权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Repeat STI Patients: Tailored Socio-Contextual Intervention to Reduce HIV Risk

重复性传播感染患者：量身定制的社会情境干预措施可降低艾滋病毒风险

基本信息

批准号：
8712553
负责人：
Lance S Weinhardt
金额：
$ 56.5万
依托单位：
UNIVERSITY OF WISCONSIN MILWAUKEE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-24 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8712553
关键词：
AIDS prevention Address Affective African American Alcohol or Other Drugs use Area Caring Case Management Case Manager Chlamydia Cities Clinic Clinic Visits Communities Complex Control Groups Cost Effectiveness Analysis Data Diagnosis Domestic Violence Economically Deprived Population Electronics Elements Employment Enrollment Ensure Epidemic Exposure to Face Funding Future Gonorrhea HIV HIV Infections HIV risk Health Health Services Accessibility Health system Housing Human immunodeficiency virus test Incidence Individual Infection Infection prevention Intervention Intervention Studies Intervention Trial Interview Lead Literature Low income Maintenance Measures Mediator of activation protein Mental Depression Modeling Outcome Pamphlets Participant Partner Notification Patients Phase Population Poverty Prevalence Prevention Preventive Intervention Problem Solving Program Evaluation Protocols documentation Public Health Publishing Quality of life Randomized Randomized Clinical Trials Recruitment Activity Relative (related person)Reporting Request for Applications Research Research Project Grants Resources Risk Risk Behaviors Risk Reduction Sampling Schedule Services Sexually Transmitted Diseases Site Social Environment Social Work Structure Substance abuse problem Sum Syphilis System Telephone Testing Time Trichomonas Infections Unemployment Visit Wisconsin Woman Work base computerized contextual factors cost cost effective cost effectiveness design effective intervention efficacy testing experience follow-up group intervention high risk high risk sexual behavior intervention effect men novel prevention service public health relevance screening sex risk skills social standard care standard of care theories transmission process

项目摘要

DESCRIPTION (provided by applicant): Repeat sexually transmitted infections (STI), such as Chlamydia, gonorrhea, trichomoniasis, and syphilis indicate persistent elevated risk activity for HIV, and repeated STI infections increase the likelihood of HIV transmission during exposure. Repeat STI patients represent a significant proportion of public STI clinic visits. Patients who seek treatment for repeat STI infections, by definition, are not adequately served by the prevention services currently provided by STI clinics, and may benefit from additional clinic-based services to reduce their risk of future infections of STI and HIV. The HIV prevention field has largely been silent about assisting repeat STI patients; there are no published studies testing interventions specifically for this population. In addition, most HIV risk-reduction intervention research based in STI clinics has focused directly on the presenting problem of sexual risk behavior, at most addressing one other related factor, such as co- existing depression or substance use, in a single study, whereas it is clear that repeat STI is driven by a wide range of contextual factors. Novel, individually tailored intervention approaches are likely needed to help repeat STI patients reduce their risk of HIV infection and infecting others. We propose to address these limitations of previous research by developing and testing an individually-tailored strengths-based prevention case management intervention strategy based on Social Action Theory (Ewart, 1991) that addresses repeat STI patients' social context and other factors that heighten STI and HIV risk among these patients. This research will be conducted in two phases. During the first 12-15 months of the project, our efforts will be devoted to conducting formative research on the phenomenon of repeat STI in Milwaukee, WI, a city with high and rising rates of STI, and on developing and piloting the intervention protocol. Our formative work will consist of three major elements. First we will conduct qualitative interviews with a sample of repeat STI patients to better understand the factors that lead to their repeated infection and what services they believe could help them avoid future infections. Second, we will develop an individually tailored clinic-based intervention to reduce risk among repeat STI patients. Third, we will conduct a feasibility and acceptability trial of the intervention. In the second phase of the project, we will conduct a full randomized clinical trial with 250 men and 250 women attending the clinic with two or more STI in a 12 month period. We will follow participants in the experimental group and the control group (clinic standard care) for 12 months following recruitment to examine the effects of the intervention on sexual risk activity, repeat STI, and other beneficial health effects. Finally, we will conduct a cost and cost-effectiveness analysis of the intervention.

描述（由申请人提供）：反复性传播感染（STI），如衣原体、淋病、滴虫病和梅毒，表明HIV的风险活动持续升高，并且反复性传播感染增加了暴露期间HIV传播的可能性。重复性传播感染患者在公共性传播感染诊所就诊中占很大比例。根据定义，寻求治疗反复性传播感染的患者没有得到性传播感染诊所目前提供的预防服务的充分服务，并且可以从额外的诊所服务中受益，以降低其未来感染性传播感染和艾滋病毒的风险。艾滋病毒预防领域在帮助重复性传播感染患者方面基本上保持沉默；目前还没有发表的研究专门针对这一人群测试干预措施。此外，大多数基于性传播感染诊所的艾滋病毒风险降低干预研究都直接关注性风险行为的当前问题，最多在一项研究中解决一个其他相关因素，如共存的抑郁症或药物使用，而很明显，重复性性传播感染是由广泛的背景因素驱动的。可能需要新的、个性化的干预方法来帮助重复性传播感染患者降低感染艾滋病毒和感染他人的风险。我们建议通过开发和测试基于社会行动理论（Ewart, 1991）的个人量身定制的基于优势的预防病例管理干预策略来解决先前研究的这些局限性，该策略解决了重复性传播感染患者的社会背景以及这些患者中增加性传播感染和艾滋病毒风险的其他因素。本研究将分两个阶段进行。在项目的前12-15个月，我们将致力于对威斯康星州密尔沃基市的重复性传播感染现象进行形成性研究，密尔沃基市的性传播感染发病率很高，而且还在不断上升，同时我们还将致力于制定和试行干预方案。我们的形成性工作将包括三个主要要素。首先，我们将对反复感染性病的患者样本进行定性访谈，以更好地了解导致他们反复感染的因素，以及他们认为哪些服务可以帮助他们避免未来感染。其次，我们将开发一种个性化的基于临床的干预措施，以降低重复性传播感染患者的风险。第三，我们将对干预进行可行性和可接受性试验。在项目的第二阶段，我们将进行一项完整的随机临床试验，250名男性和250名女性在12个月的时间里患有两次或两次以上的性传播感染。我们将在招募后对实验组和对照组（临床标准护理）的参与者进行为期12个月的随访，以检查干预对性风险活动、重复性传播感染和其他有益健康影响的影响。最后，我们将对干预措施进行成本和成本效益分析。