Adapting an EBI for HIV Sexual Risk Prevention for Homeless Women

描述（由申请人提供）：无家可归的妇女需要高度可及的，以社区为基础的艾滋病毒性风险预防服务。无家可归的妇女比有住房的低收入妇女面临更大的艾滋病毒/艾滋病和药物使用风险。循证干预措施可以降低高度脆弱人群中的艾滋病毒风险，但传播有限。可能需要调整基本收入，以适应无家可归妇女及其社区的需要。本研究的目的是为无家可归的妇女制定一种适应性的EBI，用于预防艾滋病毒性风险，并有望转化为日常实践。具体目标如下：目标1/阶段1：形成阶段：（a）开展焦点小组活动（4组，每组7-8名提供者）与住房提供者进行访谈，并与4名艾滋病毒/艾滋病服务提供者进行半结构化访谈，以评估住房提供者实施预防艾滋病毒的EBI的能力和资源的可得性;（B）系统地审查EBI并提出适应建议;（c）与无家可归妇女举行协商一致小组会议（2个小组，每个小组14-16名妇女）和收容所提供者（2个小组，每个小组14-16个供应商）决定应选择哪些EBI进行调整以及如何调整;（d）与专题专家进行磋商，并准备对选定的环境影响指标进行调整，通过重点小组（4个小组，每个小组7-8名妇女; 4个小组，每个小组7-8名提供者），向无家可归妇女和收容所提供者介绍并获得他们对经调整的《就业基本需要》的反馈意见。 目标2/阶段2：初步测试阶段：（a）通过重点小组，对无家可归妇女进行经调整的就业基础教育预试（4组;每组7-8名妇女），并根据需要进行修改;（B）对无家可归妇女进行调整后的EBI试点测试（c）与专题专家、收容所和艾滋病毒/艾滋病服务提供者协商，最后确定经调整的《扩大的基本需要》;（d）计划进行随机对照试验，以测试经调整的EBI在无家可归妇女中预防艾滋病毒的效力。 公共卫生相关性：预防艾滋病毒/艾滋病的循证干预措施至关重要，但由于不符合客户需求和提供者能力，干预措施往往没有在最需要的社区变成常规做法。这项研究将通过与无家可归的妇女和洛杉矶市中心贫民窟和西区的提供者合作来促进公共卫生，以适应EBI，减少无家可归妇女的艾滋病毒性风险。

DESCRIPTION (provided by applicant): Homeless women need highly accessible, community-based HIV sexual risk prevention services. Homeless women face greater risk of HIV/AIDS and substance use than low-income women who are housed. Evidence-based interventions (EBIs) can reduce HIV risk among highly vulnerable populations but dissemination is limited. EBIs may need to be adapted to suit homeless women's needs and their communities. The objective of this study is to produce an adapted EBI for HIV sexual risk prevention for homeless women that holds promise of translation into routine practice. The Specific Aims are as follows: Aim 1/Phase 1: Formative phase: (a) conduct focus groups (4 groups; 7-8 providers each) with shelter providers and semi-structured interviews with 4 HIV/AIDS service providers to assess the capacity and availability of resources for shelter providers to implement an EBI for HIV prevention; (b) systematically review EBIs and develop recommendations for adaptation; (c) conduct consensus group meetings with homeless women (2 groups; 14-16 women each) and shelter providers (2 groups, 14-16 providers each) to decide which EBI should be selected for adaptation and how it should be adapted; (d) consult with topical experts and prepare the adaptation of the selected EBI, and present and obtain feedback on the adapted EBI from homeless women and shelters providers through focus groups (4 groups, 7-8 women each; 4 groups, 7-8 providers each). Aim 2/Phase 2: Preliminary testing phase: (a) conduct pre-test of the adapted EBI with homeless women through focus groups (4 groups; 7-8 women each) and modify as necessary; (b) conduct pilot test of the adapted EBI with homeless women (10 groups; 7-8 women each); (c) finalize the adapted EBI with consultation from topical experts, and shelter and HIV/AIDS service providers; (d) plan for randomized controlled trial to test efficacy of adapted EBI for HIV prevention among homeless women. PUBLIC HEALTH RELEVANCE: Evidence-based interventions (EBIs) for preventing HIV/AIDS are critical, yet interventions tend not to be translated into routine practice in communities wher they are most needed due to poor fit with client needs and provider capacity. This study will advance public health through a collaboration with homeless women and providers in the Los Angeles downtown Skid Row and Westside to adapt an EBI for HIV sexual risk reduction for homeless women.