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Computer-Based HIV Prevention Package for Drug Using African American Women

针对吸毒非裔美国妇女的基于计算机的艾滋病毒预防包

基本信息

批准号：
9133473
负责人：
DOUGLAS W BILLINGS
金额：
$ 51.13万
依托单位：
ISA ASSOCIATES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9133473
关键词：
AIDS prevention AIDS/HIV problem Abstinence Accounting Address Administrator Adopted Affect African American Alcohol or Other Drugs use American Attention Behavior Behavior Control Behavior Therapy Benchmarking Biological Centers for Disease Control and Prevention (U.S.)Chlamydia Client Clinic Clinical Collaborations Communities Computers Development Disease Drug usage Effectiveness Face Female Goals Gonorrhea HIV HIV Infections HIV Seropositivity Health Heterosexuals Human Herpesvirus 2 Incidence Infection Intervention Judgment Latex Maintenance Manuals Marketing Mediation Participant Phase Play Pre-Post Tests Prevention Preventive Preventive Intervention Principal Investigator Program Effectiveness Provider Questionnaires Randomized Randomized Controlled Trials Research Risk Risk Behaviors Role Services Sexually Transmitted Diseases Source Substance abuse problem Surveys Syphilis Test Result Testing Time Vagina Woman base condoms design effective intervention field study genital herpes health disparity injection drug use male man men prevent programs protective behavior prototype sex sex risk skills transmission process usability

项目摘要

DESCRIPTION (provided by applicant): HIV/AIDS has been especially devastating to African American women. The reason for this health disparity can largely be understood within the context of the unique prevention challenges faced by African American women. Specifically, 80% of new infections among women are the result of heterosexual contact, with the primary male partner the chief source of infection.3 In African American women, heterosexual transmission plays an even larger role. Sexually transmitted infections (STIs) also disproportionately affect African American women. The risk of becoming infected with HIV is increased two to five times when infected with an STI. Finally, the impact of HIV on African American women is further augmented among those who use drugs. While this combination of factors accounts for some of the prevention challenges faced by African American women, it does not account for the primary challenge. Beyond abstinence, the most effective way to prevent HIV infection is correct and consistent use of the male latex condom. For men, increasing condom use is a behavior. For women, it is a goal. Therefore, HIV behavioral interventions for women require a special focus on women's lack of power in relationships and their asymmetrical subordination of personal protective behavior in deference to relationship maintenance. This is especially true for African American women. While the challenges are clear, the solutions are not. Of the 84 HIV behavioral interventions identified by the Centers for Disease (CDC) control as effective, only two were developed for drug-using African American women. Neither has an intervention package and neither is being actively disseminated by CDC. To address this substantial need, we intend to computer-enable Female and Culturally Specific Negotiation Intervention (FCSNI), one of the effective interventions identified by the CDC. FCSNI was specifically developed for drug-using African American women who have sex with men. Based on formative research with service providers, we intend to call the computer-enabled version of FCSNI, Safe Sistah. While the scalability of computer-based programs allows for efficient dissemination, clinics still face significant implementation barriers when tryng to deliver empirically-validated interventions. As such, we will develop a second module called Safe Sistah in your Clinic. This module will provide clinics with strategies to help them adopt and integrate Safe Sistah into their clinical offerings. The results of Phase I strongly support the feasibility and potential effectiveness of the programs - far exceeding the three usability benchmarks established in the Phase I proposal. In Phase II we will complete development of the Safe Sistah and Safe Sistah in your Clinic modules. We will test the effectiveness of Safe Sistah in a randomized controlled trial with 120 drug-using African American women. Participants will be randomly assigned to receive either the Safe Sistah program or to an attention control condition. Before, and at two points after random assignment, participants' sexual and drug use behaviors will be assessed.

描述（由申请人提供）：艾滋病毒/艾滋病对非裔美国妇女的破坏性特别大。这种健康差距的原因在很大程度上可以理解的背景下，非洲裔美国妇女面临的独特的预防挑战。具体而言，80%的妇女新感染是异性性接触的结果，主要的男性伴侣是感染的主要来源。性传播感染对非裔美国妇女的影响也不成比例。感染性传播感染艾滋病毒的风险增加了2至5倍。最后，艾滋病毒对非裔美国妇女的影响在吸毒者中进一步扩大。虽然这些因素结合在一起造成了非裔美国妇女在预防方面面临的一些挑战，但这并不是主要挑战。除了禁欲之外，预防艾滋病毒感染的最有效方法是正确和持续使用男用乳胶避孕套。对男性来说，增加避孕套的使用是一种行为。对女人来说，这是一个目标。因此，针对妇女的艾滋病毒行为干预措施需要特别关注妇女在关系中缺乏权力以及她们在个人保护行为方面不对称地服从于关系维护。这对非裔美国人来说尤其如此。虽然挑战是明确的，但解决方案却不是。在疾病控制中心（CDC）确定的84种有效的艾滋病毒行为干预措施中，只有两种是为使用毒品的非洲裔美国妇女开发的。两者都没有干预方案，疾病预防控制中心也没有积极传播。为了解决这一重大需求，我们打算计算机启用女性和文化特定的谈判干预（FCSNI），由疾病预防控制中心确定的有效干预措施之一。FCSNI是专门为与男性发生性关系的非裔美国女性开发的。基于对服务提供商的形成性研究，我们打算将FCSNI的计算机支持版本称为Safe Sistah。虽然基于计算机的程序的可扩展性允许有效的传播，但诊所在尝试提供经临床验证的干预措施时仍然面临重大的实施障碍。因此，我们将在您的诊所开发第二个模块，称为安全Sistah。该模块将为诊所提供策略，以帮助他们采用和将Safe Sistah整合到他们的临床产品中。第一阶段的结果有力地支持了项目的可行性和潜在的有效性-远远超过了第一阶段提案中建立的三个可用性基准。在第二阶段，我们将在您的诊所模块中完成Safe Sistah和Safe Sistah的开发。我们将在一项随机对照试验中对120名使用药物的非洲裔美国妇女进行安全西斯塔的有效性测试。参与者将被随机分配接受安全Sistah计划或注意力控制条件。在随机分配之前和之后的两个时间点，将评估参与者的性和药物使用行为。