LONG TERM ACCEPTABILITY OF HIV PREVENTION METHODS

在本申请中，我们提出了一个12个月的纵向随访的两个队列的妇女谁已经完成了父母的研究和他们的主要性伴侣。母研究是一项随机对照试验，我们正在评估一个框架，为目前的妇女提供多种预防选择，并评估这些方法在三个月内的可接受性。在母研究中，队列1将接受多项选择干预（MO），其中以安全性分层顺序列出3种预防方法（男用避孕套、女用避孕套、Advantage S），队列2将接受侧重于男用避孕套的单一选择条件。当前的应用建立在母研究的基础上：1）纵向检查方法的可接受性; 2）对女性的主要性伴侣进行结构化评估; 3）使用关系视角来探索个人、关系和社会文化因素如何影响女性及其伴侣的可接受性;（4）进行质性访谈，探讨影响可接受性的复杂关系和社会文化过程。将在MO干预后6个月和12个月对队列1女性进行评估，并将在3个时间点对其主要性伴侣进行访谈，以对应女性的3个月、6个月和12个月评估。为了均衡两个队列的多种选择暴露，将为队列2提供多种选择干预。将在基线以及干预后3、6和12个月对队列2女性及其伴侣进行评估。将对纵向数据进行多变量增长曲线分析。定性访谈的目的是深入了解影响不同预防方案可接受性的复杂关系和社会文化进程。将有目的地选择两个子样本。第一个样本将仅包括处于3个月或3个月以上稳定关系的女性，并且符合以下标准之一：1）采用男用或女用避孕套; 2）仅使用Advantage S;或3）根本不使用任何方法。第二个有目的的样本将包括处于新关系中的女性（三个月或更短的关系）。访谈的定性分析将使我们能够扩展我们的静态风险和保护因素的知识，影响性风险行为和使用预防方法，以更复杂的过程。对风险和保护过程的理解可以指导干预措施的制定，以提高可接受性。

In this application, we propose a 12-month longitudinal follow-up of two cohorts of women who have completed a parent study and their main sex partners. The parent study is a randomized control trial in which we are evaluating a framework for present women with multiple prevention options and assessing acceptability of these methods over a three month period. In the parent study, Cohort 1 will have receive a multiple option intervention (MO) in which 3 prevention methods (male condoms, female condom, Advantage S) were presented in a hierarchical order of safety and Cohort 2 will have received a single option condition focused on male condoms. The current application builds on the parent study by: 1) examining acceptability of methods longitudinally; 2) conducting structured assessments with women's main sex partners; 3) using a relational perspective to explore how individual, relationship, and socio- cultural factors influence acceptability for both women and their partners; and 4) conducting qualitative interviews to explore the complex relationship and socio-cultural processes that influence acceptability. Cohort 1 women will be assessed at 6 and at 12 months post MO intervention and their main sex partners will be interviewed at 3 time points to corresponds to the women's 3, 6, and 12 month assessments. To equalize exposure to the multiple options across the two cohorts, Cohort 2 will be offered the multiple option intervention. Cohort 2 women and their partners will be assessed at baseline, and at 3, 6, and 12 months post intervention. Multi-variate growth cure analyses will be applied to the longitudinal data. The goal of the qualitative interviews is to gain insight into the complex relationship and socio-cultural processes that influence acceptability of different prevention options. Two sub-samples will be purposively selected. The first sample will include only women have been in a stable relationship of 3 or more months and who meet one of the following criteria: 1) adopted male or female condoms; 2) only use Advantage S; or 3) do not use any method at all. The second purposive sample will include women who are in new relationships (a relationship of three months or less). The qualitative analysis of the interviews will allow us to extend our knowledge of static risk and protective factors that affect sexual risk behavior and use of prevention methods to more complex processes. Understanding of risk and protective processes can guide the development of interventions to improve acceptability.