Syntheses of HIV Prevention Research, Phase III

描述（由申请人提供）：这种竞争性的更新将提供持续支持的艾滋病毒/艾滋病研究项目（夏普）的合成。这些研究将集中在艾滋病毒风险降低干预措施的有效性的核心因素的问题上，针对与干预内容，风险行为改变的维持和艾滋病毒预防的结构性干预措施相关的三个相互关联的具体目标中的每一个进行一系列研究。首先，将在广泛的艾滋病毒预防研究中对强化的心理社会行为干预措施进行内容分析，这些方面将与试验的功效相关。还将对纳入个别试验的结构方面进行评价。这些结果不仅将为关键内容维度提供信息，还将突出未来干预试验报告要求的改进。其次，理论驱动的荟萃分析将研究如何最好地维持性风险行为的改变，以及如何成功地避免性感染，重点依次是青少年，异性恋女性，与男性发生性关系的男性和非洲裔美国人;每一个都将考虑支持性的社会环境在促进或阻碍疗效方面的作用。此外，有些人将在试验开始时审查整个人群的预防工作以及艾滋病毒知识的作用和受保护的性行为水平。第三，将对有关通过社会和政策结构的变化预防艾滋病毒的文献进行荟萃分析，这些变化影响到预防行动的提供，包括避孕套的提供和避孕套使用政策、针头交换方案以及增加性传播感染服务。通过仔细总结这些重要且快速增长的文献中迄今为止的证据，这些荟萃分析将告知公共卫生官员，社区干预人员和科学家哪些干预措施效果最好，干预措施的哪些组成部分影响最大，以及在何种情况下降低艾滋病毒风险的干预措施最有可能产生持久的变化。

DESCRIPTION (provided by applicant): This competing renewal will provide continuing support for the Syntheses of HIV/AIDS Research Project (SHARP). The studies will center on issues central to factors that underlie the efficacy of HIV risk-reduction interventions, with a series of studies conducted for each of three interrelated specific aims related to intervention content, maintenance of risk behavior change, and structural interventions for HIV prevention. First, intensive, psychosocial behavioral interventions will be content-analyzed across a broad set of HIV prevention studies and these dimensions will be related to the trials' efficacy. Structural aspects integrated into individual trials will also be evaluated. These results will inform not only key content dimensions but also highlight improvements to reporting requirements of future intervention trials. Second, theory-driven meta-analyses will examine how sexual risk-behavior change can best be maintained and with what success sexual infections are averted, focusing in turn on adolescents, heterosexual women, men who have sex with men, and African-Americans; each of these will consider the role of supportive social milieus in facilitating or hindering efficacy. Moreover, some will examine prevention across populations and the roles of HIV knowledge and levels of protected sexual interactions at the outset of trials. Third, meta-analyses will be performed of the literatures relating to prevention of HIV through changes in social and policy structure that affect the availability of preventative actions, including condom availability and condom-use policies needle exchange programs, and increases in services for sexually transmitted infections. By carefully summing up the evidence to date on these important and quickly growing literatures, these meta-analyses will inform public health officials, community-based interventionists, and scientists about which interventions work best, which components of interventions have the largest impact, and the circumstances under which HIV risk-reduction interventions are most likely to be produce lasting change.