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

描述（申请人提供）：这项拟议的研究是一项随机对照试验（RCT），将严格评估提供多媒体循证干预（WORTH）和简化艾滋病毒检测以预防黑人/非洲裔美国人感染艾滋病毒和其他性传播感染（STI）的有效性和成本效益。（以下简称“黑人”）妇女吸毒者在纽约市缓刑场所的人数，与仅简化艾滋病毒检测相比。主要结果将是减少生物学证实的STI的累积发生率（即，衣原体、淋病和滴虫）。在全国范围内的缓刑环境中推进艾滋病毒干预措施的连续性具有巨大的潜力，可以接触到大量仍然处于艾滋病毒/性传播感染高风险中的吸毒黑人妇女，并有助于扭转其网络和社区中高度集中的艾滋病毒/性传播感染流行病。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个试用场所对420名涉毒黑人妇女进行。符合条件的妇女将被随机分配到：（1）WORTH，包括个人简化艾滋病毒检测会议，随后是4个会议的基于小组的多媒体艾滋病毒/性传播感染预防干预，或（2）单独的个人简化艾滋病毒检测会议，这将作为比较条件。这两个条件将由5个缓刑地点的缓刑提供者提供。将在基线和干预后3、6和12个月进行重复评估。本研究还将采用混合方法，以确定多层次的理论驱动的因素，可能会影响交付价值和简化的艾滋病毒检测干预措施的有效性，在真实的世界设置的缓刑通知这些干预措施的未来传播战略。我们将与提供干预措施的缓刑提供者、一线缓刑工作人员和缓刑管理人员就可能影响WORTH对研究结果有效性的多层次因素进行反复评估和定性访谈。如果 多媒体WORTH干预措施被认为是有效的，它可以在全国范围内的缓刑环境中扩大，以遏制艾滋病毒/性传播感染在黑人妇女中的传播，并减少受影响严重的社区中的艾滋病毒差异。如果研究组之间没有发现差异，则简化的HIV检测干预措施提供了一种具有高度成本效益的HIV检测模式，也可以在试用环境中扩大。

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.