This application is submitted in response to Program Announcement PA-05-033, """"""""Men's Heterosexual Behavior and HIV Infection."""""""" The broad, long-term objective is to identify interventions to dissuade South African men from engaging in behaviors that increase their risk for sexually transmitted diseases (STDs), including HIV.
The Specific Aims are to (a) test the efficacy of an HIV/STD risk reduction intervention in increasing consistent condom use, (b) examine community-level and individual-level variables that may moderate the efficacy of the intervention, and (c) identify mediators that account for the intervention's effects on consistent condom use. The design of the study is a cluster randomized controlled trial. We will stratify Black neighborhoods near East London, South Africa on key characteristics and match them in pairs. We will randomly select 12 matched-pairs and within each pair, randomly assign the neighborhoods to one of two small-group interventions led by a male facilitator: a 6-hour HIV/STD Risk-Reduction Intervention or a 6- hour health promotion intervention concerning health issues unrelated to sexual behavior that will serve as the control condition. We will enroll in the trial 60 men from each neighborhood, for a total of 1,440 participants. The approach draws on social cognitive theory, the theory of reasoned action/theory of planned behavior, and the applicant's preliminary studies with men from the study population. The primary outcome is self-reported consistent condom use in the previous 3 months collected at baseline and 6 and 12 months post-intervention via audio-computer-assisted self-interviewing (ACASI). Secondary outcomes include number of sexual partners, frequency of unprotected sexual intercourse, condom use at last intercourse, and theoretical variables hypothesized to mediate intervention effects, including intentions, beliefs, and self- efficacy. The proposed research has great public health relevance because, while about one-half the cases of HIV/AIDS worldwide are linked to sexual relations between men and women, only a few studies have tested HIV/STD risk-reduction interventions specific to men. This research will test the efficacy of such an intervention in a developing country with some of the highest rates of heterosexually transmitted HIV infection in the world. Moreover, it will contribute to scientific knowledge about the kinds of men with whom it is most efficacious and the factors that account for its efficacy.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD053270-04
Application #
7638646
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Newcomer, Susan
Project Start
2006-09-30
Project End
2011-06-30
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
4
Fiscal Year
2009
Total Cost
$746,770
Indirect Cost
Name
University of Pennsylvania
Department
Psychiatry
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Teitelman, Anne M; Bellamy, Scarlett L; Jemmott 3rd, John B et al. (2017) Childhood Sexual Abuse and Sociodemographic Factors Prospectively Associated with Intimate Partner Violence Perpetration Among South African Heterosexual Men. Ann Behav Med 51:170-178
Prague, Melanie; Wang, Rui; Stephens, Alisa et al. (2016) Accounting for interactions and complex inter-subject dependency in estimating treatment effect in cluster-randomized trials with missing outcomes. Biometrics 72:1066-1077
Jemmott 3rd, John B; Jemmott, Loretta S; O'Leary, Ann et al. (2015) HIV/STI risk-reduction intervention efficacy with South African adolescents over 54 months. Health Psychol 34:610-21
Jemmott 3rd, John B; Stephens-Shields, Alisa; O'Leary, Ann et al. (2015) Mediation of effects of a theory-based behavioral intervention on self-reported physical activity in South African men. Prev Med 72:1-7
O'Leary, Ann; Jemmott 3rd, John B; Jemmott, Loretta S et al. (2015) Mediation of an efficacious HIV risk reduction intervention for South African men. AIDS Behav 19:1842-9
Jemmott 3rd, John B; Jemmott, Loretta S; Ngwane, Zolani et al. (2014) Theory-based behavioral intervention increases self-reported physical activity in South African men: a cluster-randomized controlled trial. Prev Med 64:114-20
Jemmott 3rd, John B; Jemmott, Loretta S; O'Leary, Ann et al. (2014) Cluster-randomized controlled trial of an HIV/sexually transmitted infection risk-reduction intervention for South African men. Am J Public Health 104:467-73
Heeren, G Anita; Icard, Larry D; O'Leary, Ann et al. (2014) Protective factors and HIV risk behavior among South African men. AIDS Behav 18:1991-7
Icard, Larry D; Jemmott 3rd, John B; Teitelman, Anne et al. (2014) Mediation effects of problem drinking and marijuana use on HIV sexual risk behaviors among childhood sexually abused South African heterosexual men. Child Abuse Negl 38:234-42
Jemmott 3rd, John B; Jemmott, Loretta S; O'Leary, Ann et al. (2011) Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial. Psychol Health 26:167-85

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