Sexual Risk Compensation and Male Circumcision Among Men in South Africa

南非男性的性风险补偿和男性包皮环切术

• 批准号: 8306719
• 负责人: Joanne Ellen Mantell
• 金额: $ 10.35万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-25 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8306719
• 关键词: AIDS prevention; Address; Adolescent; Behavioral; Behavioral Mechanisms; Biological Markers; Cellular Phone; Child health care; Clinical; Clinical Trials; Cohort Studies; Country; Data; Data Collection; Development; Effectiveness; Event; Female; Financial compensation; Future; Gender; Grant; HIV; HIV Infections; Incidence; Individual; Institutes; Intervention; Interview; Male Circumcision; Measures; Mediation; Medical; Methods; Oral; Outcome; Participant; Patient Self-Report; Perception; Prevalence; Prevention; Prevention program; Prevention strategy; Preventive Intervention; Procedures; Prophylactic treatment; Public Health; Public Sector; Risk; Risk Behaviors; Risk Reduction; Role; Sample Size; Science; Sex Behavior; Sexual Partners; South Africa; Study models; Technology; Testing; Time; Treatment Efficacy; Universities; Woman; Work; cohort; comparison group; contextual factors; design; follow-up; mathematical model; men; microbicide; prevent; prospective; response; sex risk; sexual encounter; sexually active; theories; therapy development; transmission process; young man

DESCRIPTION (provided by applicant): Sexual risk compensation - increased risk behavior due to decreased perceived risk following introduction of a partially efficacious biomedical HIV prevention intervention - can offset both the individual (prevention of HIV acquisition) and public health (prevention of continuing transmission) benefits of these new prevention technologies. With the recently initiated and imminent roll-out of three such partially efficacious strategies (medical male circumcision, microbicides, and oral pre-exposure prophylaxis), understanding sexual risk compensation is critical in the U.S. and other countries hard hit by HIV. Yet, this is an understudied field, especially outside of the artificial context of large clinical trials in which participants receive intensive, repeated HIV prevention messages and the efficacy of the intervention is unknown. The recent roll-out in South Africa of medical male circumcision, the only widely available (yet partially protective) biomedical HIV prevention strategy, affords us a unique opportunity to examine sexual risk compensation in a real-world situation. Thus, we propose to study sexual risk compensation in public sector medical male circumcision facilities in KwaZulu- Natal, South Africa, to understand behavioral responses to partially protective biomedical interventions. We are seeking an R21 developmental grant, in response to RFA-MH-11-090, with the following Specific Aims: (1) Develop and determine the feasibility of procedures for the future R01 application relating to recruitment, retention, and data collection (including potential use of cell phones for interviews) in a cohort of newly- circumcised sexually active young men and a comparison group of men who screen as eligible for MMC but who do not get circumcised~ (2) Refine the assessment of sexual behavior to be able to collect data relevant to the timing and duration of sexual risk compensation, including event-level information about sexual encounters~ (3) Develop theory-driven measures of hypothesized determinants of sexual risk compensation, including perceptions and interpretations of partial efficacy to be used for theory testing in the future R01~ (4) Pilot these and other measures in a four-month cohort study of 90 sexually active men who undergo MMC and a comparison group of 30 uncircumcised men and obtain key statistical parameters (attrition rates, standard deviation/prevalence of key predictors, and outcomes) necessary to support estimates of sample size for a future R01 study~ and (5) Explore the perspectives of female sexual partners of circumcised men on partial efficacy of MMC and the context of risk negotiation that it presents.

描述（由申请人提供）：性风险补偿 - 引入部分有效的生物医学HIV预防干预后，感知风险降低导致风险行为的增加 - 可以抵消个人（预防艾滋病毒获取）和公共卫生（预防持续传播）这些新预防技术的益处。 随着最近并迫在眉睫的三种这样的部分有效策略（医学男性包皮环切术，微生物剂和口服预防预防），了解性风险补偿在美国和其他国家受到HIV的严重打击至关重要。然而，这是一个研究的领域，尤其是在大型临床试验的人工背景之外，参与者会收到大量的，重复的HIV预防信息，而干预的疗效尚不清楚。最近在南非推出了医学男性包皮环切术，这是唯一可用的（但部分保护性）的生物医学艾滋病毒预防策略，为我们提供了一个独特的机会，可以在现实情况下检查性风险补偿。 因此，我们建议研究南非夸济鲁纳塔尔州公共部门医疗男性包皮环切术的性风险补偿，以了解对部分保护性生物医学干预措施的行为反应。 我们正在寻求对RFA-MH-11-090的R21发展赠款，其特定目的是：（1）开发并确定未来R01应用程序的可行性，与招募，保留和数据收集有关的招聘，保留和数据收集有关（包括潜在的访谈中的潜在使用）在barky中，在较年轻的年轻人中，没有一个人，而不是在筛选了一个与众不同的人，而不是在筛选了一个人，而不是在对比较的人，而不是对人类的比较，却不是在招聘中，而不是对人类的比较，而这些人的男人和较高的人都不是在招聘中的，并且是对人类的比较，但却不在类似的人群中，但却没有招募。割礼〜（2）完善对性行为的评估，以收集与性风险补偿的时间和持续时间相关的数据，包括有关性接触的事件级别的信息〜（3）（3）（3）（3）（3）开发了性风险赔偿的假设决定因素的措施，包括对部分衡量的层次效率，包括对未来的R01进行的衡量级别的衡量措施（4）。 study of 90 sexually active men who undergo MMC and a comparison group of 30 uncircumcised men and obtain key statistical parameters (attrition rates, standard deviation/prevalence of key predictors, and outcomes) necessary to support estimates of sample size for a future R01 study~ and (5) Explore the perspectives of female sexual partners of circumcised men on partial efficacy of MMC and the context of risk negotiation that it presents.