HIV RISK REDUCTION FOR WOMEN WITH SEVERE MENTAL ILLNESS

艾滋病的流行不成比例地影响着有色人种的妇女， 在社会、经济和政治上被边缘化。女性重度 城市环境中的精神疾病（SMI）是一个高风险群体 与这些人口统计数据，但进一步受到耻辱的挑战， 与认知障碍有关， 他们的精神疾病现有的艾滋病毒预防方法并没有 艾滋病在这些妇女中的传播减少了。在授标期间， 申请人旨在探索增加风险的社会背景因素， 这些女性，并开发降低个人风险的新选择 考虑到每天的现实 这项研究的具体目的是：（1）从数量上评估， 定性-精神疾病的耻辱感对性风险的影响 在美国患有SMI的女性中，2)使用测试结果 改进和进一步发展艾滋病毒预防课程， 这个人口。3)为了测试改良干预措施在一个 120名女性的随机临床试验（N=60实验; N=60 控制）从新的精神病门诊诊所招募 约克州立精神病研究所 拟议的培训计划将使申请人能够在以下方面作出贡献： 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人的主要目标是1）获得一个明确的 了解复杂的社会因素--耻辱、贫穷、种族主义， 暴力，性别不平等--限制了妇女的性选择， 使他们面临艾滋病、意外怀孕和性传播疾病的风险;以及2） 积累发展艾滋病毒预防干预措施所需的技能 适合处境不利妇女的具体情况， 世界各地职业发展奖将使申请人 接受以下方面的正式培训：1）正式课程工作 在人类学，社会学，以及流行病学，以掌握 评估背景需要、制定干预措施和 测试它们在目标人群中的效果。2)发展专门知识. 将文化、背景和性别特定变量纳入 对患有精神疾病的妇女进行干预。3)在...方面变得有知识 研究设计并完成随机临床试验的试点工作 测试申请人开发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.