Adaptation of Couples Voluntary Counseling and Testing (CVCT) for US MSM

描述(由申请人提供)：在美国，男男性行为者(MSM)中艾滋病毒的发病率持续上升，2006年美国新增艾滋病毒感染者中有50%以上是MSM。美国疾病控制与预防中心最近的一项分析表明，MSM中超过一半的艾滋病毒传播来自主要伴侣。因此，应优先开发针对主要伙伴关系中的男男性接触者的新的艾滋病毒预防措施。夫妇艾滋病毒自愿咨询和检测(CVCT)被美国疾病控制与预防中心描述为“高杠杆的艾滋病毒预防干预措施”，与单独的艾滋病毒咨询和检测相比，已被证明可以减少非洲妇女的艾滋病毒感染，并已向非洲夫妇提供了数十年。我们建议将非洲CVCT干预措施用于美国MSM，并进行一项小型可行性试验，以证明招募参与者参加这一干预试验的可行性，证明干预对美国MSM的安全性，并得出未来试验设计所需的关键参数估计(如果有指示)。将收集和分析焦点小组数据，以制定研究措施，并了解潜在客户和艾滋病毒预防顾问对适应干预措施的接受程度，后者最终将提供干预措施。干预措施的适应性和适应性干预措施的评估将以夫妻相互依赖的理论框架为指导；为了在这一理论背景下全面评估干预措施，我们还将开发和验证新的量表来衡量该理论的几个结构(对结果的偏好、夫妻效能、结果效能和对社会支持的感知)。这项研究的预期结果是为夫妇提供文化上适当的适应性艾滋病毒预防干预，支持未来疗效试验的可行性和设计的初步数据，以及用于未来试验和关于夫妇干预的其他研究的经验证的量表。

Description (provided by applicant): HIV incidence among men who have sex with men (MSM) continues to rise in the United States, and over 50% of new US HIV infections in 2006 were among MSM. A recent CDC analysis suggests that over half of HIV transmissions among MSM are from main partners. Therefore, the development of new HIV preventions that target MSM in main partnerships should be a priority. Couples HIV Voluntary Counseling and Testing (CVCT) is described by CDC as a "high leverage HIV prevention intervention", has been shown to reduce HIV infections in African women when compared with individual HIV counseling and testing, and has been provided to African couples for decades. We propose to adapt the African CVCT intervention for use with US MSM, and conduct a small feasibility trial to demonstrate feasibility to enroll participants in a trial of this intervention, to demonstrate the safety of the intervention for US MSM, and to derive estimates of key parameters that will be required for design of future trials if indicated. Focus group data will be collected and analyzed to develop study measures and to understand acceptability of the adapted intervention to both potential clients and to HIV prevention counselors, who would eventually deliver the intervention. The adaptation of the intervention and the evaluation of the adapted intervention will be guided by the theoretical framework of the couple's interdependence; to fully evaluate the intervention in this theoretical context, we will also develop and validate new scales to measure several constructs of the theory (preferences for outcomes, couple efficacy, outcome efficacy, and perception of social support). Expected outcomes of the research are a culturally appropriate adapted HIV prevention intervention for couples, preliminary data to support feasibility and design of future efficacy trials, and validated scales for use in future trials and other research on couples' interventions.