Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore
为巴尔的摩寻求家庭暴力服务的妇女制定和评估 PrEP 决策援助
基本信息
- 批准号:10327004
- 负责人:
- 金额:$ 26.3万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-11 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:AIDS preventionAIDS/HIV problemAddressAdoptionAdvocateAffectAreaAwarenessBaltimoreCenters for Disease Control and Prevention (U.S.)CharacteristicsClinicalClinical Trials DesignCoercionCognitiveCollaborationsCommunitiesConnecticutConsolidated Framework for Implementation ResearchContinuity of Patient CareDataDecision AidDevelopmentDisclosureDisinhibitionDomestic PartnersDomestic ViolenceEducationEffectivenessEpidemicEvaluationEventFocus GroupsForcible intercourseFrightGenderGeographyHIVHIV InfectionsHIV riskHeterosexualsIndividualInterventionInterviewLinkMarylandMediationModificationNeeds AssessmentOutcomePharmacotherapyPopulationPreventionPrevention ResearchPrevention programPrevention strategyProcessProviderPublic HealthRandomizedRandomized Clinical TrialsReportingResearchRiskRisk AssessmentSafe SexSafetyService settingServicesStructureSurveysTestingTimeTraumaUnsafe SexViolenceWomanarmbaseblack womencis-femalecombatcondomseffectiveness implementation studyempoweredevidence baseexperienceformative assessmentimplementation barriersimplementation determinantsimplementation outcomesimplementation processimplementation scienceimprovedinnovationinterestintimate partner violencemalemennoveloutreachpatient orientedperpetratorspre-exposure prophylaxispreferencepreventive interventionracial disparityrandomized trialresponserisk perceptionscale upservice providerssexsocial stigmasubstance usetherapy developmenttooltransmission processuptakeviolence exposure
项目摘要
HIV and intimate partner violence (IPV) are intersecting, mutually-reinforcing epidemics that significantly affect
Black women, particularly in the U.S. South. IPV escalates heterosexual transmission of HIV. IPV-exposed
women are four-times more likely to be infected with HIV than their counterparts. IPV-exposed women are at
greater risk for HIV infection due to forced and coerced sex with partners with HIV, condomless sex, enduring
fear of safe sex (condom) negotiations and substance use. Male IPV perpetrators are more likely to have
untreated HIV, directly increasing women’s HIV risk. In response to the intersection of HIV and IPV among U.S.
women, the 2020 National HIV/AIDS Strategy calls for initiatives that “expand public outreach, education, and
prevention efforts on HIV and other intersecting issues such as IPV.” The Ending the HIV Epidemic (EHE) Plan
further emphasizes the need to increase HIV prevention in areas with high HIV burden, and there is an
opportunity to increase uptake of partner-independent HIV prevention among IPV-exposed Black women in
these areas. Pre-exposure prophylaxis (PrEP) is a user-controlled, effective HIV prevention strategy for IPV-
exposed Black women, but national data indicates that PrEP is severely underutilized by women compared to
men. The CDC has outlined two challenges to PrEP implementation for women: (1) women’s accurate
assessment of their personal and partners’ HIV risk; and (2) few settings offer PrEP introductions. Informed
decision aids can overcome these obstacles because they are patient-centered interventions that can increase
PrEP awareness, reorient personal risk estimation, and empower women to make informed, values-based
decisions. A PrEP decision aid in domestic violence (DV) agencies could address these PrEP implementation
challenges. Our Type II hybrid effectiveness-implementation study seeks to adapt an existing PrEP decision aid
to IPV-exposed Black women seeking DV services in Baltimore, Maryland, an EHE priority area. Self- and
advocate-administered versions of the PrEP decision aid will be implemented and the aid will be evaluated using
a two-arm randomized trial, guided by the Consolidated Framework for Implementation Research (CFIR). A
formative evaluation using qualitative interviews with IPV-exposed Black women (N=20) and DV advocates
(N=10) will be conducted to adapt the existing PrEP decision aid. Next, the decision aid will be implemented in
a DV agency and 60 IPV-exposed Black women will be randomized to either the self- or advocate-administered
versions of the aid to compare feasibility, acceptability and preliminary effectiveness at PrEP uptake with
baseline, 1-, 3-, and 6-month surveys. Focus groups with DV advocates will assess for implementation process
outcomes. This study will: provide support for a PrEP decision aid that addresses HIV prevention for the key
population of IPV-exposed Black women; use implementation science to increase PrEP uptake in the geographic
priority area of Baltimore, Maryland; include DV agencies in intervention development and implementation; and
inform PrEP scale-up by addressing implementation factors in settings that serve IPV-exposed Black women.
