Background: HIV-1 envelope (Env) diversity is arguably the most significant challenge for the development of an efficacious vaccine. An ideal vaccine would elicit the production of broadly neutralizing antibodies (nAb), capable of retaining potent activity against a diverse panel of viral isolates. The evolutionary forces that shape the diversity of envelope and ensuing nAb responses are incompletely understood in HIV-1 subtype C infection, the dominant subtype globally. Therefore there is an urgent need to define the patterns of envelope diversity, determine the correlates of immune protection and to discover subtype C immunogens in order to develop a globally relevant vaccine. Methods: We applied the single genome sequencing strategy to study plasma derived viruses from four slow progressors and four progressors over a median of 21 months between study entry and study exit. The participants‘ samples were from the Sinikithemba cohort of antiretroviral therapy-naïve chronically infected individuals and were termed slow progressors or progressors based on CD4 T-cell counts and viral loads over two years. We analyzed env sequence diversity, divergence patterns and envelope characteristics across the entire HIV-1 subtype C gp160. We studied the evolution of autologous nAb (AnAb) and heterologous nAb responses in order to test the hypothesis that slow disease progression is associated with more potent autologous or heterologous nAb responses. Furthermore, genotypic env characteristics were correlated to potency of neutralization in order to understand possible differences in nAb responses with divergent rates of disease progression and to describe genotypic differences associated with differential nAb potencies. In addition, the binding affinities of HIV-specific immunoglobulins (IgGs) and the affinities of the IgGs to various Fcγ receptors (both activating- FcγRI, FcγRIIa, FcγRIIIa; inhibitory- FcγRIIb) were assessed. These binding affinities were used as a surrogate for the recruitment of effector functions of cells of the innate immune system e.g. macrophages or natural killer cells to initiate antibody-dependent cell-mediated cytotoxicity (ADCC) or antibody dependent cell-mediated viral inhibition (ADCVI) and these were correlated to markers of disease progression namely CD4 T-cell counts and viral loads. Results: Intra-patient diversity was higher in slow progressors for regions C2 (p=0.0006), V3 (p=0.01) and C3 (p=0.005) compared to progressors. Consistent with this finding, slow progressors also had significantly increased amino acid length in V1-V4 with fewer potential N-linked glycosylation sites (PNGs) compared to progressors (p=0.009 and p=0.02 respectively). Similarly, in progressors, the gp41 region was significantly longer and had significantly fewer PNGs compared to slow progressors (p=0.02 for both parameters). Positive selection was prominent in regions V1, C3, V4, C4 and gp41 in slow progressors, whereas in progressors, it was prominent in gp41. Signature consensus sequence differences between the groups occurred mainly in gp41. Neutralizing antibodies (nAb) evolved over time in progressors, as evidenced by significantly higher nAb IC50 titers to baseline (study entry) viruses when tested against study exit time-point plasma compared to contemporaneous responses (p=0.003). In contrast, slow progressors‘ nAb titers did not differ significantly between study entry and study exit time points. nAb IC50 titers significantly correlated with amino acid lengths for C3-V5 (p=0.03) and V1-V5 (p=0.04) for slow progressors and V1-V2 for progressors (p=0.04). Slow progressors and progressors displayed preferential heterologous activity against the subtype C panel. There were no significant differences in breadth of responses between the groups for either subtype A or C. Neutralization breadth and titers to subtype B reference strains however, was significantly higher in progressors compared to slow progressors (both p<0.03) with increasing nAb breadth from study entry to study exit in progressors. Progressors had cross-reactive neutralizing antibodies that targeted V2 and V3. Binding affinities