Enhanced STI/HIV Partner Notification in South Africa

描述（由申请人提供）：这项为期5年的研究将对南非接受性传播感染（STI）诊断和治疗服务的男性和女性进行一项基于文化定制的基于理论的行为风险降低和增强伴侣通知干预的随机临床试验。在世界上最严重的艾滋病毒流行病中，生活在受影响最严重地区的南非人有五分之一是艾滋病毒阳性。本研究的实验干预以健康行为改变的社会认知理论为基础，并在前期研究中进行了预先测试。干预包括一个单独的60分钟的风险降低咨询会议，其中包括行为技能建设部分，以提高伴侣沟通技巧，改善伴侣通知。研究设计包括两个比较条件：无伴侣沟通和通知技能增强的行为风险降低咨询和标准教学健康信息条件。我们将从开普敦的一家大型性病诊所招募525名男性和525名女性。参与者将是18岁或以上接受性传播感染服务的性传播感染诊所患者。参与者将进行基线评估并随机接受(a) 60分钟基于理论和文化定制的风险降低和伴侣沟通/通知干预；(b) 60分钟的降低风险咨询干预，不包括伴侣沟通/通知内容；或者(c)时间和接触方式与60分钟的标准教学健康信息会议相匹配。参与者将在干预后随访12个月。

DESCRIPTION (provided by applicant): This 5-year study will conduct a randomized clinical trial of a culturally tailored theory-based behavioral risk reduction and enhanced partner notification intervention for men and women who are receiving sexually transmitted infection (STI) diagnostic and treatment services in South Africa. Among the world's most severe HIV epidemics, as many as one in five South Africans living in the most affected areas are HIV positive. The experimental intervention in this study is grounded in social-cognitive theories of health behavior change and has been pre-tested in preliminary research. The intervention consists of a single 60-minute risk reduction counseling session with behavioral skills building components to enhance partner communication skills for improved partner notification. The study design includes two comparison conditions: behavioral risk reduction counseling without partner communication and notification skills enhancement, and a standard didactic health information condition. We will recruit 525 men and 525 women from a large STI clinic in Cape Town. Participants will be STI clinic patients age 18 or older who are receiving STI services. Participants will be baseline assessed and randomized to receive either (a) the 60-minute theory-based and culturally tailored risk reduction and partner communication/notification intervention; (b) a 60-minute risk reduction counseling intervention without partner communication/notification components; or (c) a time and contact matched 60-minute standard didactic health information session. Participants will be followed for 12 months post intervention. The study will test intervention effects on two primary endpoints: contracting new STI and objectively measured partner notification events. The randomized trial will determine the efficacy of the risk reduction intervention for South African men and women receiving STI clinic services. We will also test the mediating effects of partner notification on STI outcomes. Results of this research will therefore test a clinic-based HIV prevention intervention model that is urgently needed in South Africa.