HIV TESTING/RISK REDUCTION AMONG INNER-CITY WOMEN

艾滋病是纽约25-34岁女性死亡的主要原因 该市也是儿童艾滋病的中心。艾滋病毒的流行 贫困、市中心妇女和儿童中的感染使艾滋病毒抗体 对这些妇女进行咨询和测试是一种关键但有争议的方法 一级预防的重要性。这些妇女构成了特殊的预防问题。 倡议，因为他们很少看到自己处于风险之中。这个问题是 咨询和检测是否能促进建设性的艾滋病意识和 市区女性静脉注射吸毒者(IVDU)和 静脉注射吸毒者的伙伴仍然是一个令人信服但有问题的伙伴，值得 认真的实证性调查。在拟议的研究中，一个模型 将社会和民族因素与个人心理因素相结合 已被开发用于预测艾滋病毒检测决策和降低风险 行为。 拟议研究的具体目标是：(1)确定社会、 女性决定接受还是接受的心理和文化决定因素 拒绝艾滋病毒咨询和检测；(2)评估知识的影响 避孕措施和生育的艾滋病毒血清状况和 风险降低决策；以及(3)确定社会、文化、 阻碍妇女初次收养的心理和实际障碍 维持降低艾滋病毒风险的行为。 采用重复测量设计的纵向前瞻性研究 使用。将从妇科家庭招募约3400名妇女 在纽约市的三家市中心医院规划和其他诊所。 与艾滋病毒有关的知识、态度和行为、社会支持和 将对接受和拒绝艾滋病毒的女性进行心理痛苦评估 在基线和3个月的随访时进行测试。同意的女性 测试结果将在通知后7-10天内接受面谈 以评估与血清状态相关的即时痛苦。定性方法 将雇用那些没有回来通知检测结果的女性 以及那些继续从事高危性行为和针头行为的人。 从拟议研究中收集的信息将提供一个框架 发展对社会文化敏感的、以社区为基础的 干预措施，特别是将检测作为一级预防 促进降低风险的战略。

AIDS is the leading cause of death among women aged 25-34 years in New York City, which is also the epicenter of pediatric AIDS. The epidemic of HIV infection among poor, inner-city women and children has made HIV antibody counseling and testing of these women a critical, but controversial method of primary prevention. These women pose special problems for prevention initiatives because they seldom see themselves at risk. The question of whether counseling and testing can promote constructive AIDS awareness and risk reduction in the inner-city female intravenous drug users (IVDUs) and partners of IVDUs remains a compelling but problematic one, deserving serious empirical investigation. In the proposed study, a model that integrates social and ethnic factors with individual psychological factors has been developed to predict HIV test decision-making and risk-reduction behavior. Specific aims of the proposed research are to: (1) Identify the social, psychological and cultural determinants of women's decisions to accept or refuse HIV counseling and testing; (2) Evaluate the impact of knowledge of HIV serostatus on contraceptive practices and childbearing and risk-reduction decisions; and (3) Identify the social, cultural, psychological and practical barriers to women's initial adoption and maintenance of HIV risk-reduction behavior. A longitudinal prospective study with a repeated measures design will be used. Approximately 3400 women will be recruited from the gyn, family planning and other clinics at three inner-city hospitals in NYC. HIV-related knowledge, attitudes and behaviors, social support and psychological distress will be assessed in women who accept and refuse HIV testing at baseline and at 3-month follow-up. Women who consent to be tested will be interviewed 7-10 days following notification of test results to assess immediate distress related to serostatus. Qualititative methods will be employed with women who fail to return for test result notification and those who continue to engage in high-risk sexual and needle behaviors. Information gathered from the proposed study will provide a framework for the development of socioculturally-sensitive, community-based interventions, particularly the use of testing as a primary prevention strategy for promoting risk-reduction.