of non-neutralizing antibodies to HIV-specific gp120, gp41 and p24 and to activating and inhibitory Fcγ receptors (FcγRs) were similar in both groups. However, in slow progressors, CD4 T-cell counts correlated inversely with antibody binding affinity for the activating FcγRIIa (p=0.005). Conclusions: These data suggest that separate regions of Env are under differential selective forces, and the heterogeneity of env diversity and evolution differ with HIV-1 disease course. Single genome sequence analysis of circulating viruses in slow progressors and progressors indicate that diversity, length polymorphisms, sites under positive selection pressure, and PNGs consistently map to specific regions in Env. Cross-reactive neutralizing antibodies targeting epitopes in V2 and V3 indicate that nAb breadth may be dictated by a limited number of target Env epitopes. Certain key N-linked glycosylation sites were shown to be crucial for antibody neutralization. The potencies of autologous nAbs were directly affected by the amino acid lengths in certain regions of Env gp160 and by the numbers of PNGs. Target vaccine immunogens may have to be given over long periods of time and may have to include multiple subtype immunogens to elicit the production of potent, broad cross neutralizing antibodies with high binding affinity. Overall, the data suggest that neither nAbs nor non-neutralizing antibodies could be directly associated with disease attenuation in this cohort of chronically infected individuals. However, continuous evolution of nAbs was a potential marker of HIV-1 disease progression. Further studies on larger cohorts to identify people with potent nAbs and to identify specific targets of these antibodies are needed. Furthermore studies of non-neutralizing antibodies in HIV-1 infection using functional assays will be required in order to determine their role in HIV-1 pathogenesis. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.

The HIV/AIDS virus has been acknowledged as being the largest threat to developing countries with respect to economic and social issues. There is a large amount of information available with respect to causes, treatment, and generalities pertaining to HIV/AIDS. The information available is relevant to many different types of industries. There seems to be little information available on the HIV/AIDS programmes that companies are implementing to curb the effects that the virus is having on issues like the loss of skilled labour, the drop in productivity due to absenteeism, the decline in morale and the immensely high costs associated with training and recruitment. This study aims to look at the effectiveness of HIV/AIDS programmes in the motor industry and the perception of employees with regards to these programmes. The automotive industry is one of the key contributors to the wellbeing of the South African economy. The sustainability of the organisation relies heavily on the skill that the organisation has, and the ability of the organisation to carry this skill into the future. The data collection for this research was conducted via a web-based questionnaire using the online research programme Question Pro. All questions were close-ended. Some of the more important findings include that HIV/AIDS awareness needs to be promoted more strongly in the organisation. Succession planning was observed to be inadequate in the organisation. Another salient finding was that management needs to make it more evident to the workers that they are championing the HIV/AIDS initiatives within the company. The key recommendations are that management need to pay more attention to the concept of succession planning, and to encourage the workforce to participate in the community outreach programmes, as this has a positive effect on the macroeconomic outlook of the country. There are a number of companies in South Africa which do not conform to the appropriate level of HIV/AIDS programmes and further research should be undertaken to explore the deficiencies of these programmes and recommendations should be made based on the findings. / Thesis (MBA)-University of KwaZulu-Natal, Durban, 2012.

