Alcohol Epidemiology and Pilot Intervention to Reduce Alcohol, IPV and HIV in Women in Uganda

酒精流行病学和旨在减少乌干达妇女酒精、IPV 和 HIV 的试点干预措施

• 批准号: 9982135
• 负责人: Jennifer Ann Wagman
• 金额: $ 17.79万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9982135
• 关键词: AIDS prevention; Address; Adult; Affect; Africa South of the Sahara; African; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Applied Research; Battered Women; Behavior; Behavior Therapy; Biological; Caring; Client; Clinic; Cohort Studies; Communities; Counseling; Country; Data; Data Analyses; Developing Countries; Development; Disclosure; Drug usage; Educational workshop; Effectiveness; Emotional; Epidemic; Epidemiologist; Equation; Evaluation; Female; Fishes; Focus Groups; Forcible intercourse; Foundations; Future; Goals; Guidelines; HIV; HIV Infections; HIV risk; HIV/STD; Health Sciences; Healthcare; High Prevalence; Home environment; Human immunodeficiency virus test; Illicit Drugs; Incidence; Infection; Infrastructure; Instruction; Intervention; Intervention Studies; Interview; Knowledge; Measures; Mediation; Mediator of activation protein; Medical; Mentored Research Scientist Development Award; Mentors; Mentorship; Methodology; Modeling; National Institute on Alcohol Abuse and Alcoholism; Participant; Pathway interactions; Perception; Pilot Projects; Population; Positioning Attribute; Prevalence; Prevention; Professional counselor; Protocols documentation; Qualitative Research; Randomized; Randomized Controlled Trials; Reading; Reporting; Research; Research Personnel; Research Training; Risk; Risk Behaviors; Risk Factors; Rural; Service provision; Sexual Partners; Structure; Substance abuse problem; Surveys; Techniques; Testing; Training; Training Activity; Uganda; United States National Institutes of Health; Violence; Vulnerable Populations; Woman; Work; alcohol abuse therapy; alcohol and other drug; alcohol epidemiology; alcohol risk; alcohol screening and brief intervention; alcohol testing; arm; base; brief alcohol intervention; cohort; condoms; cost effective; design; effectiveness trial; epidemiology study; experience; gender-based violence; high risk sexual behavior; intimate partner violence; modifiable behavior; population based; programs; prospective; public health relevance; responsible research conduct; satisfaction; screening and brief intervention; secondary analysis; sex; sexual encounter; skills; standard of care; substance abuse epidemiology; transmission process; uptake; violence victimization

 DESCRIPTION (provided by applicant): The purpose of the proposed Mentored Research Scientist Development Award (K01) is to provide the candidate with training and research experiences that will promote her development as an independent researcher, with particular emphasis in the field of healthcare-based HIV intervention research with alcohol- using populations in sub-Saharan Africa. This training will provide her with the opportunity to develop knowledge and skills in: 1) alcohol and substance abuse epidemiology, assessment and prevention; 2) theoretically-driven behavioral interventions to reduce harmful alcohol-use and intimate partner violence (IPV), in the context of new and existing HIV infections; and 3) advanced statistical analytic techniques such as structural equation modeling. Training activities will include didactic coursework and specific workshops, directed readings and one-on-one tutorials with mentors, and instruction in the responsible conduct of research. The candidate will receive mentorship from a Training Committee comprised of globally renowned experts in the fields of alcohol and other substance abuse, HIV prevention, healthcare-based alcohol screening and brief interventions (SBI) and epidemiology research. Her applied research training will take place in Rakai, Uganda within the existing infrastructure of the Rakai Health Sciences Program (RHSP), a 25 year old HIV research and service provision organization. Rakai District is bordered by Lake Victoria and home to several fishing communities with extremely high prevalence of alcohol use and HIV. Rates of IPV are high in Rakai and associated with alcohol and HIV in women the causal pathways between alcohol, IPV, and HIV are unknown. The proposed research will be embedded in the Rakai Community Cohort Study (RCCS), one of the oldest and well-established population-based cohort studies in the world (5U01AI100031-03; 5R01HD070769; 5R01MH099733). Specific aims are to conduct secondary RCCS data analysis to: 1) estimate current prevalence and determinants of alcohol use in adult women and 2) examine associations and direct and indirect pathways between alcohol, IPV and HIV infection in adult women. Other aims are to 3) conduct qualitative interviews (n=20) with female HIV counseling and testing (HCT) clients, and focus groups (n=2) with HCT counselors and supervisors to assess perceptions of integrating an alcohol and IPV SBI into RHSP's standard HCT model; and 4) use quantitative and qualitative findings from Aims 1-3 to adapt and pilot test an alcohol and IPV SBI with 80 abused, alcohol-using women, drawn from RCCS, who seek post-test HIV counseling. Results will generate effect estimates for parameters needed to inform power calculations for a subsequent, large-scale effectiveness trial and will position the candidate to develop an R34 or R01 application for submission to NIAAA. The proposed work supports the FY2014 Trans-NIH Plan for HIV-Related Research to reduce new infections by conducting "intervention research that addresses the impact of alcohol and other drugs on sexual encounters that may contribute to HIV transmission and acquisition."

