Health Promotion for South African University Students

描述（由申请人提供）：此R34申请寻求3年的支持，以开发和实施针对南非大学生的艾滋病毒/性传播感染风险降低干预措施的初步试点测试。这项研究具有重大的公共卫生意义，因为撒哈拉以南非洲国家，包括南非，艾滋病毒普遍流行，艾滋病毒/艾滋病发病率在世界上最高。与大多数撒哈拉以南非洲国家一样，南非的主要感染方式是异性性接触。在艾滋病毒普遍流行的情况下，遏制艾滋病毒的性传播需要采取行为干预措施，使所有从事危险行为的人口都能接触到。在普遍流行的撒哈拉以南非洲国家，很少有研究测试针对大学生的降低艾滋病毒性风险干预措施。因此，拟议研究的广泛、长期目标是确定干预措施，以劝阻撒哈拉以南非洲的大学生从事艾滋病毒性风险行为。具体目标是：(a)制定一项基于理论、与环境相关的降低艾滋病毒性风险干预措施，(b)开展一项试点试验，比较其与针对与性行为无关的健康问题的健康促进控制干预措施的效果，(c)探讨参与者的性别或国籍是否会调节其效果，以及(d)确定其效果的中介因素。该方法借鉴了社会认知理论、理性行为理论、计划行为理论以及对研究人群的形成性研究。主要结果是在干预前收集的前3个月无保护性交的频率，以及通过音频计算机辅助自我访谈（ACASI）进行的6个月和12个月的随访。次要结局包括禁欲发生率、多个性伴侣、持续使用避孕套和理论中介变量，包括意图、信念和自我效能。这项探索性研究将产生有价值的初步数据，以支持随后的R01，以实施一项全面的集群随机对照试验，以测试艾滋病毒性风险降低干预措施对世界上一个艾滋病毒普遍流行的地区的大学生的有效性，该地区正在造成最严重的人员伤亡。

DESCRIPTION (provided by applicant): This R34 application is seeks 3 years of support to develop and conduct a preliminary pilot test of an HIV/STI risk-reduction intervention for university students in South Africa. This research has great public health relevance because Sub-Saharan African countries, including South Africa, have a generalized HIV epidemic and the highest rates of HIV/AIDS in the world. The primary mode of infection in South Africa, as in most Sub-Saharan African countries, is heterosexual contact. In a generalized HIV epidemic, curbing sexual transmission of HIV requires behavioral interventions to reach all populations that engage in risk behavior. Few studies have tested HIV sexual risk-reduction interventions specific to university students in Sub-Saharan African countries with a generalized epidemic. Accordingly, the broad, long-term objective of the proposed research is to identify interventions to dissuade university students in Sub-Saharan Africa from engaging in HIV sexual risk behaviors. The Specific Aims are to; (a) develop a theory-based, contextually relevant HIV sexual risk-reduction intervention, (b) conduct a pilot test of its efficacy as compared with a health-promotion control intervention on health issues unrelated to sexual behavior, (c) explore whether participants' gender or nationality moderates its efficacy, and (d) determine the mediators of its efficacy. The approach draws on social cognitive theory, the theory of reasoned action, the theory of planned behavior, and formative research with the study population. The primary outcome is frequency of unprotected intercourse in the previous 3 months collected preintervention and at 6- and 12- month follow-up via audio-computer-assisted self-interviewing (ACASI). Secondary outcomes include incidence of abstinence, multiple sexual partners, and consistent condom use and theoretical mediator variables, including intentions, beliefs, and self-efficacy. This exploratory research will yield valuable preliminary data to support a subsequent R01 to implement a full-scale clustered randomized control trial to test the efficacy of a HIV sexual risk-reduction intervention for university students in a region of the world where a generalized HIV epidemic is taking a most devastating human toll.