Unprotected heterosexual intercourse is the major cause of the transmission of the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS); however people still engage in unsafe sexual practices. Much research has therefore focused on preventive approaches and barrier methods to combat HIV and AIDS. Global HIV and AIDS statistics show that women are worst affected, leading researchers and non-governmental organizations to design interventions and programs to prevent HIV infection among women. Female condoms, also known as femidom, are effective and safe in preventing HIV if used consistently. The cost of the first generation female condom, FC1 led to slow uptake, resulting in the production of the more cost-effective second generation female condom, FC2. However, studies show that the FC2 is underutilized for a number of reasons beyond cost, including availability, reduced sexual pleasure, gender inequality and culture. There is a paucity of literature on perceptions of the female condom (Callender, 2012). This study sought to address this gap by accessing perceptions of the female condom among students on the University of KwaZulu-Natal (UKZN)’s Howard College campus. This research study adopted an interpretive paradigm and employed mixed methods of research, both quantitative and qualitative. The population/participants were drawn from male and female students at UKZN who reside in two residences on the Howard College campus, namely, John Bews and Pius Langa. A non-probability snow ball sampling method was used to select a sample frame of 124 students comprising both female and male students. Questionnaires and focus group were used to gather data; a total of 100 questionnaires were administered and a focus group was conducted with eight participants in three separate sessions. The qualitative data gathered were analyzed using the Statistical Package for the Social Sciences (SPSS), which generated simple frequencies and percentages. The quantitative data was transcribed and analyzed through thematic analysis with the help of the NVivo10 qualitative data analysis package. Thematic analysis developed by Braun & Clarke (2006) was employed to create categories and emerging themes that were derived from the coding process. Paulo Freire’s participatory development paradigm and the empowerment theory provided the conceptual framework within which the research is located. This enabled an exploration of how participatory approaches like focus group discussions create opportunities for participation. Kieffer’s (1984) four stages of empowerment guided the data analysis within the framework of empowerment theory. The study found that male students are more supportive of female condoms than female students. It also revealed that female students do not feel empowered by female condoms; this is as due to inadequate information and insufficient promotion of female condoms. Furthermore, the findings revealed that the most common source of information about female condoms among students was friends, followed by the clinic. Media and billboards had minimal effect in providing information and awareness on the female condom. Students feel that culture does not influence condom (male or female) use; this could suggest a positive future for femidom use in South Africa. / M. Soc. Sc. University of KwaZulu-Natal, Durban 2013.

M.Ed. / The phenomenon of HIV/AIDS is not restricted to the medical and behavioural sciences. The social implications of what is labelled as a pandemic, has influenced both sufferers and those in their realm of social intercourse. Education has become one of the most important strategies in an attempt to arrest the spread of the virus. The National Curriculum Statement compels educators to integrate HIV/AIDS across the whole school curriculum. The needs of educators, learners and the community must be considered in a cross-curricular HIV/AIDS education program. A quantitative survey placed focus on educator questionnaires from which a situation analysis was drawn. The research indicated that 72 (n=72) participants contributed to the study. In the study for n=72, 76.4% were female and 23.6% male. The majority of the participants indicated their ethnicity as white (95.8%) with the remaining 4.2% indicating their ethnicity to be, Black, Indian or Coloured. It was found that an integration of HIV/AIDS through an inter-disciplinary approach in the curriculum of secondary schools is not convincingly implemented. In general it was found that educators consider the integration of HIV/AIDS into the curriculum as an imperative part of education. The emphasis of integrating HIV/AIDS into the curriculum does not replace the role of parental intervention strategies in educating adolescents on the dangers of high risk health behaviour. Thus, much emphasis is placed on values education as a priority in HIV/AIDS prevention strategies to be implemented in the curriculum. Secondly, it was found that the majority of respondents show a positive attitude and willingness to the integration of HIV/AIDS across the curriculum. In support of this inference, it was found that the majority of the participants believe that HIV/AIDS should not only be addressed in the Life Orientation class and most educators supported the concept of addressing HIV/AIDS throughout the curriculum. Thirdly, it was clear that learner receptiveness towards HIV/AIDS education can be perceived as positive. However, the inference can be made that attitudes towards the HIV/AIDS stigma and prejudice is not successfully addressed in the current intervention initiatives. Fourthly, the majority of educators indicated that the formal resources for teaching (viz. the textbook) did not include much relevant material on HIV/AIDS and that most educators employed the printed media as main source of information for their lessons. Furthermore, support of educators, especially through the integration of peer group leaders that should discuss the dangers of high risk behaviour with learners, is clear. Finally, the premise that an inter-disciplinary approach to HIV/AIDS (as well as other themes of education) is the underpinning element of authentic education, is strongly supported. / Dr. M.C. van Loggerenberg

