HIV TESTING/RISK REDUCTION AMONG INNER-CITY WOMEN

艾滋病是纽约25-34岁妇女死亡的主要原因 同时也是儿童艾滋病的中心。艾滋病毒的流行 贫民区妇女和儿童感染艾滋病毒， 对这些妇女进行咨询和测试是一种关键的，但有争议的方法， 一级预防。这些妇女给预防工作带来了特殊问题 因为他们很少看到自己处于危险之中。问题 咨询和检测是否能促进建设性的艾滋病意识， 降低市中心女性静脉注射吸毒者（IVDUs）的风险， IVDU的合作伙伴仍然是一个令人信服的，但有问题的，值得 认真的实证研究。在拟议的研究中，一个模型， 将社会和种族因素与个人心理因素相结合 已经被开发用于预测艾滋病毒检测决策和降低风险 行为 本研究的具体目标是：（1）确定社会， 决定妇女是否接受或 拒绝艾滋病咨询和检测;（2）评估知识的影响， 艾滋病毒血清状况与避孕做法和生育以及 降低风险的决定;（3）确定社会，文化， 妇女初次收养的心理和实际障碍， 保持降低艾滋病毒风险的行为。 将进行一项具有重复测量设计的纵向前瞻性研究， 采用大约3400名妇女将从妇科，家庭中招募 规划和其他诊所在三个内城医院在纽约市。 艾滋病相关知识、态度和行为、社会支持和 将评估接受和拒绝艾滋病毒的妇女的心理痛苦 在基线和3个月随访时进行测试。同意被 测试将在测试结果通知后7-10天进行面试 以评估与血清状态相关的即时痛苦。预防方法 将雇用那些没有返回检查结果通知的妇女 以及那些继续从事高风险性行为和针头行为的人。 从拟议的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，特别是使用检测作为一级预防 促进减少风险的战略。

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.