Behavioral Technologies for Predicting HIV Risk

描述(由申请人提供)：旨在提供关于艾滋病毒风险的准确、基于事实的信息的大规模名义预防方案提高了对艾滋病毒/艾滋病风险的认识；然而，这些方案在预防或减少青少年参与艾滋病毒相关风险行为方面的成功相对有限。最近的个性化、基于技能的预防计划减少了艾滋病毒相关的风险行为和实际感染的发生率，但个性化的计划可能成本高昂，可能难以融入社区环境。因此，最近的工作旨在根据青少年独特的脆弱性，确定和瞄准感染艾滋病毒风险最大的青少年。通常，研究人员完全依靠自我报告工具来确定参与艾滋病毒相关危险行为的脆弱性，但这些方法有几个限制，而且它们在识别高危青少年方面的成功有限。作为另一种方法，气球模拟风险任务-青年(BART；BART-Y)可以用来客观地评估冒险倾向，而且比自我报告量表不那么透明。这一方法已经显示出与危险行为的强烈的横截面关系，但很少有人研究这种方法在未来识别高危青年方面的效用。为此，R01 DA18647获得资助，以提供BART的第一个纵向测试。我们成功地招募了277名青年(10-12岁)及其家人参加基线评估；参与者的平均年龄为11.0岁(SD=.81)，43.7%的女性，49.3%的白人，35.5%的黑人，2.9%的西班牙裔，1.4%的亚洲/太平洋岛民，10.9%的混血或其他种族。随访率一直很高，2年级的青少年比例为89%，3年级的青少年完成评估的比例仅额外下降了2%至87%。在整个项目期间，获得了补充资金以扩大：1)另外400名10-12岁儿童的样本，2)包括负强化相关风险的行为测量的理论观点，以及3)评估的广度，包括有针对性的遗传标记以及体内环境背景评估，以提供对风险承担的基因x环境脆弱性的新评估。正如在目前的申请中概述的那样，到目前为止，我们有很强的调查结果，我们建议再提供5年的支助，以便在青年进入艾滋病毒危险行为将开始达到顶峰的时期时，为这项工作的继续提供支持。

DESCRIPTION (provided by applicant): Large-scale nomothetic prevention programs aimed at providing accurate, factual-based information regarding HIV risk have led to a greater awareness of HIV/AIDS risks; however, these programs have had relatively limited success in preventing or reducing engagement in HIV-related risk taking behaviors among adolescents. More recent individualized, skill-based prevention programs have led to a reduction in HIV-related risk taking behaviors as well as incidence of actual infection, but individualized programs can be costly and may be difficult integrate into community settings. Thus, recent work has aimed to identify and targeting adolescents most at risk for HIV infection, based on their unique vulnerabilities. Typically, researchers have relied exclusively on self-report instruments to determine vulnerability for engagement in HIV-relevant risk behaviors, but these approaches have several limitations, and their success in identifying at-risk adolescents has been limited. As an alternative approach, the Balloon Analogue Risk Task-Youth (BART; BART-Y) can be used to assess risk taking propensity in an objective and less transparent manner than self-report scales. This approach has shown strong cross-sectional relationships with risk behavior, but little has been done examining the utility of the approach for prospective identification of at-risk youth. Towards this end, R01 DA18647 was funded to provide the first longitudinal test of the BART. We were able to successfully recruit 277 youth (age 10-12) and their families into a baseline assessment; participants were on average 11.0 (SD = .81) years old, 43.7% female, 49.3% White, 35.5% Black, 2.9% Hispanic, 1.4% Asian/Pacific Islander, and 10.9% of mixed or other ethnicity. Follow-up rates have been excellent, with 89% of youth at Year 2, and only an additional drop of 2% to 87% of youth at Year 3 completing assessments. Throughout the project period, supplementary funds were secured to expand: 1) the sample with another 400 10-12 year olds, 2) the theoretical perspective to include behavioral measurement of negative reinforcement related risk taking, and 3) the breadth of the assessment to include targeted genetic markers as well as in-vivo assessment of environmental context to provide a novel assessment of gene x environmental vulnerability to risk taking. As outlined in the current application we have strong findings thus far and we propose another 5 year period of support to provide for the continuation of this work as the youth are progressing into a period where HIV risk behavior will begin to peak.