Ph.D. (Employment Relations) / Extensive research has been conducted within the field of HIV/AIDS, most of which has been epidemiological, as scientists work towards finding a cure. In the interim, social scientists continue to investigate ways to address social and behavioural aspects that encourage the spread of HIV/AIDS. Employment Relation practitioners are no different as they are sensitive to the impact of HIV/AIDS in the workplace. Programmes and policies are measures that have been established by Employment Relation and Human Resource practitioners in order to reduce the influence of the disease on the workforce. Higher Education Institutions (HEIs) face similar challenges. Therefore, Higher Education HIV/AIDS Programmes (HEAIDS), together with the South African government, have developed a framework to guide HEIs in developing HIV/AIDS programmes and policies that are institution specific. Various HEIs within South Africa have developed their unique programmes based on the HEAIDS framework. However, none of these institutions at the time of commencement of this study have evaluated the effectiveness of their individual HIV/AIDS programmes. The main objective of this study was to evaluate an HIV/AIDS prevention programme at a South African university. The study investigated the university’s HIV/AIDS programme by comparing the programme against the HEAIDS framework. In order to ascertain programme effectiveness, stakeholders for whom the programme was designed were questioned on their experiences and perceptions of the university HIV/AIDS programme. Participants were asked to participate in a survey and were also interviewed. The study adopted a mixed method approach, which used a dominant explanatory sequential approach. The quantitative phase of the study was conducted with a sample size of 739 respondents. The survey included four sections: Section A included demographic-related questions; Section B included questions on programme awareness; Section C comprised of questions relating to health management; and Section D focused on HIV/AIDS programme content. The qualitative phase of the study was conducted with a sample of 14 participants...

M.A. / This dissertation will focus on the notions of masculinity in Northern KwaZulu-Natal and the impact of that on the effectiveness of HIV/Aids prevention strategies employed by the South African government. It first examines gender and gender roles in society and then questions what it means to be a man and describes the concept masculinity as a socially constructed aspect of patriarchy with reference to a particular area of South Africa today. Masculinity is extended to the relations (both sexual and social) that men have with women as well as with other men. Notions of masculinity make men vulnerable because they lead to risk-taking behaviour that may result in HIV infection. I was drawn to this field after realising that most HIV/Aids prevention programmes do not take notions of masculinity into account. This specific geographical area was chosen for its proximity as well as the very high levels of HIV prevalence. During my research I realised that the realities of manhood and masculinity in the South African context are not addressed in the HIV/Aids prevention strategies of the South African government. This gap created by the absence of gender sensitivity with regards to men enhances the vulnerability of men and women in South Africa to be infected with HIV. My research in Northern KwaZulu-Natal included semi-structured interviews with five respondents, a focus group, questionnaires as well as in-depth literature study. / Ms. C. van Rooyen

M.Cur. / HIV and AIDS education as a prevention strategy is priority number one in the National Strategic Plan for South Africa. Prevention of illnesses is also an integral part of primary health care (Department of Health, 2007: 10). There are different role players offering age-appropriate HIV and AIDS education to primary school learners, such as educators (within the Life Orientation programme), school health nurses (as part of health promotion) and non-governmental organisation (NGO) peer educators who visit schools per invitation or as part of their programme. Knowledge of collaboration amongst different role payers is necessary in order to pool the complementary strengths and maximise the positive impact of education on adolescents’ sexual behaviour. The design used in this research is quantitative and descriptive in nature. The respondents were clustered according to categories, namely school health nurses, primary school educators and NGO peer educators. As school health nurses (n=8) and peer educators (n=15) constituted a small population, they were all included in the study. Systematic random sampling was used to select respondents from the population of educators (N=75: n=42). A developed questionnaire was distributed to the consenting respondents who met the inclusion criteria. A checklist was also developed to review policies and guidelines used as a framework for providing HIV and AIDS education to learners by role players. A pilot study was conducted. The Statistical Package for Social Science (SPSS14.0) for Windows was used to analyse the data.

