Behavioral Technologies for Predicting HIV Risk

描述（由申请人提供）：旨在提供有关艾滋病毒风险的准确，基于事实的信息的大规模规范性预防计划已导致对艾滋病毒/艾滋病风险的更高认识;然而，这些计划在预防或减少青少年参与艾滋病毒相关风险行为方面的成功相对有限。最近的个性化，以技能为基础的预防方案已导致减少与艾滋病毒有关的冒险行为以及实际感染的发生率，但个性化方案可能是昂贵的，可能难以融入社区环境。因此，最近的工作旨在根据青少年特有的脆弱性，查明和针对最有可能感染艾滋病毒的青少年。通常情况下，研究人员完全依赖于自我报告工具来确定参与艾滋病毒相关风险行为的脆弱性，但这些方法有几个局限性，它们在识别高危青少年方面的成功有限。作为一种替代方法，气球锚定风险任务-青年（BART; BART-Y）可以用来评估风险承担倾向的客观和不太透明的方式比自我报告量表。这种方法已经显示出很强的横截面关系与风险行为，但很少有人做了检查的效用的方法，前瞻性识别的风险青年。为此，R 01 DA 18647获得资助，以提供BART的第一次纵向测试。我们成功招募了277名青年（10-12岁）及其家庭纳入基线评估;参与者平均11.0岁（SD = 0.81），43.7%为女性，49.3%为白色，35.5%为黑人，2.9%为西班牙裔，1.4%为亚洲/太平洋岛民，10.9%为混血或其他种族。随访率一直很好，89%的青年在2年级，只有2%至87%的青年在3年级完成评估。在整个项目期间，获得了补充资金，以扩大：1）另外400名10-12奥尔兹儿童的样本，2）理论视角，包括与负强化相关的冒险行为测量，和3）评估的广度，包括靶向遗传标记以及-环境背景的体内评估，以提供一种新的评估基因X环境脆弱性的风险承担。如本申请中所述，我们迄今为止有了强有力的发现，我们建议再提供5年的支持，以继续开展这项工作，因为年轻人正在进入艾滋病毒风险行为将开始达到高峰的时期。

DESCRIPTION (provided by applicant): Large-scale nomothetic prevention programs aimed at providing accurate, factual-based information regarding HIV risk have led to a greater awareness of HIV/AIDS risks; however, these programs have had relatively limited success in preventing or reducing engagement in HIV-related risk taking behaviors among adolescents. More recent individualized, skill-based prevention programs have led to a reduction in HIV-related risk taking behaviors as well as incidence of actual infection, but individualized programs can be costly and may be difficult integrate into community settings. Thus, recent work has aimed to identify and targeting adolescents most at risk for HIV infection, based on their unique vulnerabilities. Typically, researchers have relied exclusively on self-report instruments to determine vulnerability for engagement in HIV-relevant risk behaviors, but these approaches have several limitations, and their success in identifying at-risk adolescents has been limited. As an alternative approach, the Balloon Analogue Risk Task-Youth (BART; BART-Y) can be used to assess risk taking propensity in an objective and less transparent manner than self-report scales. This approach has shown strong cross-sectional relationships with risk behavior, but little has been done examining the utility of the approach for prospective identification of at-risk youth. Towards this end, R01 DA18647 was funded to provide the first longitudinal test of the BART. We were able to successfully recruit 277 youth (age 10-12) and their families into a baseline assessment; participants were on average 11.0 (SD = .81) years old, 43.7% female, 49.3% White, 35.5% Black, 2.9% Hispanic, 1.4% Asian/Pacific Islander, and 10.9% of mixed or other ethnicity. Follow-up rates have been excellent, with 89% of youth at Year 2, and only an additional drop of 2% to 87% of youth at Year 3 completing assessments. Throughout the project period, supplementary funds were secured to expand: 1) the sample with another 400 10-12 year olds, 2) the theoretical perspective to include behavioral measurement of negative reinforcement related risk taking, and 3) the breadth of the assessment to include targeted genetic markers as well as in-vivo assessment of environmental context to provide a novel assessment of gene x environmental vulnerability to risk taking. As outlined in the current application we have strong findings thus far and we propose another 5 year period of support to provide for the continuation of this work as the youth are progressing into a period where HIV risk behavior will begin to peak.