Adapting an EBI for HIV Sexual Risk Prevention for Homeless Women

描述（由申请人提供）：无家可归的妇女需要高度可获得的、基于社区的艾滋病毒性风险预防服务。无家可归的妇女比有住房的低收入妇女面临更大的感染艾滋病毒/艾滋病和吸毒的风险。循证干预措施（EBIs）可以降低高度脆弱人群中的艾滋病毒风险，但传播有限。可能需要调整ebi，以适应无家可归妇女及其社区的需要。本研究的目的是为无家可归妇女提供一种适合的EBI，以预防艾滋病毒性风险，并有望转化为常规实践。具体目标如下：目标1/第一阶段：形成阶段：(a)与庇护所提供者进行焦点小组（4组；每组7-8名提供者），并与4个艾滋病毒/艾滋病服务提供者进行半结构化访谈，以评估庇护所提供者实施预防艾滋病毒的EBI的能力和资源可用性；(b)系统地审查环境影响指标并制定适应建议；(c)与无家可归妇女（2组，每组14-16名妇女）和住房提供者（2组，每组14-16名提供者）举行协商一致的小组会议，以决定应选择哪一种EBI进行调整以及应如何调整；(d)与专题专家协商，准备对选定的EBI进行改编，并通过焦点小组（4个小组，每个小组7-8名妇女；4个小组，每个小组7-8名提供者）介绍并获得无家可归妇女和庇护所提供者对改编后的EBI的反馈。目标2/第2阶段：初步测试阶段：(a)通过焦点小组（4组；每组7-8名妇女）对无家可归妇女进行调整后的EBI预测试，并根据需要进行修改；(b)在无家可归妇女中进行适应性EBI试点测试（10组，每组7-8名妇女）；(c)在专题专家、庇护所和艾滋病毒/艾滋病服务提供者的协商下，最后确定经修订的EBI；(d)计划进行随机对照试验，以检验适应性EBI在无家可归妇女中预防艾滋病毒的有效性。

DESCRIPTION (provided by applicant): Homeless women need highly accessible, community-based HIV sexual risk prevention services. Homeless women face greater risk of HIV/AIDS and substance use than low-income women who are housed. Evidence-based interventions (EBIs) can reduce HIV risk among highly vulnerable populations but dissemination is limited. EBIs may need to be adapted to suit homeless women's needs and their communities. The objective of this study is to produce an adapted EBI for HIV sexual risk prevention for homeless women that holds promise of translation into routine practice. The Specific Aims are as follows: Aim 1/Phase 1: Formative phase: (a) conduct focus groups (4 groups; 7-8 providers each) with shelter providers and semi-structured interviews with 4 HIV/AIDS service providers to assess the capacity and availability of resources for shelter providers to implement an EBI for HIV prevention; (b) systematically review EBIs and develop recommendations for adaptation; (c) conduct consensus group meetings with homeless women (2 groups; 14-16 women each) and shelter providers (2 groups, 14-16 providers each) to decide which EBI should be selected for adaptation and how it should be adapted; (d) consult with topical experts and prepare the adaptation of the selected EBI, and present and obtain feedback on the adapted EBI from homeless women and shelters providers through focus groups (4 groups, 7-8 women each; 4 groups, 7-8 providers each). Aim 2/Phase 2: Preliminary testing phase: (a) conduct pre-test of the adapted EBI with homeless women through focus groups (4 groups; 7-8 women each) and modify as necessary; (b) conduct pilot test of the adapted EBI with homeless women (10 groups; 7-8 women each); (c) finalize the adapted EBI with consultation from topical experts, and shelter and HIV/AIDS service providers; (d) plan for randomized controlled trial to test efficacy of adapted EBI for HIV prevention among homeless women.