Human Immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is rapidly spreading in the whole world and many adolescents start relationships at a younger age without knowing the danger of the sexually transmitted diseases. Parents should involve themselves in imparting knowledge about HIV/AIDS related information. It is imperative that parents and adolescents should have that relationship of discussing about the dangers of HIV/ AIDS. Adolescents should be taught about the importance of relationships and how to protect themselves against the dreaded disease. The research took the form of a qualitative interpretive case study focusing on a study sample of twenty parents and twelve members of a focus group. Data was collected through semi-structured interviews, document analysis and observations. The study examined the hidden issues or underlying the involvement of parents in imparting HIV/AIDS related information to their adolescents. The study revealed that many parents are aware of the pandemic and they felt it is imperative to discuss with their adolescents. Family life education is very much important even if their adolescents are taught about the HIV/AIDS related information at schools. Government is also involved in ensuring that there are preventative measures against the killer disease. This should be a collective effort by both the parents and teachers. The study further recommends the establishment of a library in order to enhance the literacy levels of parents and educators. It will be very much significant to educate or train the trainers in order to educate even our future generation. HIV/AIDS is incurable, therefore, it is imperative for the Department of education to ensure the literacy levels so that even the department of Health contributes its information to inform everybody about the danger of incurable diseases more specifically HIV/AIDS.

Background. In the United States, adolescents are the age group least likely to be aware of their HIV infection and linked to care in a timely manner, contributing to disproportionately low rates of viral suppression and increased risk of transmitting HIV to others. A major barrier to health care for adolescents relates to confidentiality concerns, such as fears that parent/guardian consent will be required or that parents, guardians, or others will be informed of test results. This suggests that state laws related to confidentiality in sexual and reproductive health services could influence their HIV testing practices. Guided by Andersen’s Behavioral Model of Health Services Use, this dissertation utilizes a large, representative sample of sexually active high school students from the 2019 state-level Youth Risk Behavior Surveillance System (YRBSS) to investigate the potential impact of five state-level confidentiality-relevant laws on U.S. adolescents’ HIV testing practices. Methods. Data on HIV testing and individual characteristics (i.e., potential individual-level confounders/covariates) were aggregated from 25 states that participated in the 2019 state-level YRBSS. Data on contextual characteristics (i.e., potential state-level confounders/covariates) were obtained from the United States Census Bureau and the Behavior Risk Factor Surveillance System. Information about state-level confidentiality-relevant laws was compiled from the Guttmacher Institute and the Center for HIV Law and Policy to create five variables indicating whether state laws were confidentiality-promoting at the time of the 2019 state-level YRBSS. Multilevel logistic regression was used to test the following hypotheses: 1. After adjusting for individual and contextual characteristics, confidentiality-promoting state laws will be positively associated with HIV testing among sexually active U.S. high school students, such that odds of self-reported lifetime HIV testing will be significantly higher when states (a) explicitly allow minors to consent to HIV testing, (b) do not have age of consent requirements, (c) do not permit parental/guardian notification, (d) protect the confidentiality of minors insured as dependents, and (e) do not have HIV-specific criminal laws that require disclosure to sexual and/or needle-sharing partners, as compared to states with non-confidentiality-promoting laws. 2. After adjusting for individual and contextual characteristics, sex will moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active U.S. high school students, such that associations between confidentiality-promoting state laws and self-reported lifetime HIV testing will significantly differ between males and females. 