Computer-based Female Condom Education and Training for African American Women

描述（由申请人提供）：每32名非裔美国妇女中就有1人在其一生中被诊断出感染艾滋病毒，而白人妇女的这一比例为526分之一。除了禁欲，最有效的预防艾滋病的方法是男用避孕套。由于避孕套是由男性控制的，女性通常无法协商使用避孕套的问题。这对非裔美国女性来说尤其如此，她们在社会上往往在性方面被动，对男性恭敬。此外，黑人男性的高监禁率和高死亡率造成了性别比例失衡，加剧了权力差异。女用避孕套（FC）是一种阴道内腈套，为女性提供了更多的艾滋病毒预防控制，在预防艾滋病毒、性传播感染和怀孕方面与男用避孕套一样有效。此外，不一致的男用避孕套使用者通过结合两种屏障方法获得更高的受保护的性行为率。虽然目前美国的FC使用率很低，但FC教育和培训提高了女性对女用避孕套的态度和使用。黑人妇女尤其可能从FC教育中受益，因为她们在接受培训后比其他妇女更有可能增加FC的使用。此外，fc更常与主要伴侣一起使用，这是非洲裔美国妇女最常见的艾滋病毒感染来源。为了充分发挥FC的潜力，迫切需要可扩展的FC干预措施，以覆盖和教育大量妇女。疾病控制中心（CDC）对科学文献进行持续审查，以确定可能对特定人群有效的循证艾滋病毒行为干预（ebi）。在确定的73个ebi中，只有一个——女用避孕套技能培训（FEMIT）——专注于提供关于女用避孕套（FC）的教育和培训。为了提高EBI的覆盖范围，我们打算开发C- FEMIT，这是FEMIT干预的计算机启用版本。因为为个人生活环境量身定制的ebi是最有效的，C-FEMIT将根据需求量身定制

DESCRIPTION (provided by applicant): One in 32 African American women will be diagnosed with HIV in her lifetime compared to 1 in 526 White women. Beyond abstinence, the most effective way to prevent HIV is the male condom. Because condoms are male-controlled, women are often unable to negotiate their use. This is especially true for African American women, who are often socialized to be sexually passive and deferential to men. In addition, high incarceration rates and mortality among Black men creates a sex ratio imbalance that exacerbates power differentials. The female condom (FC), an intravaginal nitrile sheath, provides women with more control over HIV prevention and is as effective as the male condom at preventing HIV, STIs, and pregnancy. Furthermore, inconsistent users of the male condom achieve higher rates of protected sex acts by combining the two barrier methods. While FC use in the U.S. is currently low, FC education and training increases women's attitudes toward and use of female condoms. Black women in particular may benefit from FC education because they are more likely than other women to increase FC use after receiving training. In addition, FCs are more often used with primary partners, the most common source of HIV infection for African American women. To harness the promise of FC, scalable FC interventions that reach and educate large numbers of women are greatly needed. The Centers for Disease Control (CDC) conducts ongoing reviews of the scientific literature to identify evidence-based HIV behavioral interventions (EBIs) that may be effective for particular populations. Of the 73 EBIs identified, only one - Female Condom Skills Training (FEMIT) - is focused on providing education and training on the female condom (FC). To enhance the reach of this EBI, we intend to develop C- FEMIT, a computer-enabled version of the FEMIT intervention. Because EBIs that are tailored to the life- context of the individual are most effective, C-FEMIT will be tailored to the needs of African American women, a unique, high-risk group that accounts for the majority of HIV infections among women. This project is also designed to overcome two barriers to the implementation of EBIs. First, to manage the challenges faced by providers when integrating EBIs into clinical practice, we will develop a provider module designed to address intervention, coordinator, and organizational barriers. Second, lack of fidelity to the core elements of EBIs is common and leads to poorer outcomes. In collaboration with its creator, we will adapt the core elements of FEMIT, resulting in an intervention delivered with perfect fidelity. Utilizing these strategies, we hope to develop the first female condom EBI that is that is effective, provider-responsive, and scalable. Phase I prototype development will be informed by formative research with treatment service providers and input from our expert consultants. Next, the prototype will undergo usability testing and a prototype review with African American women seeking services at a community-based provider of HIV/STI services. Finally, treatment service providers will rate the functionality and content of the provider module.