDS among people with intellectual disabilities (ID), there is reason to believe that the prevalence of HIV/AIDS in men with ID is similar to, if not greater than, that of the non-ID population. Research has shown that people with disabilities are more likely than their nondisabled peers to have been tested for HIV, however this is not true for people with ID. In fact, people with ID are significantly less likely to be tested for HIV (Neri, Bradley, & Groce, 2007). Men with ID who have sex with non-ID men commonly engage in sexual acts which are emotionally and physically painful, are characterized by extreme power imbalance, and because of their passivity, prone to unsafe sex practices (Thompson, 1994). The literature indicates that these men are highly susceptible to sexual exploitation by males without ID, and in our preliminary studies, by non-ID female addicts, both of which contribute to a significant risk for their contracting HIV/AIDS. Furthermore, males with ID are not infrequently involved in sexual behavior with other men, however they are not gay-identified, more often "trading favors" with their peers (Cambridge, 1997; Thompson, 1994). There is a significant need to assure all men with ID have the tools to make safer sexual decisions and avoid contracting HIV/AIDS.