HIV Behavioral Disinbition Risk Reduction for Recently Circumcised South Africa M

描述（由申请人提供）：男性包皮环切术（MC）降低了南非男性感染艾滋病毒的风险。虽然避孕套对预防艾滋病毒的保护价值现在是无可争议的，但有证据表明，避孕套的预防效益可能会被避孕套使用的减少和性伴侣数量的增加所抵消。虽然有大量的关注行为去抑制的风险，或风险补偿，以下MC，有没有理论为基础的行为干预措施，旨在减少行为去抑制。拟议的研究将进行快速干预开发活动，以应对南部非洲接受MC的男性对行为去抑制预防干预的迫切需求。与受限制的男性和包皮环切术提供者的形成性访谈将为干预开发研讨会提供信息，通过该研讨会，我们将制定一个适应性的简短风险降低干预措施。将对适应性风险降低咨询的可行性、可接受性和潜在功效进行试点测试。适应性干预将是我们目前正在南非三家诊所测试的降低风险咨询干预的直接延伸。咨询模式将专门针对减少MC后可能出现的风险补偿行为/行为去抑制。如果我们发现适应性风险降低咨询干预是可接受的、可行的、潜在有效的，我们将建议在严格的随机试验中对其进行测试。男性包皮环切术（MC）降低了艾滋病毒传播的风险，并可能改变非洲艾滋病的进程。不幸的是，MC预防艾滋病毒的好处可能会被行为抑制所抵消-避孕套使用减少和MC后性伴侣数量增加。行为风险降低咨询与MC结合的必要性得到了广泛的认可。然而，没有适合用于接受MC预防艾滋病毒的男性的行为干预措施。这项研究提供了一个独特的和经济的机会，以适应干预措施，已经证明了艾滋病毒的风险降低与非洲男子在MC的背景下使用的有效性。一旦完成，这一干预措施及其所有材料将随时可供进一步研究和执行。

DESCRIPTION (provided by applicant): Male circumcision (MC) reduces the risk for HIV infection among men in South Africa. Although the protective value of MC for HIV prevention is now undisputable, there is evidence that the preventive benefits of MC could be offset by reductions in condom use and increases in numbers of sexual partners. Although there are substantial concerns about the risks for behavioral disinhibition, or risk compensation, following MC, there are no theory-based behavioral interventions designed to reduce behavioral disinhibition. The proposed research will perform rapid intervention development activities in response to the urgent need for behavioral disinhibition prevention interventions for men who undergo MC in southern Africa. Formative interviews with circumscribed men and circumcision providers will inform an intervention development workshop through which we will formulate an adapted brief risk reduction intervention. The adapted risk-reduction counseling will be pilot tested for feasibility, acceptance, and potential efficacy. The adapted intervention will be a direct extension of a risk- reduction counseling intervention that we are currently testing in three South African clinics. The counseling model will be specifically tailored to reduce risk compensatory behaviors / behavioral disinhibition that may follow MC. Should we find the adapted risk-reduction counseling intervention acceptable, feasible, and potentially efficacious, we will propose to test it in a rigorous randomized trial. Male circumcision (MC) reduces HIV transmission risks and could potentially alter the course of AIDS in Africa. Unfortunately, the benefits of MC for HIV prevention could be offset by behavioral disinhibition - reductions in condom use and increases in numbers of sex partners following MC. The need for behavioral risk reduction counseling in conjunction with MC is widely recognized. However, there are no behavioral interventions adapted for use with men who undergo MC for HIV prevention. This research offers a unique and economical opportunity to adapt an intervention that has already demonstrated efficacy for HIV risk reduction with African men for use in the context of MC. Once completed, this intervention and all of its material will be readily available for further research and implementation.