COMPREHENSIVE COMMUNITY BASED HIV/AIDS PREVENTION

我们之前的研究重点是性传播疾病和艾滋病毒预防。 针对商业性工作者(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 关于预防性病和使用避孕套的教育政策)， 目前，我们正在构思扩展计划 菲律宾南部的干预地点。扩大的努力 是针对商业性之外的高危群体 我们拥有的机构和社会卫生诊所 成功实施组织变革，从而实现 性传播疾病的显著减少。这项努力包括 性服务提供者的男性客户来自高危社区、军队/警察、 工业工人和出租车司机。扩大的努力将 还包括高危社区、社区官员和卫生 护理人员。这一全面干预的目标 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 关于与安全性行为相关的行为和态度 练习。由自我构成的理论/概念模型 安全套使用的有效性、自尊、沟通 客户和工作人员，并打算使用避孕套 研究内源性与非内生性之间的关系 外生变量。四、两组准试验设计 将对CSWS进行干预工作，并 管理人员作为所有四个站点的标准。具体来说， 对卫生工作者的干预措施将单独实施， 工业、高危社区、军队/警察和出租车/三轮车 四个站点中的一个站点的司机，第二个站点作为对照。 约7,000人将参加 干预活动。一系列双变量和多变量 程序将被用来检查干预的效果 包括使用结构方程建模来 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类型和 每个预防性病病例的成本。此外，定性分析将 用来确定干预措施成为 制度化，从而在 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.