Behavioral Technologies for Predicting HIV Risk

描述(申请人提供)：尽管公共卫生努力减少与病毒获取和传播有关的危险行为，但青少年中艾滋病毒感染的问题仍在继续增长。发育特点使艾滋病毒感染和传播成为所有青少年的关切，但也有一些青少年群体，特别是在更多的城市环境中，由于与HFV相关的危险行为水平上升，他们面临的风险相对更大。大规模的以信息为基础的计划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冒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、基于应急的干预措施显示出了希望，但这种努力的高昂成本限制了可行性。从理论上讲，通过确定最容易从事艾滋病毒风险行为的个人，这些成本可以降低。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，以索引称为气球模拟风险任务(BART)的危险行为。以前对年轻人和中青年的研究表明，这项任务的风险与当前参与艾滋病毒风险行为(例如，无保护的性行为)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。具体地说，我们建议对240名11-12岁的儿童进行为期5年的跟踪调查，包括初步评估，每隔1年进行3次后续评估)。我们期望BART基线管理中的“风险”行为指数将预测：在后续评估中艾滋病毒风险行为的出现，超过那些提供了评估人口统计学(例如，社会经济地位、性别、种族)、相关个体差异变量的自我报告测量(例如，冲动、感觉寻求)、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)以及风险行为的发展前驱的一系列更传统的自我报告措施(例如，注意力缺陷/多动、对立/挑衅和品行障碍症状严重。作为第二个问题，我们感兴趣的是BART上的风险和自我报告单元中的措施在后续管理中的稳定程度，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.