3. After adjusting for individual and contextual characteristics, young men who have sex with men (YMSM) status will moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active male high school students, such that associations between confidentiality-promoting state laws and lifetime HIV testing will be significantly stronger among males who report same-sex sexual contact than among males who report opposite-sex sexual contact only. Results. Findings supported the first hypothesis that parental notification not being permitted would be positively associated with HIV testing among sexually active U.S. high school students. After adjusting for individual (i.e., sex, grade level, race/ethnicity, sexual identity) and contextual (i.e., percentage of the state population aged 25 and older with a high school diploma or higher, median household income, lifetime HIV testing among adults) characteristics, odds of self-reported lifetime HIV testing were significantly higher in states that do not permit parent/guardian notification (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.04-1.11; p<.001) than in states that allow health care providers to inform parents or guardians that their child is seeking or receiving STI services. However, results did not support the hypothesis that the other confidentiality-promoting state laws would be positively associated with HIV testing among sexually active U.S. high school students; as compared to states with non-confidentiality-promoting laws, odds of self-reported lifetime HIV testing were significantly lower in states that explicitly allow minors to consent to HIV testing, do not have age requirements to consent to HIV testing, and do not have HIV-specific criminal laws that require disclosure. Results supported the second hypothesis that sex would moderate the relationship between state-level confidentiality-relevant laws and HIV testing among sexually active U.S. high school students, as associations between confidentiality-promoting state laws and lifetime HIV testing differed significantly between males and females. After adjusting for individual and contextual characteristics, the effects of living in a state without age requirements or HIV-specific criminal laws with disclosure requirements on lifetime HIV testing for females were 1.53 (CI: 1.07-2.20; p=.020) and 1.56 (CI: 1.16-2.10; p=.003) times those of males, respectively. Meanwhile, the effects of state laws that explicitly allow minors to consent to HIV testing, do not permit parental notification, and protect the confidentiality of minors insured as dependents on lifetime HIV testing for females were 0.73 (CI: 0.55-0.96; p=.025), 0.72 (CI: 0.52-0.99; p=.043), and 0.66 (CI: 0.48-0.90; p=.008) times those of males, respectively. Analyses with these data failed to reject the null hypothesis for the third [alternative] hypothesis that associations between confidentiality-promoting state laws and self-reported lifetime HIV testing would be significantly stronger among sexually active males who report same-sex sexual contact than among males who report opposite-sex sexual contact only. Conclusions. Findings provide evidence that parental notification not being permitted is associated with significantly increased odds of lifetime HIV testing among sexually active U.S. adolescents, and that sex differentially affects associations between state-level confidentiality-relevant laws and sexually active U.S. adolescents’ HIV testing practices. Parental/guardian notification not being permitted may increase access to and utilization of HIV testing among sexually active U.S. adolescents. Furthermore, confidentiality-promoting laws – particularly those that explicitly include HIV testing in the package of STI services to which minors may consent, do not permit health care providers to notify parents/guardians that their child is seeking or receiving STI services, and protect the confidentiality of minors insured as dependents – may facilitate access to and utilization of HIV testing for sexually active male adolescents. Altogether, this dissertation provides compelling preliminary evidence for efforts to better understand and address structural determinants of HIV and HIV prevention among sexually active U.S. adolescents. Results underscore the need for a comprehensive, multi-level approach to adolescent HIV prevention that goes beyond a focus on reducing individual-level risk factors to increase protective factors at the structural level (e.g., confidentiality-promoting state laws). To address HIV-related health inequities among young people in the United States, advocates must fight for the passage of state laws that protect adolescents’ right to confidential sexual and reproductive health care.

