Behavioral Technologies for Predicting HIV Risk

描述（由申请人提供）：尽管公共卫生努力减少与病毒感染和传播有关的危险行为，但青少年感染艾滋病毒的问题继续增长。发育特征使艾滋病毒感染和传播成为所有青少年关注的问题，但有一些青少年亚群体，特别是在更多的城市环境中，由于与艾滋病毒相关的危险行为水平升高，他们面临相对更大的风险。大规模的基于信息的项目往往提高了人们对艾滋病毒风险的认识，但在预防或减少未来参与艾滋病毒风险行为方面取得的成功相对有限。以技能培训为重点的个性化、基于偶然性的干预措施显示出了希望，但这种努力的高成本限制了其可行性。从理论上讲，这些成本可以通过识别最容易参与艾滋病毒风险行为的个人来降低。为了帮助这种识别，我们开发了一种易于使用的，适合青少年的行为评估工具来索引危险行为，称为气球模拟风险任务（BART）。先前对年轻人和青少年的研究表明，任务的风险与当前参与艾滋病毒风险行为（例如，无保护的性交）以及其他风险行为（例如，吸烟，犯罪行为）有关。在这项研究的下一步，我们的目标是确定年轻青少年在BART上的风险是否可以用来预测未来参与艾滋病毒冒险行为。具体来说，我们建议对240名11-12岁的儿童进行为期5年的随访，包括首次评估和每隔1年进行3次随访评估。我们预计，BART基线管理的“风险”行为指数将预测：在后续评估中出现的艾滋病毒风险行为超出了一系列更传统的自我报告措施，这些措施评估人口统计（例如，社会地位、性别、种族）、相关个体差异变量的自我报告措施（例如，冲动、寻求感觉）、认知过程（例如，风险感知、艾滋病毒知识）、环境因素（例如，生活事件、父母监测、同伴影响），以及冒险行为的发育前兆（例如，注意力缺陷/多动，对立/挑衅，行为障碍症状严重程度）。作为一个次要问题，我们感兴趣的是BART的风险程度和自我报告组内的措施在后续管理中是稳定的，包括这些变化与现实世界冒险行为变化的关系。

DESCRIPTION (provided by applicant): The problem of HIV infection in adolescence continues to grow despite public health efforts to reduce risk behaviors related to the acquisition and transmission of the virus. Developmental characteristics make HIV infection and transmission a concern for all adolescents, but there are subgroups of youths, especially in more urban settings, who are at relatively greater risk because of elevated levels of HFV-relevant risk behaviors. Large scale information-based programs often have led to greater awareness of HIV risks, but have had relatively limited success in preventing or reducing future engagement in HIV-risk taking behaviors. Individualized, contingency based interventions focused on skills training have shown promise, yet feasibility is limited by the high costs of such endeavors. These costs theoretically could be reduced with the identification of individuals most vulnerable to engaging in HIV-risk taking behaviors. To aid in such identification, we have developed an easy-to-use, adolescent appropriate, behavioral assessment tool to index risky behavior termed the Balloon Analogue Risk Task (BART). Previous research with young adults and middle adolescents has shown that riskiness on the task is related to current engagement in HIV risk-taking behaviors (e.g., unprotected sexual intercourse) as well as other risk-taking behaviors (e.g., smoking, delinquent behavior). In the next step in this research, we aim to determine if riskiness on the BART in younger adolescents can be used to predict future engagement in HIV risk-taking behaviors. Specifically, we propose to follow 240 11-12 year olds over a 5-year period including an initial assessment with 3 follow-up assessments occurring at 1 year intervals). We expect that the behavioral index of "riskiness" on the baseline administration of the BART will predict: the emergence of HIV risk behaviors at follow-up assessments above and beyond that provided with a battery of more traditional selfreport measures assessing demographics (e.g., SES, gender, race), self-report measures of relevant individual difference variables (e.g., impulsivity, sensation seeking), cognitive processes (e.g., risk perception, HIV knowledge), environmental factors (e.g., life events, parental monitoring, peer influence), as well as developmental precursors to risk taking behavior (e.g., attention-deficit/hyperactivity, oppositional/defiant, and conduct disorder symptom severity. As a secondary question, we are interested in the extent to which riskiness on the BART and the measures within the self-report battery are stable across follow-up administrations, including the relationship of these changes to changes in real-world risk-taking behaviors.