Providing online counseling for home-based HIV testing.

描述（由申请人提供）：男男性行为者（MSM）仍然是美国艾滋病毒流行中受影响最严重的风险群体。研究表明，男男性行为者中的大多数艾滋病毒感染事件可归因于与主要男性性伴侣的性行为;然而，缺乏针对男男性伴侣的艾滋病毒预防干预措施。正因为如此，夫妇艾滋病毒自愿咨询和检测（CVCT），一个干预措施，已被多次证明，以减少艾滋病毒传播的异性恋夫妇，已被改编为美国男男性行为者夫妇。面向MSM夫妇的CVCT现已在美国11个城市推出。FDA最近批准了以家庭为基础的艾滋病毒检测：然而，批评者指出缺乏相关的咨询，特别是对那些接受阳性艾滋病毒检测的人。拟议的活动包括创新性地将家庭艾滋病毒检测与CVCT相结合。这些活动调查了家庭艾滋病毒检测与视频Skype操作的CVCT会话相结合的实用性，该会话由远程CVCT顾问操作。通过对来自美国各地的1300对在线招募的MSM夫妇进行筛查，并在随机对照试验中招募了600对，该研究旨在研究家庭艾滋病毒检测加上视频Skype操作的CVCT会话的影响（实验条件）与单独的家庭艾滋病毒检测（对照）相比，在减少性风险、形成和遵守性协议方面，在男男性行为者夫妻关系中管理艾滋病毒风险的关系功能。拟议的活动检查干预措施对自我报告的血清一致阴性夫妇（n=300）和自我报告的血清不一致夫妇（n=300）的影响。作为第二个目标，这些活动建议调查家庭艾滋病毒检测加上视频Skype操作的CVCT会议对及时联系艾滋病毒初步阳性结果的护理的影响。夫妇将完成基线，3个月和6个月的随访问卷，详细说明最近的性风险，衡量艾滋病毒风险管理的双向沟通和应对的量表，以及关于关系外性行为的协议。研究人员假设，在家庭检测中加入Skype运营的以夫妇为中心的咨询会议，将有助于增加应对机制和沟通，以有效管理关系中的艾滋病毒风险，并将减少关系内外的性风险，对于那些接受艾滋病毒阳性检测结果的人来说，将增加与护理的及时联系。通过Skype提供CVCT提供了一个廉价的机会，可以向更广泛的受众采取以夫妇为重点的干预措施，并为那些接受家庭艾滋病毒检测的人提供一个接受咨询的机制。

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) continue to be the most heavily-impacted risk group in the US HIV epidemic. Studies suggest that the majority of incident HIV infections among MSM are attributable to sex with a main male sex partner; however, HIV prevention interventions that target male-male couples are lacking. Because of this, Couples HIV Voluntary Counseling and Testing (CVCT), an intervention that has been repeatedly shown to reduce HIV transmission within heterosexual couples, has been adapted to US MSM couples. CVCT for MSM couples is now available in 11 US cities. The FDA recently approved home-based HIV testing: however, critics have pointed to the lack of counseling involved, particularly for those who receive a positive HIV test. The proposed activities include an innovative combination of home-based HIV testing and CVCT. The activities investigate the utility of home-based HIV testing combined with a video-Skype operated CVCT session, operated by a remotely located CVCT counselor. Through the screening of 1300 online recruited MSM couples from across the US and the enrollment of 600 in a RCT, the study aims to examine the impact of home-based HIV testing PLUS a video-Skype operated CVCT session (experimental condition) versus home- based HIV testing alone (control) on reductions in sexual risk-taking, formation of and adherence to agreements around sex, relationship functioning for the management of HIV risk in relationships among MSM couples. The proposed activities examine the impact of the intervention on self-reported sero-concordant negative couples (n=300) and self-reported sero-discordant couples (n=300). As a secondary aim, the activities propose to investigate the impact of home-based HIV testing plus a video-Skype operated CVCT session on timely linkage to care for those receiving a preliminary positive HIV result. Couples will complete baseline, 3 month and 6-month follow-up questionnaires, detailing recent sexual risks, scales to measure dyadic communication and coping around HIV risk management, and agreements around sex outside of the relationship. The researchers hypothesize that adding a Skype-operated couples-focused counseling session to home-based testing will act to increase coping mechanisms and communication for the effective management of HIV risks in relationships and will lead to reductions in sexual risk taking both within and outside of the relationship and for those receiving a HIV positive test result will increase timely linkage to care. CVCT provision through Skype offers an inexpensive opportunity for a couples-focused intervention to be taken to a wider audience and to provide a mechanism for those under-taking home-based HIV testing to receive counseling.