BRIEF HIV INTERVENTIONS FOR DRUG-USING WOMEN SEX WORKERS

这项计划在迈阿密进行的为期5年的研究的动机是需要开发和评估一种替代性的降低吸毒女性性工作者艾滋病毒/丙型肝炎病毒/乙型肝炎病毒风险的模式，这种模式简短、具有成本效益、易于复制，而且超越了纯粹的说教和专家设计的信息。将现役性工作者培训为外展工作者，将前性工作者培训为艾滋病毒/丙型肝炎病毒/乙型肝炎病毒干预者，并与社区成员一起设计适当的干预措施，是赋予女性性工作者权力，使其能够控制自己的降低风险活动的方法。因此，该研究的总体目的是：1)通过随机分配800名参与者到两种治疗条件之一来实施和评估两种干预措施的有效性：a)与街头性工作者共同开发的以性工作者为中心的干预措施，由前性工作者提供；b)由前性工作者提供的常规干预（增强的“NIDA标准”）；2)检验人口统计学和其他变量在预测性、药物和其他危险行为变化中的作用；3)检查使用活跃的性工作者进行外展的适宜性，以及使用正在康复中的前性工作者来提供拟议的干预措施；4)评估两种干预措施在减少性和药物风险行为方面的成本和成本效益。该项目的实地地点将位于迈阿密主要卖淫区的中心，并进行了广泛的试点工作，以了解以性工作者为重点的干预措施和整个提案的发展情况。样本包括非裔美国人、白人-盎格鲁人和拉丁裔人，按他们在迈阿密性工作者人口中的估计比例。数据分析将使用各种统计技术来描述人口和危险行为的流行程度。随后的分析将使用先进的多变量技术来评估风险行为的变化。提出了一项积极的出版和技术转让计划。

The proposed 5-year, Miami-based study is motivated by the need to develop and evaluate an alternative model of HIV/HCV/HBV risk reduction for drug-using women sex workers that is brief, cost- effective, easily replicable, and that goes beyond a purely didactic, expert-designed message. Training active sex workers as outreach workers and former sex workers as HIV/HCV/HBV interventionists, and designing an appropriate intervention together with members of this community are ways of empowering women sex workers to control their own risk reduction activities. As such, the general purposes of the study are to: 1) implement and evaluate the effectiveness of two interventions by randomly assigning 800 participants to one of two treatment conditions: a) a sex worker-focused intervention developed in conjunction with street-based sex workers and delivered by former sex workers; and b) a conventional intervention (the augmented "NIDA Standard") delivered by former sex workers; 2) examine the effects of demographics and other variables in predicting changes in sexual, drug, and other risk behaviors; 3) examine the suitability of using active sex workers for outreach, and using former sex workers now in recovery for delivering the proposed interventions; 4) evaluate the cost and cost-effectiveness of the two interventions in reducing sexual and drug risk behaviors. The field site for the project will be located in the heart of Miami's major prostitution districts, and extensive pilot work was conducted to inform the development of the sex worker focused intervention and the proposal as a whole. The sample includes African-Americans, white-Anglos, and Latinas in proportion to their estimated representation in the active Miami sex worker population. Data analyses will use a variety of statistical techniques to describe the population and the prevalence of risk behaviors. Subsequent analyses will use advanced multivariate techniques to assess changes in risk behaviors. A vigorous publication and technology transfer program is proposed.