Videotape-based HIV Prevention Intervention

描述（由申请人提供）：基于认知行为原则的社会认知理论的艾滋病干预项目在改变艾滋病高危行为方面表现出了最大的希望。不幸的是，由于社区组织依赖于具有认知行为技能技术专长的专业干预人员，认知行为干预尚未转移到具有成本效益的实施中。相比之下，依靠录像带促进技能培养的干预措施提供了一种负担得起且易于实施的机制，指导艾滋病毒预防干预措施的实施。迄今为止，以录像带为基础的降低风险的技能培养方法仅在男性中进行了测试，尚未独立复制。本申请要求四年的研究支持，以适应、实施和评估在低收入非洲裔美国男性和女性中进行的艾滋病毒风险降低技能培训干预的效果，以提高基于视频的技能培训的普遍性。400名符合高危行为标准的非洲裔美国男性（N=200）和女性（N=200）将被随机分配到两种实验条件之一：(1)基于认知行为原则的全面降低艾滋病毒风险干预，通过录像带进行，由社区组织工作人员提供指导，并接受最低限度的咨询和调解人技能培训；(2)时间和接触匹配的标准HIV教育对照条件。因此，本研究将使用2个（干预）条件x2个性别因素设计来检验以下假设：(1)相对于对照组，艾滋病毒预防干预有望导致艾滋病毒相关知识的增加，对艾滋病毒风险的敏感性和改变危险行为的意愿；(2)艾滋病毒预防干预有望提高减少行为的自我效能感和提高与性伴侣沟通方式的有效性；(3)与对照组相比，艾滋病毒预防干预组的参与者在无保护性交、性伴侣数量减少和避孕套使用增加方面的行为改变明显更大、更持久。如果通过录像带和社区促进者提供技能指导证明是成功的，我们将建立基于录像带的艾滋病毒预防干预的普及性，使其成为非洲裔美国男性和女性预防艾滋病毒的一种可行且成本有效的方法。

DESCRIPTION (provided by applicant): AIDS Intervention Programs that are derived from social cognitive theory and based on cognitive-behavioral principles have demonstrated the greatest promise in changing HIV high-risk behaviors. Unfortunately, cognitive behavioral interventions have not been transferable to community-based organizations for cost effective implementation due to their dependence on professional interventionists with expertise in cognitive behavioral skills techniques. In contrast, interventions that rely on videotapes to facilitate skills building provide an affordable and easily implemented mechanism for guiding the delivery of HIV prevention interventions. To date, videotape-based skills building approach to risk reductions has only been tested with men and has not been independently replicated. This application requests four years of support of research to adapt, implement, and evaluate the efficacy of an HIV-risk reduction skills training intervention conducted with videotapes among low income African American men and women in an effort to increase the generalizability of video-based skills training. Four hundred African American men (N=200) and women (N=200) who meet high-risk behavior criteria will be randomly assigned to one of two experimental conditions: (1) A comprehensive HIV-risk reduction intervention based on cognitive behavioral principles delivered by videotape and facilitated by community organization staff with minimal training in counseling and facilitator skills techniques; or (2) A time- and contact- matched standard HIV education only control condition. The study will therefore use 2 (intervention) conditions X 2 gender factor designs to test the following hypotheses: (1) The HIV prevention intervention is expected to result in increased HIV-related knowledge, sensitization to HIV-risk, and intentions to change risk behaviors relative to the control group; (2) The HIV prevention interventionism expected to result in increased self-efficacy for reducing behaviors and increased effectiveness in communicating ways to reduce risk with sexual partners; (3) Participants in the HIV prevention intervention are expected to experience significantly greater reductions and longer-lasting maintenance of behavior change in unprotected sexual intercourse, decreased numbers of sexual partners, and increased use of condoms relative to the control group. If the delivery of skills instruction via videotape and community facilitators proves successful, we will have established the generalizability of videotape-based HIV prevention intervention as a feasible and cost effective method of HIV prevention among African American men and women.