Multitheoretical Approach to Prevent HIV Among Women

描述(由申请者提供)：艾滋病毒/艾滋病对伊利诺伊州中部的妇女构成越来越大的威胁。因贫穷、吸毒和/或性交易而被边缘化的妇女因共用针头、与艾滋病毒阳性的浪漫伴侣发生无保护措施的性行为或与艾滋病毒阳性的伴侣进行性行为而感染艾滋病毒的风险很高。这项初步研究旨在测试干预措施的有效性，以帮助妇女正确和始终如一地使用男性或女性避孕套。具体目标包括：1)测试增加避孕套使用的干预措施的有效性；2)评估干预措施的可接受性；3)解释避孕套使用结果指标的变异性。研究结果将用于为高危妇女制定全面的艾滋病毒预防计划。为了指导这项研究，折衷模型将把自我效能、性别和权力理论与觉醒理论结合起来，觉醒理论是一种关于改变行为的自然机会的理论。目标人群是离开县拘留所或戒毒中心的异性恋妇女，年龄在18岁或以上，没有怀孕计划，会说英语，艾滋病毒阴性，能够给予知情同意，居住在麦克莱恩或香槟县。该设计将结合随机临床试验和扎根理论方法论。主要假设是：1)治疗组的女性比对照组的女性进行无保护措施的阴道性交次数更少；2)治疗组的女性比对照组的女性更经常正确使用男性或女性避孕套。妇女(N=80)将被随机分配到治疗组和对照组(每组40人)，分别在干预前和干预后收集数据，并在3个月和6个月进行随访。将使用多变量技术分析定量数据，包括重复测量方差分析、层次回归和通径分析。在最后的数据收集点之后，将选择妇女(N=20)参加单一深度访谈，目的是利用扎根理论进行理论三角测量。访谈数据将被用来阐明假设检验、结果衡量标准的差异，以及自我效能、性别和权力与女性对性沟通和谈判技能的觉醒以及避孕套使用之间关系的本质。定性数据将采用常量比较的方法进行分析。

DESCRIPTION (provided by applicant): HIV/AIDS is a growing threat to women in central Illinois. Women marginalized by poverty, drug use, and/or sex trading are at high risk for contracting HIV from sharing needles, having unprotected sex with romantic partners who are HIV positive, or trading sex with partners who are HIV positive. This pilot study is designed to test the effectiveness of an intervention to help women correctly and consistently use male or female condoms. Specific objectives include: 1) Test the effectiveness of the intervention to increase condom use; 2) Evaluate the acceptability of the intervention; and 3) Explain variability on outcome measures of condom use. Findings will be used to develop a comprehensive HIV prevention program for women at high risk. To guide the study an eclectic model will combine theories of self efficacy, gender, and power with awakening, a theory about natural opportunities for changing behavior. The target population is heterosexual women exiting county detention facilities or drug treatment centers, 18 years or older, not planning a pregnancy, English speaking, HIV negative, able to give informed consent, and living in McLean or Champaign County. The design will combine a randomized clinical trial and grounded theory methodology. Main hypotheses are: 1) Women in the treatment group will engage in fewer unprotected episodes of vaginal intercourse than women in the comparison group; and 2) Women in the treatment group will use male or female condoms correctly more often than women in the comparison group. Women (N=80) will be randomly assigned to treatment and comparison groups (40 each) with pre and post intervention data collection and follow-up at three and six months. Multivariate techniques will be used to analyze quantitative data including repeated measures ANOVA, hierarchical regression, and path analysis. Following the final data collection point women (N=20) will be selected to participate in single in-depth interviews for the purpose of theoretical triangulation using grounded theory. Interview data will be used to shed light on hypothesis testing, variance on outcome measures, and the nature of relationships between self-efficacy, gender, and power and awakening to women's sexual communication and negotiation skills, and condom use. Qualitative data will be analyzed using constant comparison.