MULTICULTURAL OUTREACH FOR HIV/AIDS/DRUG RISKS

艾滋病毒感染正在从城市地区迅速转移到小城镇和农村 疫情可能迅速对人类健康造成毁灭性影响的地区 当地小种群的生存能力。风险特别高的是原住民 美国人和其他少数群体，他们滥用有艾滋病毒风险的药物和 性规范和文化形成的健康信仰体系让他们 相对较难接触到艾滋病预防广播媒体和城市 街道外展预防性干预的方式。 我们建议的项目针对几个农村高危文化群体， 已经被艾滋病毒外展预防研究所忽视。它的整体 目的是制定、实施和评估一项创新的 文化塑造外展干预方法与 在减少艾滋病毒方面，传统的外展将明显优越-- 在增加预防意图的同时增加行为的风险。该项目的 四个种族目标群体是纳瓦霍人和霍皮人美洲原住民，拉美裔 还有盎格鲁人。干预的目标对象是IVDU，非IV 物质滥用者，他们的性伴侣，以及其他其 生活方式使他们感染艾滋病毒的风险更高。该项目将 由一个跨学科协作的调查小组进行 以及在人种学方面经验丰富的顾问。艾滋病毒/艾滋病预防和 社区干预的流行病学研究和评价 学习。 项目第一阶段涉及风险环境和风险环境的初步测绘 人种学调查，以确定有效的、文化上合适的 试验性外展干预措施的要素加上 监测/监视战略。第二阶段(从01年第4年开始 季度)实施了一项准实验研究，测试了相对 干预策略的有效性。使用前置和后置- 干预加上对过程和结果变量的后续评估。 这两种外展干预措施都包括使用自然话语和 文化上合适的隐喻，但一个人在其传统的说教中 降低风险的信息传输，而另一种使用增强型 故事教学法是许多农村少数民族传统上使用的方法 尤其是在美洲原住民文化中。

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.