HIV Behavioral Disinbition Risk Reduction for Recently Circumcised South Africa M

描述(由申请人提供)：男性包皮环切术(MC)降低了南非男性感染艾滋病毒的风险。尽管MC在预防艾滋病毒方面的保护价值现在是无可争辩的，但有证据表明，MC的预防益处可能会被避孕套使用量的减少和性伴侣数量的增加所抵消。尽管人们对MC后行为去抑制或风险补偿的风险有很大的担忧，但目前还没有基于理论的行为干预措施来减少行为去抑制。这项拟议的研究将开展快速干预开发活动，以响应对南部非洲接受MC的男性进行行为去抑制预防干预的迫切需要。对受限制的男性和包皮环切术提供者的形成性访谈将为干预开发研讨会提供信息，通过该研讨会，我们将制定适当的简短减少风险干预措施。调整后的风险降低咨询将进行可行性、接受性和潜在疗效的试点测试。调整后的干预措施将是我们目前在南非三家诊所测试的降低风险咨询干预措施的直接延伸。咨询模式将特别定制，以减少MC之后可能出现的风险补偿行为/行为去抑制。如果我们发现适应后的降低风险咨询干预是可接受的、可行的和潜在的有效的，我们将建议在严格的随机试验中进行测试。男性包皮环切术(MC)降低了艾滋病毒传播的风险，并可能改变非洲艾滋病的进程。不幸的是，MC预防艾滋病毒的好处可能会被行为去抑制--减少避孕套的使用和MC后性伴数量的增加--所抵消。行为风险降低咨询与MC结合的必要性得到了广泛的认可。然而，目前还没有适合于接受MC的男性使用的行为干预措施来预防艾滋病毒。这项研究提供了一个独特和经济的机会，使一种已经证明对降低非洲男子艾滋病毒风险有效的干预措施用于MC。一旦完成，这项干预措施及其所有材料将随时可供进一步研究和实施。

DESCRIPTION (provided by applicant): Male circumcision (MC) reduces the risk for HIV infection among men in South Africa. Although the protective value of MC for HIV prevention is now undisputable, there is evidence that the preventive benefits of MC could be offset by reductions in condom use and increases in numbers of sexual partners. Although there are substantial concerns about the risks for behavioral disinhibition, or risk compensation, following MC, there are no theory-based behavioral interventions designed to reduce behavioral disinhibition. The proposed research will perform rapid intervention development activities in response to the urgent need for behavioral disinhibition prevention interventions for men who undergo MC in southern Africa. Formative interviews with circumscribed men and circumcision providers will inform an intervention development workshop through which we will formulate an adapted brief risk reduction intervention. The adapted risk-reduction counseling will be pilot tested for feasibility, acceptance, and potential efficacy. The adapted intervention will be a direct extension of a risk- reduction counseling intervention that we are currently testing in three South African clinics. The counseling model will be specifically tailored to reduce risk compensatory behaviors / behavioral disinhibition that may follow MC. Should we find the adapted risk-reduction counseling intervention acceptable, feasible, and potentially efficacious, we will propose to test it in a rigorous randomized trial. Male circumcision (MC) reduces HIV transmission risks and could potentially alter the course of AIDS in Africa. Unfortunately, the benefits of MC for HIV prevention could be offset by behavioral disinhibition - reductions in condom use and increases in numbers of sex partners following MC. The need for behavioral risk reduction counseling in conjunction with MC is widely recognized. However, there are no behavioral interventions adapted for use with men who undergo MC for HIV prevention. This research offers a unique and economical opportunity to adapt an intervention that has already demonstrated efficacy for HIV risk reduction with African men for use in the context of MC. Once completed, this intervention and all of its material will be readily available for further research and implementation.