PS11-003 Minority AIDS Research Initiative

描述（由申请人提供）：该提案回应了资助公告RFA-PS-11-003中列出的第5类“评估基于牙科、药店或其他非传统场所的艾滋病毒检测可行性的卫生服务研究以及与服务不足社区护理机会的联系”，少数民族艾滋病毒/艾滋病研究倡议（MARI），旨在建立黑人和西班牙裔社区以及黑人和西班牙裔研究人员进行艾滋病毒/艾滋病流行病学和预防研究的能力。最近引入的快速艾滋病毒检测为促进艾滋病毒感染的早期诊断提供了一种特别有希望的筛查方法。2006年9月，美国疾病控制和预防中心（CDC）发布了新的检测指南，将艾滋病毒筛查纳入门诊医疗机构列为优先事项。2008年12月，美国内科医师学会和艾滋病医学协会发布了一份指导声明，建议所有13岁以上的患者至少接受一次艾滋病病毒检测。由疾病预防控制中心、全国社区卫生中心协会和州牙科协会组织的几次全国会议讨论了在牙科保健机构中推出快速艾滋病毒检测的问题。一些牙医也开始提供艾滋病快速检测服务。然而，尽管取得了这些进展，目前很少有数据表明提供这种服务的可行性。一个特别令人感兴趣的领域是，患者不期望在牙科保健机构提供艾滋病毒检测，因此如果提供这种服务，可能不会接受。这一直是牙医在考虑提供艾滋病毒检测在牙科保健设置的关注。为了满足这一信息需求，我们建议探讨患者对口腔HIV快速检测的看法。我们将对患者进行访谈，对牙科记录进行审查，并对牙医和牙科保健员进行定性访谈，以1)确定患者在牙科保健机构接受牙科或牙科保健员提供的口腔艾滋病毒快速检测的比率，2)描述患者报告接受或拒绝牙科保健机构提供的口腔艾滋病毒快速检测的原因。3)描述牙医和牙科保健师对在牙科保健机构提供和实施口腔HIV快速检测的态度。本研究收集的数据将用于告知公共卫生官员，牙科保健专业人员，政策制定者和研究人员有关患者接受口腔快速艾滋病毒检测的相关因素。该研究还将有助于确定在牙科保健机构中最倾向于接受艾滋病毒快速检测的环境和/或患者群体，并将提供与资源分配相关的发现。拟议的项目将由迈阿密大学米勒医学院、Jessie Trice社区卫生中心和护理资源公司合作，所有这些都位于佛罗里达州迈阿密-戴德县。迈阿密大学米勒医学院的多米尼加裔美国人流行病学和公共卫生助理教授Margaret Pereyra博士将担任首席研究员，并将由流行病学和公共卫生教授Lisa Metsch博士指导，Lisa Metsch博士在开展NIH和cdc资助的艾滋病毒预防和护理研究方面拥有超过17年的经验。

DESCRIPTION (provided by applicant): This proposal responds to the category number 5 - "Health Services Research to Assess Feasibility of Dental-based, Pharmacy-based, or other Non-traditional Venue-based HIV Testing and Linkage to Care Opportunities in Underserved Communities" listed in the funding announcement RFA-PS-11-003, Minority HIV/AIDS Research Initiative (MARI) to Build Capacity in Black and Hispanic Communities and Among Black and Hispanic Researchers to Conduct HIV/AIDS Epidemiologic and Prevention Research. The recent introduction of rapid HIV testing offers an especially promising screening approach for facilitating earlier diagnosis of HIV infection. In September, 2006, the Centers for Disease Control and Prevention (CDC) released new testing guidelines making it a priority to bring HIV screening into outpatient health care settings. In December, 2008, the American College of Physicians and HIV Medicine Association issued a guidance statement that recommended that all patients over the age of 13 should be encouraged to receive an HIV test at least once. Several national meetings organized by the CDC, the National Association of Community Health Centers and state dental associations have discussed the roll-out of rapid HIV testing in the dental care setting. Some dentists have also begun to offer HIV rapid testing in their practices. Yet, despite these advances, little data are currently available that inform the feasibility of offering such services. One area of particular interest is that patients do not expect to be offered HIV testing in the dental care setting, and therefore may not accept such services if offered. This has been a concern for dentists in considering offering HIV testing in the dental care setting. To fill this need for information, we propose to explore patients' perspectives about oral HIV rapid testing in the dental care setting. We will conduct a combination of patient interviews, dental record reviews, and qualitative interviews with dentists and dental hygienists to 1) determine the rate at which patients accept an oral HIV rapid test in the dental care setting when offered by a dentist or dental hygienist, 2) describe the reasons patients report for accepting or rejecting an offer of an oral HIV rapid test in the dental care setting, and 3) describe dentists' and dental hygienists' attitudes toward offering and conducting oral HIV rapid testing in the dental care setting. The data collected in this study will be used to inform public health officials, dental care professionals, policymakers and researchers about factors associated with patients' acceptance of oral rapid HIV testing in the dental care setting. The study will also help to identify settings and/or groups of patients most inclined to accept HIV rapid testing in the dental care setting and will provide findings relevant to resource allocation. The proposed project will be a collaboration among the University of Miami Miller School of Medicine, the Jessie Trice Community Health Center, and Care Resource, Inc., all in Miami- Dade County, Florida. Dr. Margaret Pereyra, a Dominican-American Assistant Professor of Epidemiology and Public Health at the University of Miami Miller School of Medicine, will serve as Principal Investigator and will be mentored by Dr. Lisa Metsch, Professor of Epidemiology and Public Health, with over 17 years of experience in conducting NIH and CDC-funded HIV prevention and care research.