Multicomponent Intervention to Reduce Sexual Risk and Substance Use

减少性风险和药物使用的多成分干预

基本信息

  • 批准号:
    8675352
  • 负责人:
  • 金额:
    $ 7.34万
  • 依托单位:
  • 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:
    2012-08-01 至 2017-07-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Project Summary Transgender women (TW) are at significant risk for HIV infection or transmission as a result of high levels of sexual risk behavirs and co-occurring substance use. Despite HIV and STI rates greater than those of men who have sex with men, there are currently no CDC-approved "best evidence interventions" to reduce HIV risk for TW. This project seeks to evaluate the efficacy of a peer-led innovative and scalable 7-session hybrid individual- and group-based HIV risk reduction intervention, based on Motivational Interviewing (MI) and Cognitive-Behavioral Skills Training (CBST) with TW in New York City (NYC). The intervention is based on promising findings from a CDC-funded pilot peer-led group intervention for TW, which was shown to be feasible, acceptable, and indicated preliminary efficacy in a short-term follow-up of a non-randomized design with no control group. We propose to expand and refine this intervention, in conjunction with TW and community partners who provide medical, social, and other services for TW, in order to evaluate the longer- term efficacy of a scalable 7-session intervention (two MI-based individual sessions, four MI and CBST-based group sessions, and one MI-based individually-tailored health navigation session) all delivered by TW peer- health navigators (PHN) to reduce risky sex and substance use among TW in NYC. The last session in both conditions will be followed by a phone call from the PHN regarding follow-through with accessing services and facilitation of any needed assistance, and a brief post-intervention assessment of primary outcomes. This randomized control trial (RCT) will examine short (immediate, and 4-months post-intervention) and longer-term (8 and 12-months post-intervention) outcomes between TW randomized to the intervention or an attention control education condition, both of which will include a booster session at 4-months post-intervention. Primary outcomes will be: (1) reductions in sexual risk (self-report and STI incidence), and (2) reductions in substance use (self-report, urine, and substance use related problems) and non-medically monitored hormone treatment and silicone injections. Secondary outcomes will be: (1) increases in resilience (e.g., engagement in care, self- esteem, positive coping), and (2) reductions in minority stress (e.g., internalized transphobia, stigma). In Phase I we will train four TW to be peer health navigators (PHNs) to deliver the 7-session intervention. We will also refine the intervention and develop a 7-session attention education condition based on feedback from PHNs and our community partners. In Phase II, we will recruit 20 TW to pilot both conditions. Participant and PHN feedback will be collected to fine-tune the intervention. In Phase III, 240 TW will be randomized to one of the two arms and outcomes will be assessed over 12-months post intervention. We will conduct biological testing (HIV, Chlamydia, gonorrhea, and syphilis) and collect self-report data to evaluate intervention efficacy. The proposed project will iteratively strengthen an existing promising intervention to provide much needed evidence-based support to reduce the syndemic of risk factors faced by TW, and test the efficacy of a 7- session intervention led by TW peers. This study will be the first in NYC and the US to formally evaluate the utility of a peer-delivered MI and CBST- based intervention tailored for TW, which can then be scalable and replicated in various communities to provide continuous support and protection for this underserved and marginalized vulnerable group.
描述(由申请人提供):项目摘要跨性别妇女(TW)是在艾滋病毒感染或传播的高风险性风险的结果高水平的HIV病毒和共同发生的物质使用的重大风险。尽管艾滋病毒和性传播感染率高于男男性行为者,但目前没有CDC批准的“最佳证据干预措施”来降低TW的艾滋病毒风险。该项目旨在评估一个同行领导的创新和可扩展的7届混合个人和群体为基础的艾滋病毒风险降低干预措施的有效性,动机访谈(MI)和认知行为技能培训(CBST)与TW在纽约市(NYC)。该干预措施基于CDC资助的TW试点同行领导的小组干预的有希望的结果,该干预措施被证明是可行的,可接受的,并在短期随访的非随机设计中显示了初步疗效,没有对照组。我们建议与TW和为TW提供医疗、社会和其他服务的社区合作伙伴一起扩大和完善这种干预,以评估可扩展的7次干预的长期疗效。(两个基于MI的个人会议,四个基于MI和CBST的小组会议,和一个基于MI的个性化定制健康导航会话),所有这些都由TW同伴健康导航员(PHN)提供,以减少纽约TW中的危险性行为和物质使用。在两种情况下的最后一次会议之后,PHN将打电话询问后续服务获取和任何所需援助的便利,并对主要结局进行简短的干预后评估。这项随机对照试验(RCT)将检查TW随机分配到干预或注意力控制教育条件之间的短期(即时和干预后4个月)和长期(干预后8个月和12个月)结局,这两种情况都将包括干预后4个月的强化治疗。主要结果将是:(1)降低性风险(自我报告和STI发病率),(2)减少物质使用(自我报告,尿液和物质使用相关问题)和非医学监测的激素治疗和硅胶注射。次要结果将是:(1)弹性增加(例如,参与护理,自尊,积极应对),和(2)减少少数民族的压力(例如,内化的跨性别恐惧症,污名)。在第一阶段,我们将培训四名TW成为同伴健康导航员(PHN),以提供7次干预。我们亦会根据PHN及社区合作伙伴的反馈,完善干预措施,并制定一个7节的注意力教育条件。在第二阶段,我们会招募20名荃湾工人,以试验这两种情况。将收集参与者和PHN的反馈,以微调干预措施。在III期,240名TW将被随机分配到两个组中的一个,并将在干预后12个月内评估结局。我们将进行生物检测(艾滋病毒、衣原体、淋病和梅毒),并收集自我报告数据,以评估干预效果。拟议的项目将反复加强现有的有希望的干预措施,以提供急需的循证支持,以减少TW面临的风险因素的综合征,并测试由TW同行领导的7次干预的有效性。这项研究将是纽约市和美国首次正式评估针对TW量身定制的基于同行交付的MI和CBST的干预措施的效用,然后可以在各个社区扩展和复制,为这个服务不足和边缘化的弱势群体提供持续的支持和保护。

