PS07-005 Multi-Site Rapid HIV Testing in Urban Community Mental Health Settings

描述(由申请人提供)：我们建议实施一项多地点计划，旨在增加艾滋病毒检测，并改善在有大量非裔美国人的社区精神卫生环境中护理艾滋病毒感染者的联系。采用为期六个月的纵向设计，我们将招募符合纳入标准的参与者进行评估、咨询和基线快速艾滋病毒检测。这些参与者将在干预后6个月再次接受采访。这项研究旨在评估艾滋病毒危险行为的变化、与艾滋病毒护理的联系以及随后使用精神卫生服务的情况。作为主要的协调机构，宾夕法尼亚大学的研究团队将通过我们在马里兰大学的合作者，与费城和巴尔的摩的三种类型的设施进行合作。这两个城市的目标设施包括以大学为基础的住院精神病病房、社区精神卫生中心(CMHCs)和自信社区治疗(ACT)计划。如本申请所述，这两个城市的设施非常匹配，两个站点将使用相同的协议和程序。我们计划在每个城市内为每个项目类型招募200人，总共1200名研究参与者。我们希望收集这些受试者中至少75%的6个月的随访数据，以获得900多个完整的纵向样本。根据美国黑人全国调查(杰克逊，1991)提供的医疗保健利用数据，我们认为，通过针对这些人接受服务的共同计划类型，最好地解决未来与患有精神疾病的非裔美国人有关的公共卫生问题。这一点尤其适用于SMI患者中范围较小的SES，这些人基本上符合SSI和SDI资格，并将医疗补助作为其医疗服务的付款人。通过对住院患者、CMHC门诊患者和ACT消费者的抽样，我们获得了美国精神卫生服务提供的三种主要交付方式的压倒性数据(心理健康美国，2002)。

DESCRIPTION (provided by applicant): We propose the implementation a multi-site program designed to increase HIV testing and improve linkage to care for HIV-infected in community mental health settings with large numbers of numbers of African Americans. Using a six-month longitudinal design, we will be enrolling participants who meet inclusion criteria for assessment, counseling, and Rapid HIV Testing at baseline. These participants will be interviewed again at 6 months post intervention. on the study is designed to evaluate changes in HIV risk behaviors, linkages to HIV care, and subsequent use of mental health services. As the primary coordinating institution, the Penn research team will be collaborating with a mix of three types of facilities in Philadelphia and Baltimore, through our collaborators at the University of Maryland. Target facilities in both cities include university-based inpatient psychiatric units, Community Mental Health Centers (CMHCs), and Assertive Community Treatment (ACT) programs. As described in this application, the facilities in the two Cities are well matched and both sites will use the same protocol and procedures. We plan to recruit 200 persons per program type within each city for a total of 1200 study participants. We expect to collect six-month follow-up data on at least 75% of these subjects for a complete longitudinal sample of more than 900. Based on data on health care utilization from the National Survey of Black Americans (Jackson, 1991) we believe that future public health relevance for mentally ill African Americans is best addressed by targeting common program types where these individuals receive services. This is particularly true for the attenuated range of SES among persons with SMI who are largely SSI and SDI eligible and have Medicaid as their payor for health services. By sampling inpatients, CMHC outpatients, and ACT consumers, we capture overwhelmingly the three predominant modalities of delivery mental health service delivery in the United States (Mental Health United States, 2002).