High Risk Crack Use Settings and HIV in El Salvador

萨尔瓦多的高风险快克使用环境和艾滋病毒

• 批准号: 8214667
• 负责人: Julia B Dickson-Gomez
• 金额: $ 54.17万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-20 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8214667
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Affect; Africa South of the Sahara; Asia; Attention; Awareness; Behavior; Centers for Disease Control and Prevention (U.S.); Central America; Clinic; Code; Collaborations; Communities; Country; Cross-Sectional Studies; Data; Decision Making; Developing Countries; Drug usage; El Salvador; Epidemic; Evaluation; Event; Evidence based intervention; Exposure to; Government; HIV; HIV Infections; HIV Seropositivity; Health; Human immunodeficiency virus test; Illicit Drugs; Incentives; Individual; International; Interpersonal Violence; Intervention; Intervention Studies; Interview; Latin America; Lead; Life; Low income; Measures; Methods; Multiple Partners; Participant; Persons; Phase; Population; Population Intervention; Preventive Intervention; Process; Public Health; Qualitative Methods; Recruitment Activity; Research; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Running; Salvadoran; Site; Social Environment; Social Network; Social Problems; Social Work; Structure; Surveys; System; Testing; Time; Time Series Analysis; Training; Translating; Translations; base; behavior change; combat; community intervention; community setting; condoms; effectiveness measure; empowerment; high risk; high risk behavior; informant; intervention effect; meetings; neglect; non-drug; parent project; peer; protective behavior; public health relevance; scale up; sex; sex risk; skills; social; trend

DESCRIPTION (provided by applicant): The proposed project is a renewal of "High Risk Crack Use Settings and HIV in El Salvador" and builds on a successful research collaboration between the Center for AIDS Intervention Research (CAIR), the Universidad Centroamericana Jos¿ Sime¿n Ca¿as (UCA) and the Fundaci¿n Antidrogas de El Salvador (FUNDASALVA) to test a multi-level community-based intervention developed in the parent project in collaboration with community residents, crack users, and the Ministry of Public Health and Social Services. Project Encuentro consists of provision of social network HIV testing and Peer Network Interventions among crack users. Specific aims of the proposed research are: (1) To measure the effectiveness of the multi-level community-based intervention with regard to increasing testing rates and decreasing sexual risk behavior among crack users; (2) To analyze the combined effects of the Peer Network and social network HIV testing components on increases in testing and reductions in sexual risk behavior among crack users; (3)To explore the community and organizational factors of successful or unsuccessful implementation (systems level analysis) of various components of the multi-level, community-based HIV prevention intervention. To accomplish these aims we will use a mixed qualitative, quantitative approach. In order to explore aims 1 and 2, we will conduct cross-sectional surveys with crack users residing, buying or using crack in each of the 4 community sites (n=300 per assessment) and measure HIV testing rates in MSPAS clinics before and after implementation of the social network HIV testing. Implementation of the intervention components will be rolled out consecutively, and we will administer multiple assessments (6 total, including 2 baselines) in order to assess trends in increasing effects of the intervention components over time. We will also carefully measure exposure to non-Encuentro HIV prevention interventions and information, to further rule out historical change unrelated to our intervention. To explore aim 3, we will conduct semi-structured interviews with community partners, and observations of trainings, community meetings and steering committee meetings. To examine fidelity and quality of intervention components, we also will collect observations of HIV testing, and sessions of the Peer Network Intervention with crack users. Data for Specific Aim 3 will be collected throughout the project. Results from key informant interviews and observations will be coded to reflect key systems factors related to successful implementation of intervention components in the four community sites. Coded barriers and facilitators will then be included as data in the cross-section surveys for each community, corresponding to the same time periods of intervention implementations and field observation or interviews. PUBLIC HEALTH RELEVANCE: This study is significant in that it will provide a comprehensive, holistic evaluation of a multi-level community based HIV prevention intervention delivered to a high-risk population in a relatively neglected region of the world. We will assess intervention impact on community capacity, the reach and intensity of the intervention, and population level behavior change among crack users. Because we will carefully evaluate community and organizational level factors that may impact implementation, this project will provide important information about the translation, scale up, and sustainability of evidence-based interventions into real world settings.

描述（由申请人提供）：拟议的项目是“高风险裂缝使用设置和艾滋病毒在萨尔瓦多萨尔瓦多”的更新，并建立在艾滋病干预研究中心（CAIR），中美洲大学何塞·西蒙·卡纳斯（UCA）和基金会之间的成功研究合作的基础上。n Antidrogas de El萨尔瓦多（FUNDASALVA）与社区居民，破解用户，以及公共卫生和社会服务部。Encuentro项目包括在破解用户中提供社交网络艾滋病毒检测和同伴网络干预。本研究的具体目标是：（1）测量多层次社区干预措施在提高检测率和降低快克使用者性风险行为方面的有效性;（2）分析同伴网络和社交网络艾滋病毒检测组件对提高检测率和降低快克使用者性风险行为的综合影响;（3）探讨多层次、以社区为基础的艾滋病预防干预的各个组成部分成功或不成功实施的社区和组织因素（系统层面分析）。为了实现这些目标，我们将采用定性和定量相结合的方法。为了探索目标1和目标2，我们将对居住、购买或使用快克的快克用户进行横断面调查（每次评估n=300），并在实施社交网络艾滋病毒检测之前和之后测量MSPAS诊所的艾滋病毒检测率。干预部分的实施将连续展开，我们将进行多项评估（共6项，包括2项基线），以评估干预部分随着时间的推移效果增加的趋势。我们还将仔细衡量非Encuentro艾滋病毒预防干预措施和信息的暴露情况，以进一步排除与我们的干预措施无关的历史变化。为了探索目标3，我们将与社区合作伙伴进行半结构化访谈，并观察培训，社区会议和指导委员会会议。为了检查干预组件的保真度和质量，我们还将收集艾滋病毒检测的观察结果，以及与破解用户的同伴网络干预会话。具体目标3的数据将在整个项目期间收集。将对关键知情人访谈和观察结果进行编码，以反映与在四个社区站点成功实施干预组件相关的关键系统因素。然后，编码的障碍和促进者将作为数据纳入每个社区的横截面调查，对应于干预措施实施和实地观察或访谈的相同时间段。 公共卫生关系：这项研究的重要性在于，它将提供一个多层次的，以社区为基础的艾滋病毒预防干预提供给一个相对被忽视的世界地区的高风险人群的全面，整体的评价。我们将评估干预对社区容量的影响，干预的范围和强度，以及裂缝用户之间的群体水平行为变化。因为我们将仔细评估可能影响实施的社区和组织层面的因素，该项目将提供有关将循证干预措施转化为真实的世界环境的重要信息。