Enhanced STI/HIV Partner Notification in South Africa

描述(申请人提供)：这项为期5年的研究将对在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随机临床试验，以降低基于文化的理论为基础的行为风险和增强的伴侣通知干预。在世界上最严重的艾滋病毒流行中，生活在受影响最严重地区的南非人中，多达五分之一的人艾滋病毒呈阳性。本研究中的实验干预以健康行为改变的社会认知理论为基础，并已在初步研究中进行了预先测试。干预包括一次60分钟的风险降低咨询会议，其中包含行为技能构建组件，以增强合作伙伴的沟通技能，从而改进合作伙伴通知。研究设计包括两个比较条件：没有伴侣沟通和通知技能增强的行为风险降低咨询，以及标准的教学健康信息条件。我们将从开普敦的一家大型性传播感染诊所招募525名男性和525名女性。参与者将是接受性病服务的18岁或18岁以上的性病门诊患者。参与者将接受基线评估和随机分组，以接受(A)60分钟基于理论和文化定制的减少风险和合作伙伴沟通/通知干预；(B)60分钟减少风险咨询干预，不包括合作伙伴沟通/通知部分；或(C)时间和联系人匹配的60分钟标准教学健康信息会议。参与者将在干预后接受为期12个月的跟踪调查。 这项研究将测试对两个主要终端的干预效果：签订新的STI和客观衡量的合作伙伴通知事件。这项随机试验将确定降低风险干预对接受性传播感染诊所服务的南非男性和女性的效果。我们还将测试合作伙伴通知对STI结果的中介作用。因此，这项研究的结果将检验南非迫切需要的以诊所为基础的艾滋病毒预防干预模式。

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.