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Development of a Novel HIV Risk Reduction Intervention for Abused Women

为受虐妇女制定新型降低艾滋病毒风险的干预措施

基本信息

批准号：
8701398
负责人：
MICHAEL P CAREY
金额：
$ 25.11万
依托单位：
MIRIAM HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-12 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8701398
关键词：
AIDS prevention Address Adult Battered Women Behavioral Child Child Sexual Abuse Clinic Clinical Research Consent Development Disease Elements Feedback Funding Funding Mechanisms Goals Guilt HIV HIV Infections HIV risk Health behavior Incidence Intervention Intervention Studies Intervention Trial Interview Knowledge Lead Manuals Mediating Mediator of activation protein Modeling Motivation Participant Phase Play Populations at Risk Preparation Preventive Intervention Probability Procedures Protocols documentation Public Health Randomized Randomized Controlled Trials Reaction Recording of previous events Recruitment Activity Reporting Research Research Personnel Risk Risk Reduction Role Sample Size Sex Behavior Sexually Transmitted Diseases Structure Surveys Testing Trust Vulnerable Populations Woman Work base clinically significant community living computerized design effective intervention experience follow-up group intervention improved informant innovation novel psychologic safer sex satisfaction screening sex risk simulation skills success theories therapy development

项目摘要

DESCRIPTION (provided by applicant): HIV and sexually transmitted diseases (STDs) are major public health problems among women. Childhood sexual abuse (CSA) has been shown to increase women's vulnerability to these diseases. Studies have consistently found that CSA is associated with sexual risk behavior and with STD and HIV infection. In addition, compared to women who have not been abused, women with a history of CSA show less improvement following traditional sexual risk reduction interventions. Thus, sexual risk reduction intervention targeted to the unique needs of women with a history of CSA are needed. The purpose of the proposed research is to develop, refine, and pilot test an innovative, theoretically-guided sexual risk reduction intervention for women with a history of CSA. We will build on previous findings that suggest such an intervention should address the psychological consequences of CSA (i.e., the traumagenic dynamics constructs of traumatic sexualization, interpersonal trust, guilt, and powerlessness), as well as the typical antecedents of sexual risk behavior (i.e., knowledge, motivation, and behavioral skills). To inform intervention development, 25 women attending an urban, public STD who report a history of CSA will be recruited to participate in key informant interviews. Based on interview findings and guided by theory and empirical precedent, a novel sexual risk reduction intervention will be developed. The intervention will be refined based on feedback from 24 women recruited from the STD clinic who report a history of CSA and sexual risk behavior. Finally, the intervention will be pilot tested with 60 women recruited from the clinc who report a history of CSA and current sexual risk behavior. These women will complete a computerized survey to assess childhood sexual abuse, adult sexual risk behavior, HIV-related information, safer sex motivation, behavioral skills, traumatic sexualization, interpersonal trust, guilt, and powerlessness. Behavioral skills will also be assessed through role-plays and simulation scenarios. Women will be randomly assigned to the novel intervention or to a structurally equivalent intervention focused only on the psychological antecedents of sexual risk behavior. Three months after intervention completion, women will return to complete computerized interviews and behavioral skills assessments. The long-term goal of this research is to develop a feasible and effective sexual risk reduction intervention for women who have a history of CSA. If, as we anticipate, the intervention is successful in reducing sexual risk behavior, the proposed research will have addressed an important public health problem: reducing the disproportionately high rates of STDs and HIV among women who were sexually abused as children.

描述（由申请人提供）：艾滋病毒和性传播疾病（性病）是妇女的主要公共卫生问题。儿童期性虐待已被证明会增加妇女对这些疾病的脆弱性。研究一致发现，CSA与性风险行为以及STD和HIV感染有关。此外，与未受虐待的妇女相比，有CSA病史的妇女在传统的性风险降低干预措施后表现出较少的改善。因此，需要针对有CSA病史的女性的独特需求进行性风险降低干预。拟议研究的目的是为有CSA病史的女性开发，完善和试点测试创新的，理论指导的性风险降低干预措施。我们将以先前的研究结果为基础，这些研究结果表明这种干预应该解决CSA的心理后果（即，创伤性化、人际信任、内疚和无力感的创伤性动力学结构），以及性风险行为的典型前因（即，知识、动机和行为技能）。为了解干预措施的发展，将招募25名报告有CSA病史的城市公共性病患者参加关键线人访谈。基于访谈结果，并在理论和经验先例的指导下，将开发一种新的性风险降低干预措施。该干预措施将根据从性病诊所招募的24名妇女的反馈进行改进，这些妇女报告了CSA和性风险行为的历史。最后，该干预措施将与60名从诊所招募的妇女进行试点测试，这些妇女报告了CSA病史和当前的性风险行为。这些妇女将完成一项计算机化的调查，评估儿童期性虐待、成人期性风险行为、艾滋病毒相关信息、安全性行为动机、行为技能、创伤性化、人际信任、内疚和无力感行为技能也将通过角色扮演和模拟情景进行评估。妇女将被随机分配到新的干预或结构上等同的干预只集中在性风险行为的心理前因。干预完成后三个月，妇女将返回完成计算机化访谈和行为技能评估。本研究的长期目标是为有CSA病史的女性制定一种可行且有效的降低性风险的干预措施。如果像我们预期的那样，干预措施在减少性风险行为方面取得了成功，那么拟议的研究将解决一个重要的公共卫生问题：降低儿童遭受性虐待的妇女中不成比例的高性病和艾滋病毒感染率。