WOMEN WITH STDS: HIV RISK REDUCTION IN AN HMO (PSST)

描述(摘自摘要)：艾滋病在中国迅速增加 在美国女性中，它现在是#年的第四大死因 年龄在25-44岁之间的女性。性病是艾滋病毒风险的标志：活动性性病 感染使人暴露在感染艾滋病毒的更大风险中。 在拟议的四年研究中，首席调查员和她 联合公司将开发和测试一个单独的-和小的-小组- 实施行为改变干预，今天实行安全的性行为 (Psst)，以改善STD治疗、依从性和预防进一步的STD 感染，包括艾滋病毒。潜在的假设是Psst将是 与(1)更一致和适当的避孕套使用有关， (2)生理记录的性传播疾病感染率较低；(3)较低 这些疾病给患者带来的情感负担，以及(4)利用率较低 和医疗保健服务的费用。 具体目标是：(1)开发和预试PSST程序， 从目标成员获得输入和结构化反馈 人口(n=80)，通过焦点小组和个人访谈的方式。使用 在整个多阶段开发过程中进行顾问审查；(2) 招募600名女性，年龄在18-35岁之间，被诊断患有任何一种性传播疾病 在北加州三个凯撒医疗中心之一；(3)聚集 关于他们性行为的人口统计和其他基线信息， 避孕套的使用和其他心理社会特征为他们提供了一种 更安全的性行为套装和避孕套优惠券将在健康中心兑换 教育署，并以相等的数目随机分配给 Psst计划与那些分配给治疗条件的计划，包括 个人教育(面对面和最多两个电话联系人)和 与一名健康教育者进行三次小组会议，妇女们将在其中 讨论与性传播疾病相关的传播途径、治疗和风险， 有机会实践新的自我保护策略；(5) 在18个月的时间里跟踪这些女性，在6岁时收集信息- 卫生保健利用率和成本的每月间隔，并将两者记录在案 有症状和无症状的新发/复发性性病感染；(6)比较 Psst和控制妇女在比例方面完全符合 性病治疗建议，比例一致和正确 使用避孕套、性病发病率、抑郁程度、使用安全套 医疗服务及医疗成本；及(7)厘定成本- 干预的有效性(#年干预的边际成本 与节省医疗保健成本有关)。

DESCRIPTION (adapted from the Abstract): AIDS is rapidly increasing in the United States among women; it is now the fourth leading cause of death in women aged 25-44 years. STDs are a marker for HIV risk: active STD infection places a person at greater risk of contracting HIV is exposed. In the proposed four-year study the Principal Investigator and her associated will develop and test an individually-and small-group- administered behavior changes intervention, Practicing Safer Sex Today (Psst), to improve STD treatment, compliance and to prevent further STD infection, including HIV. The underlying hypothesis is the Psst will be associated with (1) more consistent and appropriate reported condom use, (2) lower rates of physiologically documented STD infection, (3) lesser emotional burden of these illnesses on patients, and (4) lower utilization and cost of health care services. The specific aims are to: (1) develop and pretest the Psst program, obtaining input and structured feedback from members of the target population (n=80) by way of focus groups and personal interviews. with consultant review, throughout the multi-stage development process; (2) enroll 600 women, 18-35 years of age, diagnosed with any of several STDs at one of three Kaiser Medical Centers in Northern California; (3) gather demographic and other baseline information on their sexual behavior, condom use, and other psychosocial characteristics, provide them with a safer-sex kit and coupon for condoms to be redeemed at the Health Education Department, and assign them randomly in equal numbers to the Psst program with those assigned to the treatment condition, consisting of individual education (in person and with up to two phone contacts) and three small group sessions with a health educator, in which the women will discuss the transmission route, treatment, and risks associated with STDs, couple opportunities to practice new self-protection strategies; (5) follow these women over an 18-month period, gathering information at six- month intervals on health care utilization and costs, and documenting both symptomatic and asymptomatic new/recurring STD infections; (6) compare Psst and control women in terms of the proportions fully compliant with STD treatment recommendations, the proportions consistently and correctly using condoms, STD incidence rates, levels of depression, utilization of health care services, and health care costs; and (7) determine the cost- effectiveness of the intervention (marginal cost of the intervention in relation to health care cost savings).