LONG TERM ACCEPTABILITY OF HIV PREVENTION METHODS

在这项申请中，我们建议对两组完成了父母研究和主要性伴侣研究的女性进行为期12个月的纵向随访。父母研究是一项随机对照试验，我们正在评估现有妇女的多种预防选择框架，并评估这些方法的可接受性，为期三个月。在父母研究中，队列1将接受多选项干预（MO），其中三种预防方法（男用避孕套，女用避孕套，优势S）按安全等级顺序呈现，队列2将接受单一选项条件，重点关注男用避孕套。当前的应用程序建立在母体研究的基础上：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)运用关系视角探讨个体、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)进行定性访谈，探索影响可接受性的复杂关系和社会文化过程。队列1女性将在MO干预后6个月和12个月进行评估，她们的主要性伴侣将在3个时间点接受访谈，以对应于女性的3、6和12个月评估。为了平衡两个队列的多种选择，队列2将提供多种选择干预。队列2女性及其伴侣将在基线、干预后3、6和12个月进行评估。多变量生长曲线分析将应用于纵向数据。定性访谈的目标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过程。有目的地选择两个子样本。第一个样本将只包括处于稳定关系3个月或以上的女性，并且符合以下标准之一：1)使用男用或女用避孕套；2)只使用优势S；或者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（关系不超过三个月）。访谈的定性分析将使我们能够扩展我们对影响性风险行为的静态风险和保护因素的知识，并将预防方法的使用扩展到更复杂的过程。了解风险和保护过程可以指导干预措施的发展，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.