Computer-Based HIV Prevention Package for Drug Using African American Women

描述(由申请人提供)：为了抗击艾滋病毒的传播，疾病控制中心(CDC)对科学文献进行持续审查，以确定基于证据的艾滋病毒行为干预(EBI)。已经确定了73个EBI。同时，疾病预防控制中心为社区组织以及州和地方卫生部门提供培训和技术援助，以满足这些EBI的较小子集(29)。这一努力被称为有效行为干预扩散(DEBI)项目。跨EBI的一致发现是，以理论为基础并针对个人生活背景量身定做的干预措施最有效。在确定的73个EBI中，只有两个地址 黑人妇女感染的最常见方式(即异性接触和吸毒)。这两个项目都不是Debi项目的一部分，也都没有干预方案。然而，每32名非洲裔美国女性中就有一人会在一生中的某个时候被诊断出感染艾滋病毒。相比之下，每526名白人女性中就有一人会被感染。在吸毒的非裔美国妇女中，艾滋病毒的不成比例的影响进一步增强。为了满足这种需求，我们打算为EBI女性和特定于文化的谈判干预(FCSNI)开发一个基于计算机的程序包。FCSNI是专门为与男性发生性关系的非裔美国女性使用毒品而开发的。还有大量文献表明，社区组织和卫生服务提供者在尝试将EBI纳入其临床实践时面临重大障碍。为了克服这些障碍，我们打算开发第二个模块，专门帮助医疗保健提供者将基于计算机的FCSNI整合到他们的临床实践中。EBI也有对干预成功至关重要的核心要素，因此不应加以修改。不幸的是，对这些核心要素缺乏忠诚度是很常见的，导致了更糟糕的结果。通过调整FCSNI的核心要素以适应基于计算机的环境，它将以跨时间和跨地点的完美保真度交付。通过这种方式，我们希望开发出第一批既可扩展又可广泛使用的EBI之一。第一阶段原型的开发将由首席研究员从FCSNI的原始验证和与治疗服务提供商的形成性研究中获得通知。之后，原型将接受基于任务的可用性测试，使用药物的非裔美国妇女在社区卫生服务提供商寻求艾滋病毒/性传播感染服务。最后，治疗服务提供商将对模块2的功能和内容进行评级。 公共卫生相关性：该项目旨在为与男性发生性行为的非裔美国女性开发一个基于计算机的艾滋病毒预防计划。对于诊所来说，这将使他们能够向客户提供经验性验证的艾滋病毒预防干预措施，而不会对已经不堪重负的工作人员产生额外的需求。对于非裔美国女性来说，这项计划中包含的技能将帮助她们减少危险行为，并最终防止艾滋病毒的传播。

DESCRIPTION (provided by applicant): To combat the spread of the HIV, the Centers for Disease Control (CDC) conducts ongoing reviews of the scientific literature to identify evidence-based HIV behavioral interventions (EBIs). Seventy-three EBIs have been identified. In conjunction with this, the CDC provides training and technical assistance to community based organizations and state and local health departments for a smaller subset (29) of these EBIs. This effort is known as the diffusion of effective behavioral interventions (DEBI) project. A consistent finding across EBIs is that interventions that are theoretically-based and tailored to the life- context of the individual are most effective. Of the 73 EBIs identified, only two address the most common ways that Black women become infected (i.e., heterosexual contact and drug use). Neither are part of the DEBI project and neither has an intervention package. And yet, 1 in 32 African American women will be diagnosed with HIV at some point in her lifetime. In comparison, 1 in 526 white women will become infected. Among drug using African American women the disproportionate impact of HIV is further enhanced. To address this need, we intend to develop a computer-based package for the EBI Female and Culturally Specific Negotiation Intervention (FCSNI). FCSNI was developed specifically for drug using African American women who have sex with men. There is also a substantial body of literature indicating that community-based organizations and health providers face significant barriers when trying to integrate EBIs into their clinical practice. To overcome these barriers, we intend to develop a second module designed specifically to help health providers integrate the computer-based FCSNI into their clinical practice. EBIs also have core elements that are key to intervention success and therefore should not be modified. Unfortunately, lack of fidelity to these core elements is common, leading to poorer outcomes. By adapting the core elements of FCSNI for a computer-based environment, it will be delivered with perfect fidelity across time and location. In this way, we hope to develop one of the first EBIs that is both scalable and widely utilized. Development of the Phase I prototype will be informed by the principal investigator from the original validation of FCSNI and formative research with treatment service providers. Following this, the prototype will undergo task-based usability testing with drug using African American women seeking services at a community-based health provider of HIV/STI services. Finally, treatment service providers will rate the functionality and content of module 2. PUBLIC HEALTH RELEVANCE: This project aims to develop a computer-based HIV prevention program for drug using African American women who have sex with men. For clinics, this will allow them to provide an empirically validated HIV prevention intervention to their cliens without creating additional demands on their already overburdened staff. For African American women, the skills contained in this program will help them reduce risk behaviors and, ultimately, prevent the spread of HIV.