Venue-Based Recruitment and HIV Prevention for AOD Using Couples in South Africa

项目摘要/摘要 南非之前的研究发现，问题饮酒、性风险和基于性别的暴力是 相关行为患病率高。研究表明，赋权干预增加了 通过技能建设活动的自我效能感减少了危险行为。然而，仍有大量的 关于干预措施如何处理这些危险行为的相互关系的知识差距 以及这些行为如何受到环境因素(例如，地点)的影响 人们在哪里喝酒，这些饮酒场所及其周围的暴力行为，以及邻里特征)。这 建议有必要测试针对发生危险行为的饮酒场所的顾客的干预措施 以及在这些场馆附近进行艾滋病毒预防干预，以挑战 社区行为。这项提议通过从以下地点进行基于地点的招聘来回应这一需求 通过地理信息系统(GIS)识别的随机街区中的饮酒场所 映射到三个研究条件。拟议的美国和南非调查小组将建立 在最初的研究中，通过首先关注环境来解决这些相互关联的危险行为 背景和关于将小组随机社区试验的拟议干预措施细化为以下之一 个人评估、艾滋病毒检测和团体干预的三种干预条件 在饮酒场所外的移动单元中进行。这三项干预是条件1--男性的控制 团体和女人的笼子；条件2-男人作为伙伴和女人的笼子；和条件3-男人作为 《伴侣》、《女人的笼子》和《夫妻会话》。女人的笼子和夫妻俩都有证据- 已在国际上采用的以艾滋病毒为基础的干预措施。《男人做伴侣》在韩国开展 非洲，以及全世界。这项建议的具体目标是： 目标1.描述饮酒场所的类型(例如，许可证状况和规模)及其直接背景 (例如，观察到其他毒品的可获得性、暴力和性活动)以及周围社区 在两个大的社区街区中抽样的特征(例如，饮酒场所的数量) 南非开普敦的黑人/非洲人和有色人种社区。 目标2.通过定性方法提炼与技能建设有关的拟议干预措施，以 解决性别角色期望、性伙伴关系、性别权力、暴力和 饮酒和性危险行为时有发生。 目的3.进行随机分组试验，比较综合干预的相对效果 (条件3：强化夫妻)、以性别为重点的干预(条件2：性别)和 条件1：男性对AOD使用的控制和女性对AOD使用、性危险行为和性别的限制 在6个月和12个月的随访中发生暴力事件。

PROJECT SUMMARY/ABSTRACT Previous studies in South Africa have identified problem drinking, sexual risk, and gender-based violence as high prevalence interrelated behaviors. Research has shown that empowering interventions that increase self-efficacy through skills-building activities have reduced risky behavior. However, there is still a substantial gap in knowledge regarding how interventions might address the interrelationships of these risky behaviors between men and women and how these behaviors are influenced by environmental factors (e.g., place where people drink, violence in and around these drinking venues, and neighborhood characteristics). This suggests a need to test interventions that target patrons of drinking venues where these risk behaviors occur as well as conducting HIV prevention interventions in close proximity to these venues to challenge community behaviors. This proposal responds to this need by conducting a venue-based recruitment from drinking venues in randomized neighborhood blocks identified through geographic information systems (GIS) mapping to three study conditions. The proposed team of U.S. and South African investigators will build upon its initial studies to address these interrelated risk behaviors by first focusing on the environmental context and on refining the proposed interventions for the group randomized trial of neighborhoods to one of three intervention conditions in which individual assessments, HIV testing, and group interventions will be conducted in a mobile unit outside drinking venues. The three interventions are Condition 1-Men's Control Group and Women's CoOp; Condition 2-Men as Partners and Women's CoOp; and Condition 3-Men as Partners, Women's CoOp, and Couples' Sessions. Both the Women's CoOp and the couples are evidenced- based HIV interventions that have been adapted internationally. Men as Partners is conducted in South Africa, as well as worldwide. The specific aims of this proposal are: Aim 1. To characterize the types of drinking venues (e.g., licensure status and size), their immediate context (e.g., observed availability of other drugs, violence and sexual activity), and surrounding neighborhood characteristics (e.g., number of drinking venues) in the sampled neighborhood blocks in two large Black/African and Coloured communities in Cape Town, South Africa. Aim 2. To refine through qualitative methods the proposed interventions in relation to skills-building to address gender-role expectations, sexual partnering, gender power, violence, and environments where drinking and sexual risk behaviors occur. Aim 3. To conduct a randomized group trial to compare the relative efficacy of a comprehensive intervention (Condition 3: Enhanced Couples) to the gender-focused intervention (Condition 2: Gender) and to Condition 1: Men's Control and Women's CoOp on AOD use, sexual risk behavior, and gender-based violence at 6- and 12-month follow-ups.