 描述（由申请人提供）：拟议的指导研究科学家发展奖（K 01）的目的是为候选人提供培训和研究经验，以促进她作为独立研究人员的发展，特别强调在撒哈拉以南非洲地区酒精使用人群中基于医疗保健的艾滋病毒干预研究领域。本次培训将为她提供发展以下知识和技能的机会：1）酒精和药物滥用流行病学，评估和预防; 2）理论驱动的行为干预措施，以减少有害的酒精使用和亲密伴侣暴力（IPV），在新的和现有的艾滋病毒感染的背景下;和3）先进的统计分析技术，如结构方程建模。培训活动将包括教学课程和具体讲习班、指导阅读和与导师一对一辅导，以及指导负责任地开展研究。候选人将接受培训委员会的指导，该委员会由酒精和其他药物滥用，艾滋病毒预防，基于医疗保健的酒精筛查和简短干预（SBI）和流行病学研究领域的全球知名专家组成。她的应用研究培训将在乌干达的Rakai进行，在Rakai健康科学计划（RHSP）的现有基础设施内进行，Rakai是一个有25年历史的艾滋病毒研究和服务提供组织。Rakai区毗邻维多利亚湖，是几个酗酒和艾滋病毒流行率极高的渔业社区的所在地。Rakai的IPV率很高，与女性的酒精和艾滋病毒有关，酒精，IPV和艾滋病毒之间的因果关系尚不清楚。拟议的研究将嵌入Rakai社区队列研究（RCCS），这是世界上最古老和完善的基于人群的队列研究之一（5 U 01 AI 100031 -03; 5 R 01 HD 070769; 5 R 01 MH 099733）。具体目标是进行二级RCCS数据分析，以：1）估计成年妇女饮酒的当前流行率和决定因素，2）检查成年妇女饮酒、IPV和艾滋病毒感染之间的关联和直接和间接途径。其他目标是3）与女性艾滋病毒咨询和检测（HCT）客户进行定性访谈（n=20），与HCT咨询师和监督员进行焦点小组访谈（n=2），以评估将酒精和IPV SBI纳入RHSP标准HCT模式的看法;和4）使用目标1-3的定量和定性研究结果，对来自RCCS的80名受虐待、酗酒的妇女进行酒精和IPV SBI调整和试点测试，在检测后寻求艾滋病咨询的人结果将生成为后续大规模有效性试验的把握度计算提供信息所需参数的效应估计值，并将使候选人能够开发R34或R 01申请，以提交给NIAAA。拟议的工作支持2014财年跨NIH艾滋病毒相关研究计划，通过开展“干预研究，解决酒精和其他药物对可能导致艾滋病毒传播和获得的性接触的影响，以减少新的感染。"

项目成果

Process evaluation of the SHARE intervention for preventing intimate partner violence and HIV infection in Rakai, Uganda.

乌干达拉凯预防亲密伴侣暴力和艾滋病毒感染的 SHARE 干预措施的过程评估。

• DOI: 10.1016/j.evalprogplan.2017.12.009
• 发表时间: 2018
• 期刊: Evaluation and program planning
• 影响因子: 1.6
• 作者: Wagman,JenniferA;Gray,RonaldH;Nakyanjo,Neema;McClendon,KatherineA;Bonnevie,Erika;Namatovu,Fredinah;Kigozi,Grace;Kagaayi,Joseph;Wawer,MariaJ;Nalugoda,Fred
• 通讯作者: Nalugoda,Fred