Changing Behavior in Repeat HIV Testers

描述（由申请人提供）：来自UCSF艾滋病的合作团队 健康项目，加州大学旧金山分校艾滋病预防研究中心，和旧金山 弗朗西斯科公共卫生部提出了一个为期三年的，随机的， 一项单次咨询干预的对照试验， 感染艾滋病毒风险最大的男性的行为：那些继续从事 与男性发生高风险性行为以及反复进行艾滋病毒检测的人。艾滋病毒感染率 这样的人--测试过三次或三次以上的人--几乎是 弗朗西斯科所有测试者的名单干预措施有助于个人 识别和重新评估他们的“自我辩护”，即思想， 态度，或信仰存在于他们的脑海中，当他们从事无保护的， 肛交在对这种方法进行了成功的研究之后， 聘请心理健康专业人员进行干预，该小组现在 希望测试干预措施的有效性， 准专业顾问作为风险评估的一个组成部分 艾滋病毒抗体咨询的组成部分（“检测前咨询”）。完成 这300名男子将被招募时，他们打电话来安排一个匿名的艾滋病毒 抗体检测参与者必须报告无保护的肛门插入或接受 在过去的12个月内与非主要伴侣发生性关系，以及三个或更多 之前的HIV检测参与者将被随机分配到干预组 （加强考前辅导）或对照组（标准考前辅导） 并将在6个月和12个月时完成随访。主要结局 措施将是无保护的肛交次数的变化， 非主要合作伙伴。参与者对考前咨询的满意度将 也可以在组间进行测量和比较。这项研究将回答一个 一个实际的问题：这种基于理论的单次咨询 由受过训练的准专业顾问进行的干预， 降低一群高危男性的风险一个肯定的答案将有 对提高艾滋病咨询效果的直接影响 在全国范围内，并可能减少艾滋病毒的传播。

DESCRIPTION (provided by applicant): A collaborative team from the UCSF AIDS Health Project, the UCSF Center for AIDS Prevention Studies, and the San Francisco Department of Public Health proposes a three-year, randomized, controlled trial of a single-session counseling intervention designed to change the behavior of men at greatest risk of HIV: those who continue to engage in high-risk sex with men and who repeatedly test for HIV. HIV incidence among such men-individuals who had tested three or more times-was almost triple that of all other testers in San Francisco. The intervention helps individuals identify and re-evaluate their "self-justifications," that is, the thoughts, attitudes, or beliefs present in their minds when they engage in unprotected anal sex. Following a successful study of this approach, in which the team employed mental health professionals to conduct the intervention, the team now wishes to test the efficacy of the intervention when performed by paraprofessional counselors as an integral part of the risk assessment component of HIV antibody counseling ("pre-test counseling"). To accomplish this, 300 men will be recruited when they call to schedule an anonymous HIV antibody test. Participants must report unprotected anal insertive or receptive sex with a non-primary partner in the prior 12 months, and three or more previous HIV tests. Participants will be randomized to the intervention group (enhanced pre-test counseling) or control group (standard pre-test counseling) and will complete follow-up interviews at 6 and 12 months. The primary outcome measure will be change in the number of episodes of unprotected anal sex with non-primary partners. Participant satisfaction with pre-test counseling will also be measured and compared between the groups. This study will answer a practical question: can this theory-based, single-session counseling intervention, conducted by trained paraprofessional counselors, result in reduced risk among a group of high-risk men? An affirmative answer will have immediate implications for improving the effectiveness of HIV counseling nationwide and potentially reducing transmission of HIV.