Cambodia Integrated HIV and Drug Prevention Implementation Program

描述（由申请人提供）：在柬埔寨，女性娱乐和性工作者（FESW）是艾滋病毒的最高风险群体之一：艾滋病毒的流行率和发病率很高，使用非注射安非他明类兴奋剂（ATS）也很高。我们在那里的研究表明，安非他明类兴奋剂大大增加了艾滋病毒的风险。这项拟议的研究将评估实施新的组合艾滋病毒预防干预方案（药物滥用预防和小额信贷工具）整合到现有的艾滋病毒预防计划（SMART女孩）针对高风险的柬埔寨FESW的影响。SMART女孩提供一系列教育和外联服务，特别是转介进行艾滋病毒检测，以及性传播感染、生殖健康和计划生育方面的保健服务。这是该国针对高危妇女传播最广的艾滋病毒方案，估计该国从事娱乐工作的35 000名妇女中有三分之一以上与艾滋病毒方案有接触。我们将使用一项阶梯楔形随机分组试验，评估我们在10个省实施的SMART女孩Plus计划是否会导致艾滋病毒风险比标准SMART女孩更大的下降。干预措施包括在SMART女孩平台内培训和实施针对安非他明类兴奋剂使用者的有条件现金转移方案，并将符合条件的妇女介绍给小额供资组织，以获得财务培训和资源。不使用安非他明类兴奋剂的妇女（有条件现金援助和非有条件现金援助方案的客户）将有资格被转介给小额信贷组织。这项申请的第二个目标是在柬埔寨建立一个艾滋病毒实施科学合作组织。HISC将把来自我们集团与柬埔寨艾滋病毒预防和护理团体的广泛历史和当前伙伴关系的一系列政府、学术和社区利益攸关方联系起来。HISC的使命将是推动柬埔寨艾滋病毒预防研究的转化，包括：（1）就SMART女孩附加项目提供咨询意见和观点;（2）参与和促进关键的可持续性活动，特别是在新环境中的培训和教育机会。 （3）参与计划传播活动，旨在柬埔寨和更广泛的国际艾滋病预防界分享研究和计划成果。拟议的项目将由一个经验丰富的合作研究小组进行，包括来自加州大学旧金山弗朗西斯科，FHI 360柬埔寨，和来自澳大利亚，新南威尔士大学。这些团体中的每一个都在柬埔寨的艾滋病毒预防研究、方案规划和实施方面拥有十多年的经验和专门知识，所有这些都是在该国的其他关键团体的合作下进行的。拟议的实施科学项目将为柬埔寨的艾滋病毒预防实践带来重要的新知识和潜在的改进。

DESCRIPTION (provided by applicant): In Cambodia, female entertainment and sex workers (FESWs) are one of the highest risk groups for HIV: prevalence and incidence of HIV are high, as is use of non injected amphetamine type stimulant (ATS) use. Our research there has shown that ATS contributes significantly to HIV risk. This proposed research will assess the impact of implementing new combination HIV prevention intervention options (drug abuse prevention and microfinance tools) integrated into an existing HIV prevention program (SMART girl) targeting high risk Cambodian FESWs. SMART girl provides a range of education and outreach services, especially referrals to HIV testing, and health services for sexually transmitted infections, reproductive health and family planning. It is the most widely disseminated HIV program for at risk women in the country, estimated to have contact with over one third of the country's 35,000 women engaged in entertainment work. Using a stepped wedge randomized cluster trial, we will evaluate whether our proposed SMART girl Plus program, implemented in 10 provinces over 30 months, will result in larger decreases in HIV risk compared to standard SMART girl. The intervention consists of training for and implementation of a conditional cash transfer program (CCT) aimed at ATS users within the SMART girl platform, and referrals of eligible women to a microfinance organization for financial training and resources. Women who do not use ATS (CCT and non- CCT program clients) will be eligible for referral to the microfinance organization. A second goal of this application entails the creation of an HIV Implementation Science Collaborative (HISC) in Cambodia. The HISC will link a range of governmental, academic and community-based stakeholders drawn from our groups' extensive historic and current partnerships with HIV prevention and care groups in Cambodia. The HISC mission will be to advance translational aspects of HIV prevention research in Cambodia, including by (1) providing advice and perspectives on the SMART girl Plus project; (2) participating in and promoting key sustainability activities, especially training and education opportunities in the new field of Implementation and Dissemination Science; and (3) participate in program dissemination activities aimed at sharing the research and program results within Cambodia and the broader international HIV prevention community. The proposed project will conducted by an experienced collaborative research group including from University of California San Francisco, FHI 360 Cambodia, and from Australia, the University of New South Wales. Each of these groups has over a decade each of experience and expertise in HIV prevention research, program planning and implementation in Cambodia, all in collaboration together or with other key groups in that country. The proposed implementation science project will result in significant new knowledge and potential improvements to HIV prevention practice in Cambodia.