A Multimedia HIV/STI Intervention for Black Drug-involved Women on Probation

描述(由申请人提供)：拟议的研究是一项随机对照试验(RCT)，将严格评估在纽约市(NYC)的缓刑地点对黑人/非裔美国人(以下简称黑人)女性吸毒者进行多媒体循证干预(VALUE)和简化艾滋病毒检测以预防艾滋病毒和其他性传播感染(STI)的有效性和成本效益，与单独进行简化艾滋病毒检测相比。主要结果将是减少生物确认的性传播感染(即衣原体、淋病和滴虫)的累积发病率。在全国范围内推进在缓刑环境中的艾滋病毒干预措施具有巨大的潜力，可以接触到大量与毒品有关的黑人妇女，她们仍然处于艾滋病毒/性传播感染的极高风险之中，并有助于扭转其网络和社区中高度集中的艾滋病毒/性传播感染流行。拟议的随机对照试验将在纽约市受艾滋病毒和性传播感染严重影响的社区的5个缓刑点对420名涉及毒品的黑人妇女进行。符合条件的妇女将被随机分配到：(1)单独简化艾滋病毒检测课程，然后进行4节以小组为基础的多媒体艾滋病毒/性传播感染预防干预；或(2)单独进行简化艾滋病毒检测课程，作为比较条件。这两个条件都将由5个缓刑地点的缓刑提供者提供。重复评估将在基线以及干预后3、6和12个月进行。这项研究还将使用混合方法来确定可能影响提供有价值的和简化的艾滋病毒检测干预措施的有效性的多层次理论驱动的因素，以便为这些干预措施的未来传播战略提供信息。我们将对可能影响价值对研究结果有效性的多层面因素进行反复评估和定性访谈，缓刑提供者、一线缓刑工作人员和缓刑管理人员将提供干预。如果 多媒体值得干预被发现是有效的，可以在全国范围内的缓刑环境中扩大规模，以遏制艾滋病毒/性传播疾病在黑人妇女中的传播，并减少受严重影响社区的艾滋病毒差距。如果研究人员之间没有发现差异，简化的艾滋病毒检测干预提供了一种高成本效益的艾滋病毒检测模式，也可以在缓刑环境中扩大规模。

DESCRIPTION (provided by applicant): The proposed study is a randomized controlled trial (RCT) that will rigorously evaluate the effectiveness and cost-effectiveness of delivering a multimedia evidence-based intervention (WORTH) and streamlined HIV testing to prevent HIV and other sexually transmitted infections (STIs) with Black/African-American (hereafter referred to as Black) women drug users in probation sites in New York City (NYC), compared to streamlined HIV testing alone. The primary outcome will be to reduce cumulative incidence of biologically confirmed STIs (i.e., Chlamydia, gonorrhea and trichomonas). Advancing a continuum of HIV interventions in probation settings nationwide has tremendous potential for reaching a large number of drug-involved Black women who remain at very high risk for HIV/STIs and helping to reverse highly concentrated HIV/STI epidemics in their networks and communities. The proposed RCT will be conducted with 420 drug-involved Black women at 5 probation sites located in communities in NYC heavily affected by HIV and STIs. Eligible women will be randomly assigned to: (1) WORTH consisting of an individual Streamlined HIV Testing session followed by a 4-session group-based multimedia HIV/STI prevention intervention or (2) an individual Streamlined HIV Testing session alone, which will serve as the comparison condition. Both conditions will be delivered by probation providers at the 5 probation sites. Repeated assessments will occur at baseline and 3, 6, and 12- months post intervention. This study will also employ mixed methods to identify multi-level theory-driven factors that may influence the effectiveness of delivering WORTH and Streamlined HIV testing interventions in the real world setting of probation to inform future dissemination strategies for these interventions. We will conduct repeated assessments and qualitative interviews on multi-level factors that may influence the effectiveness of WORTH on study outcomes with probation providers delivering the interventions, frontline probation staff, and probation administrators. If the multimedia WORTH intervention is found to be effective, it may be scaled up in probation settings nationwide to curb the spread of HIV/STIs among Black women and to reduce HIV disparities in heavily impacted communities. If no difference is found between study arms, the Streamlined HIV Testing intervention offers a highly cost-efficient model of HIV testing that may also be scaled up in probation settings.