Cambodia Integrated HIV and Drug Prevention Implementation Program

描述（由申请人提供）：在柬埔寨，女性娱乐工作者和性工作者（FESWs）是感染艾滋病毒的最高风险群体之一：艾滋病毒的患病率和发病率很高，非注射性安非他命类兴奋剂（ATS）的使用也是如此。我们在那里的研究表明，ATS显著增加了艾滋病毒的风险。这项拟议的研究将评估将新的艾滋病毒预防联合干预方案（药物滥用预防和小额信贷工具）整合到现有的针对高风险柬埔寨FESWs的艾滋病毒预防计划（SMART girl）中的影响。SMART girl提供一系列教育和外联服务，特别是转介艾滋病毒检测，以及性传播感染、生殖健康和计划生育方面的保健服务。这是该国传播最广泛的针对高危妇女的艾滋病毒项目，据估计，在该国3.5万名从事娱乐工作的妇女中，有三分之一以上的妇女与之接触。采用楔形随机聚类试验，我们将评估我们提出的SMART girl Plus项目，在10个省实施30个月后，与标准SMART girl相比，是否会导致更大的艾滋病毒风险降低。干预措施包括培训和实施针对SMART girl平台内ATS用户的有条件现金转移计划（CCT），并将符合条件的妇女介绍给小额信贷组织，以获得财务培训和资源。不使用ATS的妇女（有条件现金援助和非有条件现金援助项目客户）将有资格转介到小额信贷组织。这项申请的第二个目标是在柬埔寨建立艾滋病毒实施科学合作组织（HISC）。HISC将把一系列政府、学术和社区利益攸关方联系起来，这些利益攸关方来自我们集团与柬埔寨艾滋病毒预防和护理团体的广泛的历史和目前的伙伴关系。HISC的使命将是推动柬埔寨艾滋病毒预防研究的转化方面，包括：(1)为SMART girl Plus项目提供建议和观点；(2)参与和推动关键的可持续发展活动，特别是在新的培训和教育机会

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.