MULTICULTURAL OUTREACH FOR HIV/AIDS/DRUG RISKS

艾滋病毒感染正迅速从城市地区向小城镇和农村地区转移。 在这些地区，流行病可能迅速对 当地少数民族的生存能力。 风险特别高的是原住民 美国人和其他少数群体，他们的艾滋病毒风险药物滥用， 性规范和文化塑造的健康信仰体系使他们 艾滋病预防广播媒体和城市 街头外展预防性干预的方式。 我们建议的项目针对几个农村高风险文化群体， 被艾滋病预防研究所忽视。 其整体 目的是开发、实施和评估一个创新的 一种文化塑造的外联干预方法， 传统的外展活动在减少艾滋病毒感染方面显然具有上级优势， 在增加预防意图的同时， 该项目的 四个种族目标群体是纳瓦霍和霍皮美洲原住民，西班牙裔 盎格鲁人 干预的目标受试者是静脉吸毒者，非静脉吸毒者 药物滥用者，他们的性伴侣，以及其他个人， 生活方式使他们感染艾滋病毒的风险更高。 该项目将 由一个跨学科的合作调查小组进行 和具有民族志经验的顾问。 艾滋病毒/艾滋病预防和 流行病学研究和基于社区的干预评估 问题研究 项目第一阶段涉及风险环境的初步测绘， 民族志调查，以确定有效的，文化上适当的 实验性外联干预措施的要素， 监测/监督战略。 第2阶段（从第4年开始 四分之一）实施了一项准实验研究，测试相对 干预策略的有效性。 使用前和后- 干预加上对过程和结果变量的后续评估。 这两种外联干预措施都包括使用自然话语， 文化上适当的隐喻，但一个是传统的说教，在其 一种是降低风险的信息传输，另一种是增强的 许多农村少数民族传统上使用的以故事为基础的方法 尤其是在美洲土著文化中。

HIV infection is rapidly moving from urban areas to smaller towns and rural areas where the epidemic can quickly have devastating effects on the viability of small local populations. At particularly high risk are Native Americans and other minority groups whose HIV-risking substance abuse and sexual norms and culturally shaped health belief systems have left them relatively inaccessible to both AIDS prevention broadcast media and urban styles of street outreach preventive interventions. Our proposed project addresses several rural high risk cultural groups that have been neglected by HIV outreach prevention research. Its overall purpose is the development, implementation and evaluation of an innovative method of culturally shaped outreach intervention which as compared to conventional outreach would be demonstrably superior in reducing HIV- risking behaviors while increasing preventive intentions. The project's four ethnic target groups are Navajo and Hopi Native Americans, Hispanics and Anglos. The targeted subjects for intervention are IVDU's, non-IV substance abusers, their sexual partners, and other individuals whose lifestyles place them at higher risk for HIV infection. The project would be conducted by an interdisciplinary collaborative team of investigators and consultants experienced in ethnography. HIV/AIDS prevention and epidemiologic research, and evaluation of community based intervention studies. Project Phase 1 involves preparatory mapping of risk environments and ethnographic investigations to define effective, culturally appropriate elements of the experimental outreach interventions plus the monitoring/surveillance strategies. Phase 2 (beginning 01 year 4th quarter) implements a quasi-experimental study testing the relative effectiveness of the intervention strategies. Using pre and post- intervention plus follow-up assessments of process and outcome variables. Both outreach interventions include the use of natural discourse and culturally appropriate metaphors, but one is conventionally didactic in its risk-reduction information transmission while the other uses an enhanced story-based approach which is traditionally used by many rural minorities and in Native American cultures in particular.