Sustained Safe Behavior in High-Risk Women

描述（由申请人提供）：这项为期4年的前瞻性纵向研究旨在探索增强或阻碍女性避孕套在预防艾滋病毒/性传播感染方面的初始和持续使用的因素。这项研究的对象是康涅狄格州哈特福德市的高危城市妇女，她们主要是非洲裔美国人和波多黎各人，包括吸毒者、性工作者、有多个性伴侣或性伴侣的非吸毒妇女，以及少数高危男性。本研究的目的是：1)在减少了与缺乏信息和可及性相关的初始障碍后，研究影响高危妇女及其男性性伴侣首次和持续使用女用避孕套预防艾滋病毒/性传播感染的因素；2)研究影响女性安全套使用的因素与人际网络和性关系因素的关系。这项研究包括两个主要组成部分，它们共同使定性和定量方法结合起来，以评估目标人群中持续使用女用避孕套的情况。其中一个组成部分是对500名高危妇女进行定量队列研究，她们将参加一项前瞻性纵向调查，测量人口统计学、流行病学（艾滋病毒风险和预防）、社会心理（态度、个人代理）、性关系（伴侣、性别）和社会网络/同伴影响因素，在3个时间点（摄入、1个月和10个月）进行。该队列研究旨在评估与不同类型的性伴侣初次使用女用避孕套的预测因素以及与持续使用有关的因素。第二个组成部分是对75对夫妇（高风险女性及其男性主要伴侣、随性伴侣和/或付费伴侣）进行定性和定量的女用避孕套试验，在试验中，他们一起使用女用避孕套，进行一到两次连续两周的试验，以评估性关系、性别动态和其他影响他们使用女用避孕套的因素。通过试验后和10个月的随访访谈来评估他们长期以来与这个和其他伴侣持续使用女用避孕套的情况。将使用定性和定量数据来检验关于影响持续使用女用避孕套的因素的假设，并评估研究人口中采用女用避孕套的过程和动态。同时实施两个研究组成部分和抽样设计，将在两个组成部分中创建等效样本，支持定性和定量数据的综合分析，以增强我们对项目结果的解释。

DESCRIPTION (provided by applicant): This 4-year prospective, longitudinal study is designed to explore factors that enhance or impede the initial and sustained use of the female condom for HIV/STI prevention. The study targets high-risk urban women in Hartford, CT, who are primarily African American and Puerto Rican, including drug users, sex workers, non-drug using women with multiple or drug-using sex partners, as well as a small number of high-risk men. The study aims are: 1) to examine factors affecting initial and sustained use of the female condom for HIV/STI prevention among high-risk women and their male sex partners after reducing initial barriers associated with lack of information and accessibility; and 2) to examine conditions affecting female condom adoption associated with personal network and sexual relationship factors of high-risk women and men overtime. The study includes two primary components that together allow the integration of qualitative and quantitative methods to assess sustained female condom use in the target population. One component is a quantitative cohort study of 500 high-risk women who will participate in a prospective, longitudinal survey measuring demographic, epidemiological (HIV risk and prevention), psycho-social (attitudinal, personal agency), sexual relationship (partner, gender), and social network/peer influence factors conducted at 3 time points (intake, 1-month and 10-months). The cohort study is designed to assess predictors of initial female condom use with different types of sex partners and factors associated with its sustained use. The second component is a qualitative and quantitative partners' female condom trial with 75 couples (high-risk women and their male primary, casual, and/or paying partners), in which they use the female condom together for one or two consecutive 2-week trials to assess sexual relationship, gender dynamic, and other factors affecting their use of female condoms, with post-trial and 10-month follow-up interviews to assess their sustained use of the female condom with this and other partners over time. Qualitative and quantitative data will be used to test hypotheses regarding factors affecting sustained female condom use and to assess the process and dynamics of female:, condom adoption in the study population. Concurrent implementation of the two study components and a sampling design that will create equivalent samples in both components support the integrated analysis of qualitative and quantitative data to enhance our interpretation of project findings.