Alternative Strategies in the Prevention on HIV/STDS

描述（由申请人提供）：本三组前瞻性实验 750名吸毒人员高危性行为干预研究 用户将两种行为干预与对照组进行比较， 接受常规的艾滋病检测前后咨询。目标包括：（1）评估 干预措施的有效性，（2）检查调解人的变化， 干预措施;（3）确定干预措施的效果 效果随着时间的推移而保持。两种行为干预措施是：（a） 尊重项目，该项目已被证明在改变性风险方面有效 行为，并在这里适用于破解用户;和（B）项目尊重加， 由我们的调查人员修改，专门针对替代品， 我们的形成性研究已经提出了减少性风险的有效策略， 在瘾君子中很常见这一创新性的干预措施解决了 吸毒者的生活方式和关于艾滋病毒预防的世俗信仰体系， 性生活外联工作人员将从六个不同的领域招募参与者， 社区在迈阿密/戴德县，佛罗里达，并将随机分配 使用地理随机化将受试者分配至三个组之一， 交叉设计，旨在减少内部污染 吸毒者的地理和社会群体。这项研究设计使我们能够 估计每种行为干预措施的效果， 方法学效应的影响（即前测试和后测试的影响） 咨询和重复测量行为）。样本量足以 确保有足够的权力来检测对危险性行为的影响。以上随访 18个月将使我们能够评估归因于 干预措施是持续的。调查人员有很长的历史， 以社区为基础的研究与类似的人群。

DESCRIPTION (provided by applicant): This three-arm prospective experimental study of interventions to reduce high-risk sexual behaviors among 750 crack users will compare two behavioral interventions with a comparison group that receives usual HIV pretest- posttest counseling. Aims include (1) evaluating the effectiveness of the interventions, (2) examining changes in mediators of the intervention efforts, and (3) determining how well the interventions' effects are maintained over time. The two behavioral interventions are: (a) Project Respect, which has been demonstrated effective in changing sexual risk behaviors and is here applied to crack users; and (b) Project Respect Plus, modified by our investigators to specifically target alternative, less effective strategies for sexual risk-reduction that our formative research has shown to be common among crack smokers. This innovative intervention addresses the crack user lifestyle and the lay belief systems regarding HIV prevention in sexual situations. Outreach staff will recruit participants from six diverse neighborhoods in Miami/Dade County, Florida, and will randomly assign participants to one of the three arms using geographical randomization with a crossover design, which has been designed to reduce contamination within geographical and social groupings of drug users. This study design allows us to estimate the effects of each of the behavioral interventions over and above the impact of methodological effects (i.e. the effects of pre and post-test counseling and repeated measurement of behaviors). Sample size is sufficient to ensure adequate power to detect effects on sexual risk behavior. Follow-up over 18 months will allow us to assess how well the changes attributed to the interventions are sustained. The investigators have a long history of community-based research with similar populations.