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。循证干预可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EBI，以适应无家可归妇女的需求和她们的社区。这项研究的目的是为无家可归的妇女制作一种适用于艾滋病毒性风险预防的EBI，有望转化为常规做法。具体目标如下：目标1/阶段1：形成阶段：(A)与收容所提供者开展重点小组(4个小组；每组7-8名提供者)，并与4个艾滋病毒/艾滋病服务提供者进行半结构访谈，以评估收容所提供者实施艾滋病毒预防EBI的能力和资源的可用性；(B)系统审查EBI并制定适应建议；(C)与无家可归妇女(2组；每组14-16名妇女)和收容所提供者(2组，每组14-16名提供者)举行协商一致的小组会议，以决定应选择哪一种EBI进行适应，以及如何对其进行调整；(D)与专题专家协商，准备对选定的EBI进行调整，并通过重点小组(4组，每组7-8名妇女；4组，每组7-8名提供者)介绍和获得无家可归妇女和庇护所提供者对调整后的EBI的反馈。目标2/阶段2：初步测试阶段：(A)通过重点小组(4个小组，每组7-8名妇女)对经调整的EBI进行预测试，并根据需要进行修改；(B)在无家可归的妇女(10组，每组7-8名妇女)中进行经调整的EBI的试点测试；(C)在专题专家、收容所和艾滋病毒/艾滋病服务提供者的咨询下，最后确定经调整的EBI；(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有效性。

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.