Collaborative biosocial research on HIV risk and prevention in women

描述（由申请人提供）：本R21提案是对NOT-MH-12-001的回应，美俄双边合作研究伙伴关系（CRP）关于预防和治疗艾滋病毒/艾滋病和合并症。拟议的研究将收集有关艾滋病毒检测使用情况的信息，以及对处于艾滋病毒暴露风险的俄罗斯普通青年妇女艾滋病毒检测决定的影响。该研究将比较两种低屏障检测策略（选择加入与选择退出）对艾滋病毒检测的接受程度，并将对这些策略进行首次随机实验比较。艾滋病毒检测是预防艾滋病毒传播的一项关键内容，对一般人群中的妇女尤其突出。这项研究将创新性地利用焦点小组来收集定性数据，并确定参与同行讨论是否会导致不接受测试的人重新考虑测试决定。总体目标是获得可用于提高俄罗斯高危年轻妇女艾滋病毒检测使用率的知识，并为改进预防提供迫切需要的针对性别的战略。该提案建立在俄克拉荷马大学健康科学中心（OUHSC）和圣彼得堡州立大学（SPSU）之间建立的合作研究项目的基础上。研究目的包括：(1)估计影响检测决策的艾滋病毒风险流行程度、态度、信念和障碍；(2)通过实验比较选择加入和选择退出HIV检测策略，探索亚群调节效应；(3)通过焦点小组对测试进行讨论，估计不接受测试者可能接受测试的人数；(4)根据在目标1-3中获得的信息，制定在俄罗斯年轻妇女中增加艾滋病毒检测和降低风险的战略。据我们所知，该项目将是第一个将重点放在性活跃的俄罗斯年轻女性中，以确定特定性别的艾滋病毒风险和预防策略，减少艾滋病毒传播，并实验性地比较选择加入和选择退出检测策略的项目之一。这项研究将提供有关检测屏障作用的关键信息，

DESCRIPTION (provided by applicant): This R21 proposal is in response to NOT-MH-12-001, the US-Russia Bilateral Collaborative Research Partnerships (CRP) on the Prevention and Treatment of HIV/AIDS and Co-morbidities. The proposed study will gather information about HIV testing utilization and influences on HIV testing decisions among young, general population Russian women at-risk of HIV exposure. The study will compare HIV testing acceptance across two types of low-barrier testing strategies (opt-in vs. opt-out) and will conduct one of the first randomized experimental comparisons of these strategies. HIV testing is a key element of HIV transmission prevention that is particularly salient for women in the general population. The study will make innovative use of focus groups to gather qualitative data and to determine if participation in peer discussion may lead to reconsideration of testing decisions among testing non-acceptors. The overarching goal is to gain knowledge that can be used to increase utilization of HIV testing among at-risk young women in Russia and offer urgently needed gender- specific strategies for improving prevention. The proposal builds on an established collaborative research program between the University of Oklahoma Health Sciences Center (OUHSC) and St. Petersburg State University (SPSU). Study aims include: (1) estimating HIV risk prevalence, attitudes, beliefs, and barriers that influence testing decisions; (2) experimentally comparing opt-in vs. opt-out HIV testing strategies and exploring subpopulation moderating effects; (3) estimating the number of testing non-acceptors who might accept testing after peer discussion about testing in a focus group; and (4) based on the information obtained in aims 1-3, developing a strategy for increasing HIV testing and risk reduction among young Russian women. To our knowledge, this project will be among the first that focuses on sexually active young Russian women in the general population to identify gender-specific HIV risk and prevention strategies, reduce HIV transmission, and experimentally compare opt-in vs. opt-out testing strategies. The study will provide critical information about the role of testing barriers, testing presentation, and peer influence on HIV testing decisions, which can be used to engineer and refine public health strategies.