项目成果

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JEFFREY T PARSONS其他文献

JEFFREY T PARSONS的其他文献

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{{ truncateString('JEFFREY T PARSONS', 18)}}的其他基金

Examining Modifiable Psychosocial Predictors of HIV Seroconversion in a Large Nationwide Cohort of High Risk Men
检查全国范围内大量高危男性中 HIV 血清转化的可修改心理社会预测因素
  • 批准号:
    9393474
  • 财政年份:
    2017
  • 资助金额:
    $ 7.34万
  • 项目类别:
Examining community-based effectiveness of a substance use and HIV risk reduction intervention for young men of color
检查基于社区的针对有色人种年轻男性的药物滥用和艾滋病毒风险降低干预措施的有效性
  • 批准号:
    9065055
  • 财政年份:
    2016
  • 资助金额:
    $ 7.34万
  • 项目类别:
Examining community-based effectiveness of a substance use and HIV risk reduction intervention for young men of color
检查基于社区的针对有色人种年轻男性的药物滥用和艾滋病毒风险降低干预措施的有效性
  • 批准号:
    9296114
  • 财政年份:
    2016
  • 资助金额:
    $ 7.34万
  • 项目类别:
Improving HIV and Alcohol-Related Outcomes among HIV+ Persons in Clinic Settings
改善诊所环境中艾滋病毒感染者的艾滋病毒和酒精相关结果
  • 批准号:
    8723710
  • 财政年份:
    2013
  • 资助金额:
    $ 7.34万
  • 项目类别:
Improving HIV and Alcohol-Related Outcomes among HIV+ Persons in Clinic Settings
改善诊所环境中艾滋病毒感染者的艾滋病毒和酒精相关结果
  • 批准号:
    8842555
  • 财政年份:
    2013
  • 资助金额:
    $ 7.34万
  • 项目类别:
Improving HIV and Alcohol-Related Outcomes among HIV+ Persons in Clinic Settings
改善诊所环境中艾滋病毒感染者的艾滋病毒和酒精相关结果
  • 批准号:
    9059546
  • 财政年份:
    2013
  • 资助金额:
    $ 7.34万
  • 项目类别:
Improving HIV and Alcohol-Related Outcomes among HIV+ Persons in Clinic Settings
改善诊所环境中艾滋病毒感染者的艾滋病毒和酒精相关结果
  • 批准号:
    8544147
  • 财政年份:
    2013
  • 资助金额:
    $ 7.34万
  • 项目类别:
Multicomponent Intervention to Reduce Sexual Risk and Substance Use
减少性风险和药物使用的多成分干预
  • 批准号:
    8515387
  • 财政年份:
    2012
  • 资助金额:
    $ 7.34万
  • 项目类别:
Multicomponent Intervention to Reduce Sexual Risk and Substance Use
减少性风险和药物使用的多成分干预
  • 批准号:
    8421982
  • 财政年份:
    2012
  • 资助金额:
    $ 7.34万
  • 项目类别:
Intervention Targeting Substance Using Older Adults with HIV
针对使用感染艾滋病毒的老年人的药物进行干预
  • 批准号:
    8207429
  • 财政年份:
    2010
  • 资助金额:
    $ 7.34万
  • 项目类别:
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