Introduction. The HIV prevalence among men who have sex with men (MSM) in China keeps increasing sharply. A high proportion of the MSM in China have male regular sex partner (RP) and prevalence of unprotected anal intercourse (UAI) involving such RP is higher than when non-RP is involved. Trust, intimacy and cognitive factors are the factors associated with UAI with RP. Several cross-sectional studies have been demonstrated the important factors associated with UAI with RP among MSM in China. However, no study about intervention for MSM-RP is found to be conducted. To reduce UAI with RP, an intervention tailored to RP is urgently developed and identified its efficacy. / Objectives. The study aimed to describe the prevalence of UAI, as well as of which associated factors among MSM-RP in Beijing and Chengdu, China, and to evaluate the efficacy of an enhanced HIV voluntary counseling and testing (VCT) in increasing condom use with RP among MSMRP in China by a randomized controlled trial (RCT). / Subjects and Methods. A cross-sectional survey and a randomized controlled trial have been conducted. For the cross-sectional survey, total 307 HIV negative MSM who have RP have been recruited by three ways. Face to face interview has been conducted to participants. Based on the associated factors found in the cross-sectional survey, interventions including video, education leaflets and enhanced counseling contents have been tailored to RP among MSMRP. For the randomized controlled trial, total 336 MSMRP have been recruited and randomly assigned 169 subjects to the Intervention Group in which participants have been given enhanced VCT plus an audio-visual and four leaflets components and 167 subjects to the Control Group in which participants have been given only standard-of-care VCT at the baseline. Evaluation was conducted at Month 3 and 6. Statistical methods such as descriptive analyses, Chi-square test and logistic regression were used in this study. / Results. The results have been found were the prevalence of UAI with RP among MSMRP was 52.4%, and the Theory of Planned Behavior (TPB) related cognitions, trust, intimacy, depression and anxiety were associated with UAI with RP among MSMRP. In the RCT study, participants in the Intervention Group had less UAI (36.1% vs. 49.1%) than those of the Control Group at Month 3. / Conclusions. This study showed a high prevalence of UAI among MSMRP, whilst trust, intimacy and cognitive factors were associated with UAI with RP. The efficacy of Enhanced VCT tailored to RP has been identified. The acceptability and feasibility of the tailored intervention were demonstrated. In the future HIV prevention programs, the effective intervention should be considered to be incorporated into standard-of-care VCT procedures and be implemented in the specific population. / 介紹：中國男男性接觸者中的愛滋病發病率一直保持著上升的狀態。而在中國男男性接觸者中有很大比例存在著固定性伴侶。男男性接觸者同固定性伴發生無保護肛交行為的比例大於其同非固定性伴。信任，親密以及認知因素已經被證實是影響男男性接觸者同其固定性伴發生無保護肛交行為的因素。但是在中國還沒有發現專門針對有固定性伴的男男性接觸者的干預研究。為了降低男男性接觸者同其固定性伴的無保護肛交的發生率，針對有固定性伴的男男性接觸者的干預方法應該被發展同時證實其有效性。 / 目的：本研究目的在於調查北京及成都男男性接觸者的固定性伴的比例，及其影響因素，包括健康行為理論的影響因素以及人際關係因素。同時，本研究也驗證了以隨機對照實驗來評估針對有固定性伴男男性接觸者的提高型愛滋病自願檢測諮詢對減少其高危性行為的效果。 / 對象與方法：本研究由橫斷面研究以及隨機對照試驗組成。在橫斷面調查中，307名愛滋病陰性的有固定性伴的男男性接觸者被招募。基於在橫斷面調查中發現的對男男性接觸者與固定性伴間發生無保護性行為的影響因素，一項專門針對有固定性伴的男男性接觸者的提高型愛滋病自願檢測諮詢干預方法被發展應用了隨機對照試驗中已驗證其有效性。在隨機對照試驗中，169名和167名研究對象被招募並分別被隨機分配到干預組（接受提高型愛滋病自願檢測諮詢）和對照組（接受標準型愛滋病自願檢測諮詢）中。分別於干預後的3個月和6個月回訪進行干預結果的評估。在本次研究中，運用了卡方检验和logistic回歸等統計學方法。 / 結果：在橫斷面調查中發現，男男性接觸者同固定性伴的無保護肛交發生率為52.4%。影響與固定性伴無保護肛交的因素包括：健康行為理論（TPB）相關的認知，信任，親密以及抑鬱和焦慮。在隨機對照試驗中發現，在3個月隨訪中干預組的男男性接觸者與固定性伴發生無保護肛交的比例較對照組明顯降低（36.1% vs. 49.1%）。 / 結論：本研究結果顯示中國男男性接觸者的固定性伴的比例很高，同時幾乎一半的有固定性伴的的男男性接觸者同時有多個性伴，這就有增加感染愛滋病及其他性病的風險。一項針對有固定性伴的男男性接觸者設計的提高型愛滋病自願檢測諮詢方法在降低其危險性行為上的可接受性和有效性已經被證實。提示在今後的愛滋病干預項目中可以進一步的推廣應用。 / Li, Chunrong. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 149-178). / Abstracts and appendixes also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Li, Chunrong. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.