Brief intervention for drug-using rural women at high-risk for HIV/HCV

描述（由申请人提供）：本研究的总体目的是减少艾滋病毒和丙型肝炎高危农村弱势吸毒妇女的危险行为，提高健康和行为健康服务的利用率。在阿巴拉契亚农村地区出现重大公共卫生风险的时期，该项目有可能对科学作出重大贡献，增进对这一高风险、弱势、未得到充分研究的妇女群体的健康差异、高风险行为（注射吸毒、性风险）和服务利用的了解。该项目将纳入标准化筛查（nida修订的ASSIST），以识别监狱中的高危农村妇女吸毒者，包括注射者。同意的妇女（N=350）将被要求参加基线访谈，然后将被随机分配到两个研究组之一：(1)HIV教育（HIV- Ed N= 175），其中包括NIDA标准的检测前和检测后咨询，HIV和HCV快速检测，以及现有社区药物滥用和HIV/HCV资源的信息包；(2)基于动机性访谈的降低艾滋病毒风险（MI-HIV n=175），除了在艾滋病毒教育组中接受的内容外，还包括针对高风险妇女的循证简短干预，重点是个性化计划，以增强减少风险行为和在社区中使用健康和行为健康服务的动机。具体目的包括：(1)比较基于证据的艾滋病毒风险降低干预（MI-HIV）与艾滋病毒教育（NIDA标准）在减少性风险行为、注射行为和吸毒方面的有效性，在一个文化独特的弱势群体中，吸毒的农村妇女是艾滋病毒和丙型肝炎病毒的高危人群；(2)检验MI-HIV干预参与对HIV和HCV高危农村弱势吸毒妇女随访时社区健康和行为健康服务利用（包括药物治疗和心理健康）的预测作用。这个项目是创新的，因为它1)针对高风险和研究不足的妇女群体，2)使用简短的干预，不仅减少风险行为，而且增强使用社区健康和行为健康资源的动机，3)利用现实世界的环境来识别高风险的女性吸毒者。这项研究的长期目标是增加获得保健和行为保健服务的机会，以提高高风险农村妇女的健康质量。

DESCRIPTION (provided by applicant): The overall aim of this study is to reduce risk behaviors and increase health and behavioral health service utilization among disadvantaged, drug-using rural women at high-risk for HIV and HCV. This project has potential to make a significant contribution to science by advancing knowledge about the health disparities, high-risk behaviors (injection drug use, sex risk), and service utilization of this high-risk, vulnerable, an understudied group of women during a time of emerging and significant public health risk in an Appalachian rural setting. This project will incorporate standardized screening (NIDA-modified ASSIST) to identify high-risk rural women drug users from jails, including injectors. Consenting women (N=350) will be asked to participate in a baseline interview, and will then be randomly assigned to one of two study groups: (1) HIV Education (HIV- Ed n=175) which includes the NIDA standard pre and post-test counseling, HIV and HCV rapid testing, and an information packet on existing community drug abuse and HIV/HCV resources; or (2) Motivational Interviewing- based HIV Risk Reduction (MI-HIV n=175) which, in addition to what is received in the HIV-Ed group, also includes an evidence-based brief intervention for high-risk women focused on an individualized plan for enhancing motivation to reduce risk behaviors and to use health and behavioral health services in the community. Specific aims include: (1) to compare the effectiveness of an evidence-based HIV risk reduction intervention (MI-HIV) to HIV Education (NIDA Standard) in reducing sex risk behaviors, injection practices, and drug use among a culturally unique sample of disadvantaged, drug-using rural women at high-risk for HIV and HCV; and (2) to examine MI-HIV Intervention engagement as a predictor of community health and behavioral health service utilization (including drug treatment and mental health) at follow-up among disadvantaged, drug- using rural women at high risk for HIV and HCV. This project is innovative because it 1) targets a high-risk and understudied group of women, 2) uses brief intervention to not only reduce risk behavior but also to enhance motivation for using community health and behavioral health resources, and 3) utilizes a real-world setting to identify high-risk women drug users. The long-term goal of this study is to increase access to health and behavioral health services in order to improve the quality of health of high-risk rural women.