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

描述（改编自摘要）：艾滋病正在迅速增加， 它现在是美国妇女死亡的第四大原因， 25-44岁的妇女。性病是艾滋病毒风险的标志：活动性性病 感染会使一个人面临更大的感染艾滋病毒的风险。 在这项为期四年的研究中，首席研究员和她的 联合会将开发和测试一个单独的和小组的， 管理行为改变干预，今天更安全的性行为 （Psst），以改善性病治疗，依从性和防止进一步的性病 感染，包括艾滋病毒。潜在的假设是， 与（1）更一致和适当地报告避孕套使用有关， (2)生理记录的STD感染率较低，（3）较少 这些疾病对患者的情感负担，以及（4）较低的利用率 和医疗保健服务的成本。 具体目标是：（1）开发和预测试Psst程序， 从所述目标的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。与 在多阶段开发过程中进行顾问审查;（2） 招募了600名18-35岁的女性，被诊断患有几种性病中的任何一种 在北方加州的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学和其他基线信息， 安全套的使用，以及其他心理社会特征，为他们提供了一个 安全性行为套及安全套代用券可于健康中心 ，并以相同数目随机分配至 PSST程序与分配给治疗条件的程序，包括 个人教育（亲自和最多两个电话联系人）， 三个小组会议与健康教育家，其中妇女将 讨论性病的传播途径、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，收集6个月的信息， 每隔一个月就医疗保健利用率和成本进行一次调查，并记录两者 有症状和无症状的新发/复发性STD感染;（6）比较 PSST和对照组妇女的比例完全符合 性病治疗建议，比例一致，正确 避孕套使用，性病发病率，抑郁水平， （7）医疗服务及医疗费用;及（7）厘定费用- 干预的有效性（干预的边际成本） 节约医疗费用）。

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).