HIV RISK REDUCTION FOR WOMEN WITH SEVERE MENTAL ILLNESS

艾滋病流行对有色人种妇女的影响不成比例，她们 在社会、经济和政治上处于边缘地位。患有重症的女性 城市环境中的精神疾病(SMI)是一个高危群体 与这些人口统计，但进一步挑战的耻辱此外 与认知障碍有关，通常与精神症状有关 他们的精神疾病。已建立的预防艾滋病毒的方法还没有 遏制了艾滋病在这些妇女中的流行。在颁奖期内， 申请者的目标是探索增加风险的社会背景因素 这些妇女，并为个人减少风险制定新的选择 鉴于这些日复一日的现实。 这项研究的具体目的是：1)评估--定量和 定性--精神疾病的污名对性风险的影响 美国患有SMI的女性的行为。2)使用结果 目标1改进和进一步发展#年艾滋病毒预防课程 这群人。3)测试修改后的干预措施在 120名妇女的随机临床试验(N=60名试验者，N=60名 受控)从纽约精神科门诊招募 纽约州立精神病研究所。 拟议的培训计划将使申请者能够为 在弱势、文化多样的妇女中预防艾滋病毒 严重的精神疾病。申请者的总体目标是1)获得一个明确的 理解复杂的社会因素--耻辱、贫困、种族主义、 暴力、性别不平等--限制了女性的性选择， 使他们面临艾滋病、意外怀孕和性传播疾病的风险；以及2) 积累制定艾滋病毒预防干预措施所需的技能 对处于不利地位的妇女来说是适当的和相关的 环游世界。职业发展奖将使申请者 接受以下方面的正规培训：1)正规课程工作 在人类学、社会学以及流行病学方面，以便掌握 评估背景需求、制定干预措施和 在目标人群中测试它们的效果。2)在以下方面发展专业知识 将文化、背景和性别特定的变量整合到 对患有精神疾病的妇女的干预。3)具备以下方面的知识 一项随机临床试验的研究设计和完成试点工作 检测申请人制定的艾滋病毒预防干预措施。

The AIDS epidemic disproportionately affects women of color who are marginalized socially, economically, and politically. Women with severe mental illness (SMI) in urban city settings represent a high risk group with these demographics, but are further challenged by stigma in addition to cognitive impairment and frequently, psychiatric symptoms related to their mental illness. Established methods of HIV prevention have not curtailed the AIDS epidemic among these women. During the award period the applicant aims to explore social contextual factors that increase risk for these women, and to develop new options for individual risk reduction given these day to day realities. The specific aims of the study are to 1) To assess--quantitatively and qualitatively--the impact of the stigma of mental illness on sexual risk behavior among women with SMI in the United States. 2) To use the results of Aim 1 to refine and further develop the curriculum of HIV prevention in this population. 3) To test the modified intervention for efficacy in a randomized clinical trial of 120 women (N=60 experimental; N=60 controlled) recruited from the outpatient psychiatric clinics of the New York State Psychiatric Institute. The proposed training plan will enable the applicant to contribute to prevention of the HIV among disadvantaged, culturally diverse women with severe mental illness. The applicant's broad goals are 1) to gain a clear understanding of how complex social factors--stigma, poverty, racism, violence, gender inequality--constrain the sexual choices of women, putting them at risk for AIDS, unwanted pregnancies, and STDs; and 2) to amass the skills necessary for developing HIV preventative interventions that are contextually appropriate and relevant for disadvantaged women around the world. The career development award would enable the applicant to receive formal training in the following areas: 1) formal course work in anthropology, sociology, as well as epidemiology in order to master methodologies for assessing contextual needs, developing interventions and testing their effects in the target populations. 2) develop expertise at integrating culture, context, and gender-specific variables into interventions for women with mental illness. 3) become knowledgeable in research design and complete pilot work for a randomized clinical trial testing the HIV preventative intervention developed by the applicant.