Sound Public Health Approaches to Knowing Exposure to HIV

了解艾滋病毒暴露情况的良好公共卫生方法

• 批准号: 9123629
• 负责人: CAROL L GALLETLY
• 金额: $ 19.82万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-10 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9123629
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Administrator; Area; Attention; Characteristics; Client; Colorado; Consent; Counseling; Crime; Criminal Law; Data; Diagnosis; Disclosure; Discrimination; Effectiveness; Effectiveness of Interventions; Ensure; Environment; Environment and Public Health; Epidemic; Event; Exposure to; Failure; Future; Geographic state; HIV; HIV Infections; HIV Seropositivity; Health; Health system; Human Resources; Individual; Infection; Intervention; Interview; Laws; Legal; Life; Light Exercise; Methods; Monitor; Nature; Needs Assessment; Persons; Prevalence; Prevention education; Prevention program; Preventive Intervention; Procedures; Public Health; Public Health Practice; Recording of previous events; Records; Relapse; Research; Risk; Risk Assessment; Risk Behaviors; Sampling; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Stereotyping; System; Testing; Time; Vacuum; Variant; Work; contextual factors; disorder later incidence prevention; effective intervention; follow-up; innovation; intervention program; prevent; programs; prospective; sex; social stigma; sound; surveillance data; transmission process

 DESCRIPTION (provided by applicant): Approximately half of all new HIV infections in the US arise from persons who are aware of their HIV- positive status. In some cases, these individuals have informed their partners of their positive serostatus and their partners have consented to sex assuming the risk of infection. In other cases, the partners have not been informed. The majority of US states have passed HIV-specific laws that make it a crime for PLH to engage in sexual activities with a partner without having first disclosed his or her HIV-positive status. Our research suggests that the criminalization of HIV exposure is not an effective HIV prevention intervention. There are also lingering concerns about the potential deleterious effects of the criminalization of HIV exposure (e.g., increasing stigma, reinforcing HIV-related discrimination, deterring testing). The National HIV/AIDS Strategy recommends that to minimize the potential negative effects of criminalizing HIV exposure and to maximize national efforts to prevent the spread of HIV, we must ensure that HIV exposure laws "support our current understanding of best public health practices for preventing [transmission of] HIV." Yet to our knowledge, no studies have examined the actual intervention efforts developed for these individuals by the agencies that work with them the most-state and local health departments. The proposed study will, we believe, be the first in the US to explore how US health departments identify, verify, and intervene with PLH who are, or are believed to be, engaging in behaviors that risk forward HIV transmission with partners to whom they have not disclosed their HIV-positive status. The study will identify the variety of interventions used in health departments to respond to this client group and will evaluate the effectiveness of one state health department's program to assist PLH who put others at risk of infection. The latter will be accomplished through a preliminary quantitative analysis, using client case records and integrated HIV/STI surveillance data, of the effectiveness of the Colorado Department of Public Health and Environment's intervention efforts with this client group.

 描述（由申请人提供）：在美国，大约一半的新艾滋病毒感染者是那些知道自己艾滋病毒阳性的人。在某些情况下，这些人已将其阳性血清状况告知其伴侣，其伴侣已同意承担感染风险进行性行为。在其他情况下，合伙人没有得到通知。美国大多数州都通过了专门针对艾滋病毒的法律，规定艾滋病毒携带者在没有首先披露其艾滋病毒阳性状况的情况下与伴侣进行性活动是犯罪行为。我们 研究表明，将接触艾滋病毒定为刑事犯罪并不是有效的艾滋病毒预防干预措施。对艾滋病毒暴露的刑事定罪的潜在有害影响也存在挥之不去的关切（例如，增加耻辱感，加强与艾滋病毒有关的歧视，阻止检测）。《国家艾滋病毒/艾滋病战略》建议，为了尽量减少将接触艾滋病毒定为刑事犯罪的潜在负面影响，并尽最大努力防止艾滋病毒的传播，我们必须确保接触艾滋病毒的法律“支持我们目前对预防[传播]艾滋病毒的最佳公共卫生做法的理解。“然而，据我们所知，还没有研究检查过与这些人合作的机构--大多数州和地方卫生部门--为这些人制定的实际干预措施。我们相信，这项拟议中的研究将是美国第一个探索美国卫生部门如何识别、验证和干预那些正在或被认为正在与伴侣进行艾滋病毒传播风险行为的艾滋病毒携带者的研究。这项研究将确定卫生部门用于应对这一客户群的各种干预措施，并将评估一个州卫生部门的计划，以帮助PLH谁把其他人的感染风险的有效性。后者将通过初步定量分析来完成，使用客户案例记录和艾滋病毒/性传播感染综合监测数据，分析科罗拉多公共卫生和环境部对这一客户群体的干预努力的有效性。