Prevention of HIV/AIDS and STDs in Women over Fifty

描述（由申请人提供）：老年成年妇女（50岁以上）几乎占美国艾滋病毒/艾滋病人口的三分之一，并且这一群体的感染率正在上升。拟议的II期申请的总体目标是为老年妇女，特别是非洲裔美国人和拉丁裔妇女开发一种文化敏感、性别特定和适合年龄的艾滋病毒预防干预措施，这些妇女感染艾滋病毒/性病的风险极高。我们的目标人群是越来越多的离婚/分居的老年妇女，由于队列和社会背景因素，她们可能没有意识到自己处于危险之中，比单身（未婚）妇女更有可能放弃使用避孕套。在第一阶段和ARRA研究结果的基础上，我们第二阶段的目标是创建、测试和商业化一种基于积极心理学的“智能网络”干预，以促进正在约会或计划约会的不同文化的老年离婚或分居女性的健康和安全性行为。具体的第二阶段目标是：1)创建SmartWeb干预；2)在50岁以上离婚/分居女性的随机对照试验（RCT）中评价其有效性；3)准备SmartWeb干预的营销和商业化计划。与我们第一阶段的目标一致，即开发内容以解决M-AARM理论模型的第1-3阶段，拟议的第二阶段包括解决M-AARM第4-5阶段的新组件。第二阶段也响应了第一阶段的评估结果，包括对移动接入、会员资格的渴望；对妇女健康、阳性老龄化、多元文化社区的艾滋病毒/性病预防、安全性行为谈判策略和灰色离婚等方面的专家进行视频采访；基于积极心理学的自我效能和情感提升电子邮件，以及第一阶段组件的扩展版本，以加强M-ARRM理论模型的第1-3阶段。我们在波士顿、麻萨诸塞州和哥伦比亚南卡罗莱纳州的合作伙伴支持这些努力，这两个地方是进行随机对照试验的地点。参与合作伙伴包括提供商业化支持的机构（全球保护公司，南加州大学哥伦比亚分校孵化器，SC启动，Moker CPCA），波士顿的招聘和营销支持（新英格兰50岁以上艾滋病毒协会，马萨诸塞州公共卫生部全州艾滋病毒/艾滋病消费者咨询委员会，布里格姆妇女医院妇女健康中心）和哥伦比亚的(南卡罗来纳州副州长老龄化办公室，南卡罗来纳州艾滋病毒/艾滋病委员会，南卡罗来纳北部艾滋病服务、南卡罗来纳低地艾滋病服务、南卡罗来纳联合之路协会、南卡罗来纳初级保健协会、南卡罗来纳哥伦比亚住房管理局、棕榈艾滋病生命支持服务)以及内容和技术开发与支持（南卡罗来纳大学社会工作学院和计算机科学与工程系、南卡罗来纳艾滋病毒/艾滋病委员会、蓝莓山制作公司）。

DESCRIPTION (provided by applicant): Older adult women (age 50+) account for almost a third of the U.S. HIV/AIDS population, and infection rates among this group are increasing. The overall goal of the proposed Phase II application is to develop a culturally-sensitive, gender-specific, and age-appropriate HIV prevention intervention for older women, especially African American and Latino women who are at disproportionally high risk for HIV/STD infection. Our target population is the growing number of divorced/separated older women for whom interventions have not been developed and, due to cohort and social contextual factors, are likely unaware that they are at risk, and more likely than single (never married) women to forgo condom use. Building on Phase I and ARRA study results, our Phase II objectives are to create, test, and commercialize a positive psychology-based "SmartWeb" intervention to promote wellbeing and safe sex practices among culturally diverse older divorced or separated women who are dating or planning on dating. Specific Phase II Aims are: 1) Create the SmartWeb intervention; 2) Evaluate its effectiveness in a randomized controlled trial (RCT) of divorced/separated women over 50; and 3) Prepare marketing and commercialization plans for the SmartWeb intervention. Consistent with our Phase I objectives, i.e., developing content to address Stages 1-3 of the M-AARM theoretical model, the proposed Phase II includes new components to address M-AARM Stages 4-5. The Phase II is also responsive to Phase I evaluation findings, including the desire for mobile access, membership; video interviews with experts in women's health, positive aging, HIV/STD prevention in culturally diverse communities, safe sex negotiation strategies, and gray divorce; online community, and positive psychology- based self-efficacy and affect-boosting emails, as well as expanded versions of Phase I components to reinforce stages 1-3 of the M-ARRM theoretical model. We are supported in these efforts through our partnerships in both Boston, MA and Columbia SC, the sites for the randomized controlled trial. Participating partners include those providing commercialization support (Global Protection Corp, USC Columbia Incubator, SC Launch, Moker CPCA), recruitment and marketing support in Boston (New England Association of HIV over 50, Massachusetts Department of Public Health Statewide Consumer Advisory Board on HIV/AIDS, Brigham & Women's Hospital Women's Health Center) and in Columbia (South Carolina Lieutenant Governor's Office on Aging, South Carolina HIV/AIDS Council, AID Upstate in South Carolina, Lowcountry AIDS Services, United Way Association of South Carolina, South Carolina Primary Care Association, Columbia Housing Authority in South Carolina, Palmetto AIDS Life Support Services), and content and technology development and support (University of South Carolina College of Social Work and Department of Computer Science and Engineering, South Carolina HIV/AIDS Council, Blueberry Hill Productions).