Behavioral Technologies for Predicting HIV Risk

描述（由申请人提供）：旨在提供准确、基于事实的艾滋病毒风险信息的大规模名义预防项目，提高了人们对艾滋病毒/艾滋病风险的认识；然而，这些项目在预防或减少青少年与艾滋病毒相关的冒险行为方面取得了相对有限的成功。最近，个性化的、以技能为基础的预防项目减少了与艾滋病毒相关的冒险行为和实际感染的发生率，但个性化的项目可能成本高昂，而且可能难以融入社区环境。因此，最近的工作旨在根据青少年独特的脆弱性，确定并针对最有可能感染艾滋病毒的青少年。通常，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，但这些方法有一些局限性，并且它们在识别高危青少年方面的成功受到限制。作为一种替代方法，气球模拟风险任务-青少年（BART; BART- y）可以用来评估风险承担倾向，以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与风险行为的强烈的横断面关系，但很少有人检查这种方法在潜在风险青少年识别中的效用。为此，R01 DA18647获得资助，提供BART的第一次纵向测试。我们能够成功招募277名青少年（10-12岁）及其家人进行基线评估；参与者的平均年龄为11.0 （SD = 0.81）岁，43.7%为女性，49.3%为白人，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。随访率非常好，第2年有89%的青少年完成了评估，第3年只有2%的青少年完成了评估，达到87%。在整个项目期间，获得了补充资金，以扩大：1)另外400名10-12岁儿童的样本，2)理论视角，包括负强化相关风险承担的行为测量，以及3)评估的广度，包括目标遗传标记以及环境背景的体内评估，以提供基因x环境风险脆弱性的新评估。正如在目前的申请中概述的那样，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，以提供这项工作的继续，因为青少年正在进入艾滋病毒风险行为开始达到顶峰的时期。

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.