COMPREHENSIVE COMMUNITY BASED HIV/AIDS PREVENTION

我们以前的研究工作主要集中在性病和艾滋病毒的预防 为商业性工作者（CSW）和经理/主管 在菲律宾雇用他们的机构。基于 基于个人和组织的方法的成功结果 包括同伴教育和组织变革（包括 关于预防性传播疾病和使用避孕套的教育政策）， 我们目前正在构思一项扩展计划， 菲律宾南部的干预地点。 扩大的努力 是针对商业性以外的高危人群 我们在这些机构和社会卫生科诊所设有 成功实施组织变革， 大大降低了STD。包括在扩展的努力是 来自高风险社区、军队/警察、 工业工人和出租车司机。 扩大的努力将 还包括高风险社区、社区官员和卫生 护理人员。 这种全面干预的目的 是建立一个探索性的模型来检验 期望、社区规范和价值观以及社会影响 与安全性行为相关的行为和态度 实践一个理论/概念模型，包括自我- 有效性，自尊，安全套使用沟通 客户和工人，并打算使用避孕套， 研究了内源性和 外生变量四、二组准实验设计 将与对CSW的干预工作一起使用， 管理人员作为所有四个站点的标准。具体地说， 干预措施将单独针对卫生工作者实施， 工业、高风险社区、军队/警察和出租车/三轮车 驱动程序在四个站点之一，第二个站点作为控制。 大约7,000人将参加 干预活动。一系列二元和多元 将使用程序来检查干预的效果 包括使用结构方程建模， 考察内生与外生之间的因果结构 变量结果变量还包括性病的类型， 预防性病的成本。此外，定性分析将 用于确定干预措施成为 制度化，从而保持长期的影响， 社区

Our previous research efforts focused on STD and HIV prevention for Commercial sex workers (CSWs) and manager/supervisors of establishments which employ them in Philippines. Based on the sucessful results of individual and organization based approaches consisting of peer education and organization change (including educational policy regarding STD prevention and condom use), an expanded program is being conceptualized in our current intervention sites in the southern Philippines. The expanded effort is directed toward high-risk groups outside the commercial Sex establishments and Social Hygiene Clinics where we have successfully implemented organizational changes leading to significant reductions in STD. Included in the cxpanded effort are male clients of CSWs from high-risk communities, military/police, indussrial workers, and taxicab drivers. The expanded efforts will also include high-risk communities, community officials and health care personnel. The objective-of this comprehensive intervention is to build an exploratory model to examine the value expectancies, community norms and values, and social influences on the behaviors and attitudes associated with safer sexual practices. A theoretical/conceptual model consisting of self- efficacy, self-esteem, communication of condom use between client and worker, and intention to use condoms has been developed to examine the relationship between endogenous and exogenous variables. Four, two group quasi-experimental designs wlll be employed with intervention efforts for CSWs and managers as a standard across all four sites. Specifically, interventions will be implemented separately for health workers, industries, high-risk communities, military/police and taxi/pedicab drivers in one of four sites with a second site serving as a control. Approximately 7,000 individuals will participate in the intervention activities. A series of bivariate and multivariate procedures will be used to examine the effects of the intervention including the use of use of structural equation modeling to examine the causal structure between endogenous and exogenous variables. The outcome variables also include type of STD and cost per prevented STD case. In addition, qualitative analyses will be used to identify the process by which the interventions become institutionalized thus maintaining long term effects in the community.