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Rapid HIV Testing and Counseling in High Risk Women in Shelters

对收容所中的高危妇女进行快速艾滋病毒检测和咨询

基本信息

批准号：
8515531
负责人：
DAWN M JOHNSON
金额：
$ 17.73万
依托单位：
UNIVERSITY OF AKRON
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-07-23 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8515531
关键词：
AIDS prevention AIDS/HIV problem Address Alcohol or Other Drugs use American Anal Sex Anxiety Awareness Behavior Therapy Caring Centers for Disease Control and Prevention (U.S.)Child Child Care Client Clinical Clinical Services Clinical Trials Communities Counseling Data Development Diffusion Domestic Violence Early Diagnosis Emergency Situation Environment Face Focus Groups Forcible intercourse Fright Future Goals HIV HIV Infections HIV Seropositivity HIV risk Health Expenditures Health Insurance Health Services Healthcare High Risk Woman Human Resources Human immunodeficiency virus test Injecting drug user Institutes Intervention Knowledge Left Life Link Literature Manuals Mediation Medical Modeling Morbidity - disease rate Multiple Partners Pilot Projects Population Post-Traumatic Stress Disorders Preventive Intervention Protocols documentation Public Health Quality of life Recording of previous events Reporting Research Research Proposals Risk Risk Behaviors Risk Factors Risk Reduction Safety Sampling Services Severities Sex Behavior Sexual Partners Sexually Transmitted Diseases Shelter facility Site Staging Substance Use Disorder Symptoms Target Populations Test Result Testing Time Training Transportation Trichomonas Infections Underserved Population United States Unsafe Sex Vagina Visit Vulnerable Populations Woman base condoms disorder risk evidence base follow-up help-seeking behavior high risk high risk sexual behavior improved information gathering innovation intimate partner violence meetings mortality novel prevent programs response secondary outcome sex transmission process

项目摘要

DESCRIPTION (provided by applicant): Early knowledge of HIV status is critical to prevent transmission to others, to link those who are HIV positive to medical care and services that can reduce morbidity and mortality and improve quality of life, and to reduce health care expenditure. Consistently, the National HIV/AIDS strategy has established a goal of increasing the awareness of HIV status in Americans from 79% to 90% in the next four years. The proposed research is in direct response to PA-11-119, "HIV/AIDS Testing and Follow-up Among the Underserved in the United States," and proposes to investigate the acceptability, feasibility, and initial efficacy of a rapid HIV testing and counseling protocol in residents of domestic violence shelters. Intimate partner violence (IPV) is a pervasive public health problem, and a growing body of research highlights the association between IPV and HIV/STI risk (e.g., increased unprotected sexual occasions, sex with risky partners, trading sex, multiple partners). Further, IPV is associated with many barriers to receiving adequate health care (e.g., transport difficulties, child care needs, safety issues, lack of health insurance). Domestic shelters present an opportune setting for providing health care services for women, providing a safe and supportive environment for testing, while addressing many of the barriers to testing and linkage to care faced by shelter residents. RESPECT-2 is an evidence- based CDC Diffusion of Effective Behavioral Interventions (DEBI), utilizing a client-focused, interactive HIV risk reduction counseling model delivered in conjunction with rapid testing. Residents of domestic shelters, however, face distinct HIV risk factors, such as difficulty in negotiating condom use out of fear of retaliation from their abuser, and thus needs to be tailored to meet the specific needs of shelter residents. Thus, in the proposed exploratory/developmental research plan, we aim to expand RESPECT-2 for our target population (i.e., RESPECT-IPV), and to collect preliminary data on RESPECT-IPV + rapid testing's feasibility, acceptability, and initial efficacy in a sample of 100 high-risk shelter women. Predictors of acceptability (e.g., PTSD symptoms, substance use, IPV severity, prior testing history, HIV knowledge, HIV risk behavior, HIV anxiety, stage of change) will also be explored. Our primary hypotheses are that RESPECT-IPV will be associated with reduced unprotected vaginal or anal sex occasions at 1-week and 3-months post-shelter and fewer cases of vaginal trichomoniasis 3-months after leaving shelter.

描述（由申请人提供）：早期了解艾滋病毒状况对于防止传播给他人、让艾滋病毒阳性者获得可降低发病率和死亡率、提高生活质量的医疗保健和服务以及减少医疗保健支出至关重要。国家艾滋病毒/艾滋病战略始终设定了一个目标，即在未来四年内将美国人对艾滋病毒状况的认识从 79% 提高到 90%。拟议的研究是对 PA-11-119“美国服务不足人群的艾滋病毒/艾滋病检测和随访”的直接回应，并提议调查家庭暴力庇护所居民中快速艾滋病毒检测和咨询方案的可接受性、可行性和初步效果。亲密伴侣暴力 (IPV) 是一个普遍存在的公共卫生问题，越来越多的研究强调 IPV 与 HIV/STI 风险之间的关联（例如，无保护的性行为次数增加、与高风险伴侣发生性行为、性交易、多个伴侣）。此外，IPV 还与获得充分医疗保健的许多障碍有关（例如交通困难、儿童保育需求、安全问题、缺乏健康保险）。存在国内避难所为妇女提供医疗保健服务的有利环境，为检测提供安全和支持性的环境，同时解决庇护所居民面临的检测和与护理联系的许多障碍。 RESPECT-2 是一种基于证据的 CDC 有效行为干预措施 (DEBI) 扩散，利用以客户为中心的交互式 HIV 风险降低咨询模型与快速检测相结合。然而，家庭收容所的居民面临着独特的艾滋病毒风险因素，例如难以协商使用安全套由于担心受到施虐者的报复，因此需要进行定制以满足庇护所居民的具体需求。因此，在拟议的探索性/发展性研究计划中，我们的目标是针对目标人群扩展RESPECT-2（即RESPECT-IPV），并在100名高危收容所女性样本中收集RESPECT-IPV +快速检测的可行性、可接受性和初步疗效的初步数据。还将探讨可接受性的预测因素（例如 PTSD 症状、物质使用、IPV 严重程度、既往检测史、HIV 知识、HIV 危险行为、HIV 焦虑、变化阶段）。我们的主要假设是，RESPECT-IPV 将与庇护所后 1 周和 3 个月内无保护的阴道或肛交次数的减少以及离开庇护所后 3 个月后阴道滴虫病病例的减少有关。