Linking high-risk young women to HIV prevention and care for comorbid conditions

将高危年轻女性与艾滋病毒预防和共病护理联系起来

• 批准号: 9040235
• 负责人: Bronwyn Myers
• 金额: $ 17.02万
• 依托单位: MEDICAL RESEARCH COUNCIL OF SOUTH AFRICA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-25 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9040235
• 关键词: 18 year old; 21 year old; AIDS prevention; Address; Adherence; Affect; Age; Age-Years; Alcohol or Other Drugs use; Attention; Behavioral; Caring; Case Management; Child; Cognitive; Communities; Counseling; Data; Development; Disadvantaged; Distal; Enrollment; Ensure; Focus Groups; Foundations; Goals; HIV; HIV Infections; HIV risk; Health; Health Personnel; Health Services; Human immunodeficiency virus test; Incidence; Individual; Infection; Institutional Review Boards; Intervention; Interview; Laws; Letters; Life; Link; Mental Health; Methods; Modeling; Outcome; Parental Consent; Participant; Perception; Personal Satisfaction; Population; Populations at Risk; Predisposition; Pregnancy; Preparation; Prevention; Prevention approach; Prevention strategy; Preventive Intervention; Province; Public Health; Readiness; Regulation; Reproductive Health; Reproductive Health Services; Research; Risk; Risk Behaviors; Risk Reduction; Sampling; Science; Series; Services; Sexual abuse; Sexually Transmitted Diseases; South Africa; South African; Substance Use Disorder; Target Populations; Technology; Testing; Trauma; Underserved Population; United States National Institutes of Health; Ursidae Family; Vertical Disease Transmission; Victimization; Woman; Women' s Health; Work; age group; efficacy testing; emerging adult; emerging adulthood; evidence base; experience; follow-up; gender disparity; high risk; human subject protection; improved; innovation; microbicide; neglect; novel; outreach; parental involvement; physical abuse; prevent; response; screening; sexual victimization; substance abuse treatment; uptake; young woman

 DESCRIPTION (provided by applicant): HIV is increasing in the Western Cape province of South Africa, with new infections occurring mostly among young women from poor communities. Substance use and victimization are key drivers of risk for HIV in this population, yet these conditions are rarely treated. As untreated substance use and victimization negatively impact on the uptake of HIV prevention, it is imperative to expand HIV prevention for young women to include linkage to treatment for these co-occurring conditions. Seek, test, treat and retain (STTR) approaches have been used to engage high-risk populations in HIV prevention and treatment, but have not yet been used as a model for engaging high-risk young women in HIV prevention and treatment for co-occurring substance use and victimization. The goal of this project is to address this gap by adapting a women-focused STTR HIV prevention model to include linkage to substance use and victimization services. Using the ADAPT-ITT framework to guide intervention adaptation, we will first conduct in-depth interviews with health providers and focus groups with young women with substance use disorders and victimization experiences to explore their perceptions of barriers to engagement and retention in services for HIV, substance use and victimization among young women. Findings will guide decisions about how to adapt the Women's Health CoOp, an STTR model for HIV prevention, to facilitate linkage to treatment for substance use and victimization. Next, we will administer the adapted intervention in a series of focus groups with high-risk young women. Findings will be used to further adapt the model to enhance relevance, fit, and acceptability for the target population. Finally, we will test the inital feasibility of this adapted STTR model for HIV prevention by seeking 60 high-risk young women through street outreach in selected communities and enrolling these young women into the STTR intervention where they will be tested for HIV, pregnancy and recent substance use and assessed for trauma related to victimization and HIV risk behavior. They will then receive the HIV prevention intervention that includes preparation and linkage to treatment for substance use and victimization. Immediately after receiving the last intervention session, they will complete a brief assessment. Thereafter, participants will receive case management services that provide ongoing support for service use and target structural barriers to retention in services. Participants will be assessed three months after the last assessment to examine whether the model has the potential for facilitating linkage to substance use and victimization services.

 描述（由申请人提供）：南非西开普省的艾滋病毒感染人数正在增加，新增感染者主要发生在来自贫困社区的年轻女性中。药物使用和受害是该人群感染艾滋病毒风险的关键驱动因素，但这些情况很少得到治疗。由于未经治疗的药物滥用和受害会对艾滋病毒预防措施的实施产生负面影响，因此必须扩大对年轻女性的艾滋病毒预防，包括与这些并发疾病的治疗联系起来。寻求、检测、治疗和保留（STTR）方法已被用来让高危人群参与艾滋病毒预防和治疗，但尚未被用作让高危年轻女性参与艾滋病毒预防和治疗同时发生的药物滥用和受害的模式。该项目的目标是通过调整以妇女为中心的 STTR HIV 预防模式，纳入与药物滥用和受害服务的联系，来弥补这一差距。使用 ADAPT-ITT 框架来指导干预措施的调整，我们将首先对卫生服务提供者和有药物滥用障碍和受害经历的年轻女性焦点小组进行深入访谈，探讨他们对年轻女性参与和保留艾滋病毒、药物滥用和受害经历的障碍的看法。研究结果将指导有关如何调整妇女健康合作社（一种用于艾滋病毒预防的 STTR 模式）的决策，以促进与药物滥用和受害治疗的联系。接下来，我们将对一系列高危年轻女性焦点小组进行适应性干预。研究结果将用于进一步调整模型，以增强目标人群的相关性、拟合度和可接受性。最后，我们将通过在选定社区的街头宣传寻找 60 名高危年轻女性，并将这些年轻女性纳入 STTR 干预措施，对她们进行艾滋病毒、怀孕和近期药物使用检测，并评估与受害和艾滋病毒危险行为相关的创伤，从而测试这种适应的 STTR 模型用于艾滋病毒预防的初步可行性。然后，他们将接受艾滋病毒预防干预措施，包括药物滥用和受害治疗的准备和联系。在接受最后一次干预后，他们将立即完成简短的评估。此后，参与者将获得案例管理服务，为服务使用提供持续支持，并针对保留服务的结构性障碍。参与者将在最后一次评估后三个月接受评估，以检查该模型是否有可能促进与药物滥用和受害服务的联系。