艾滋病毒和亲密伴侣暴力是相互交叉、相互强化的流行病,
黑人女性,尤其是在美国南部。IPV加剧了艾滋病毒的异性传播。IPV暴露
妇女感染艾滋病毒的可能性是其同行的四倍。接触IPV的女性在
与艾滋病毒感染者发生强迫和胁迫性行为、无安全套性行为、长期
对安全性行为(避孕套)谈判和使用药物的恐惧。男性IPV犯罪者更有可能
未经治疗的艾滋病毒,直接增加妇女的艾滋病毒风险。为了应对美国艾滋病毒和IPV的交叉,
2020年国家艾滋病毒/艾滋病战略呼吁采取措施,“扩大公共宣传,教育,
艾滋病毒和其他交叉问题的预防工作,如IPV。终止艾滋病毒流行(EHE)计划
进一步强调需要在艾滋病毒高负担地区加强艾滋病毒预防,
有机会增加IPV暴露的黑人妇女对独立于伴侣的艾滋病毒预防的接受,
这些地区暴露前预防(PrEP)是一种用户控制的有效的IPV艾滋病毒预防策略,
暴露的黑人妇女,但国家数据表明,PrEP是严重不足的妇女相比,
男人疾病预防控制中心概述了为妇女实施PrEP的两个挑战:(1)妇女的准确性
评估其个人和伴侣的艾滋病毒风险;(2)很少有设置提供PrEP介绍。知情
决策辅助工具可以克服这些障碍,因为它们是以患者为中心的干预措施,
PrEP意识,重新调整个人风险估计,并赋予妇女权力,使她们能够在知情的情况下,
决策家庭暴力(DV)机构的PrEP决策援助可以解决这些PrEP实施问题
挑战我们的II型混合有效性-实施研究旨在适应现有的PrEP决策辅助
在马里兰州的巴尔的摩寻求家庭暴力服务的暴露于IPV的黑人妇女,这是EHE的优先领域。自我和
将实施PrEP决策辅助的倡导者管理版本,并将使用
一项由实施研究综合框架(CFIR)指导的双臂随机试验。一
使用与IPV暴露的黑人妇女(N=20)和家庭暴力倡导者的定性访谈进行的形成性评价
(N=10),以适应现有的PrEP决策辅助。下一步,决策辅助将在
一个DV机构和60名IPV暴露的黑人妇女将被随机分配到自我管理或倡导者管理组。
不同版本的援助,以比较可行性,可接受性和初步有效性在PrEP吸收与
基线、1个月、3个月和6个月调查。与家庭暴力倡导者的焦点小组将评估执行进程
结果。这项研究将:为解决艾滋病毒预防的关键问题的PrEP决策援助提供支持
暴露于IPV的黑人妇女人口;使用实施科学来增加地理区域的PrEP吸收
马里兰州巴尔的摩的优先地区;将家庭暴力机构纳入干预措施的制定和实施;以及
通过解决为接触IPV的黑人妇女服务的环境中的实施因素,为扩大PrEP提供信息。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Jaimie Meyer其他文献
Jaimie Meyer的其他文献
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{{ truncateString('Jaimie Meyer', 18)}}的其他基金
Integrated eHealth for HIV and Substance Use Disorders in Justice-involved Women
针对参与司法的妇女的艾滋病毒和药物滥用障碍的综合电子保健
- 批准号:
10573552 - 财政年份:2022
- 资助金额:
$ 26.3万 - 项目类别:
Integrated eHealth for HIV and Substance Use Disorders in Justice-involved Women
针对参与司法的妇女的艾滋病毒和药物滥用障碍的综合电子保健
- 批准号:
10700121 - 财政年份:2022
- 资助金额:
$ 26.3万 - 项目类别:
Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore
针对巴尔的摩寻求家庭暴力服务的妇女的 PrEP 决策援助的开发和评估
- 批准号:
10654773 - 财政年份:2021
- 资助金额:
$ 26.3万 - 项目类别:
Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore
针对巴尔的摩寻求家庭暴力服务的妇女的 PrEP 决策援助的开发和评估
- 批准号:
10468296 - 财政年份:2021
- 资助金额:
$ 26.3万 - 项目类别:
Identifying Modifiable Risk and Protective Processes at the Day-Level that Predict HIV Care Outcomes Among Women Exposed to Partner Violence
识别日间可改变的风险和保护流程,预测遭受伴侣暴力的妇女的艾滋病毒护理结果
- 批准号:
10524760 - 财政年份:2020
- 资助金额:
$ 26.3万 - 项目类别:
Identifying Modifiable Risk and Protective Processes at the Day-Level that Predict HIV Care Outcomes Among Women Exposed to Partner Violence
识别日间可改变的风险和保护流程,预测遭受伴侣暴力的妇女的艾滋病毒护理结果
- 批准号:
10308056 - 财政年份:2020
- 资助金额:
$ 26.3万 - 项目类别:
Identifying Modifiable Risk and Protective Processes at the Day-Level that Predict HIV Care Outcomes Among Women Exposed to Partner Violence
识别日间可改变的风险和保护流程,预测遭受伴侣暴力的女性的艾滋病毒护理结果
- 批准号:
9912923 - 财政年份:2020
- 资助金额:
$ 26.3万 - 项目类别:














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