Family-Focused HIV Disclosure Intervention in Thailand

描述（由申请人提供）：这是一个指导研究科学家发展奖的建议。研究者的长期目标是成为一名研究领导者，与社区密切合作，为受艾滋病毒影响的家庭设计和实施行为干预措施。艾滋病毒的披露是泰国受艾滋病毒影响家庭的一个主要压力源，其影响波及整个家庭。通过解决艾滋病毒披露作为一个家庭问题，拟议的研究旨在应用艾滋病毒披露决策的综合模式，以开发和试点在泰国东北部的文化定制的干预措施，是一个组合的小组会议和家庭为基础的活动。为了确保可行性和可持续性，拟议的干预措施将被设计为整合在泰国东北部地区医院的现有医疗保健基础设施中，这些医院被选定用于拟议的研究。本研究的训练目标为：1.获得定性研究方法的专业知识，特别是在行为干预研究中使用的深入访谈和焦点小组技术。2.获得行为干预设计方面的专业知识，重点是以家庭为中心的干预措施。3.获得定量研究方法的额外专业知识，特别是多水平重复测量分析。在完成培训目标后，本研究的具体目标是：1.从艾滋病病毒感染者、家庭成员和服务提供者的角度探讨艾滋病病毒披露的文化态度和背景因素中的问题、障碍和动机（第1阶段）。2.根据第一阶段的研究结果，制定一项以家庭为重点的干预措施，重点是艾滋病毒的披露（第二阶段）。3.试点测试和评估干预措施对艾滋病毒披露以及社会、身体、心理健康和行为结果的影响（第3阶段）。公共卫生相关性：拟议的研究将与泰国公共卫生部和泰国东北部的当地地区医院团队合作进行。拟议研究的总体目标是为PLH制定和试点干预措施，以帮助他们就向家人披露艾滋病毒做出深思熟虑、知情的决定。建议的干预措施将改善艾滋病毒携带者及其家庭的适应。

DESCRIPTION (provided by applicant): This is a proposal for a Mentored Research Scientist Development Award. It is the investigator's long-term goal is to be a research leader who works closely with the community to design and implement behavioral interventions for HIV-affected families. HIV disclosure is a key stressor among HIV-affected families in Thailand, and the impact radiates throughout the family. By addressing HIV disclosure as a family matter, the proposed study aims to apply the Integrative Model of HIV Disclosure Decision Making in order to develop and pilot a culturally tailored intervention in Northeastern Thailand that is a combination of group sessions and home-based activities. To ensure the feasibility and sustainability, the proposed intervention will be designed to be integrated within the existing health care infrastructure of the district hospitals in Northeastern Thailand selected for the proposed study. The training goals of the proposed study are: 1. To gain expertise in qualitative research methodology, especially in-depth interviewing and focus group techniques used in behavioral intervention research. 2. To gain expertise in behavioral intervention design, with focus on family-focused interventions. 3. To gain additional expertise in quantitative research methodology, particularly on multi-level repeated measures analysis. Upon completion of the training goals, the specific aims of the proposed study are: 1. To explore the concerns, barriers and motivators within cultural attitudes and contextual factors around HIV disclosure from the perspectives of PLH, family members, and service providers (Phase 1). 2. To develop a family-focused intervention focusing on HIV disclosure (Phase 2), based on the findings from Phase 1. 3. To pilot test and assess the impact of the intervention on HIV disclosure, and social, physical, mental health, and behavioral outcomes (Phase 3). PUBLIC HEALTH RELEVANCE: The proposed study will be conducted in collaboration with the Thai Ministry of Public Health and the local district hospital teams in Northeastern Thailand. The overall goal of the proposed study is to develop and pilot an intervention for PLH to help them make thoughtful, well-informed decisions about HIV disclosure to their family members. The proposed intervention will improve the adjustment of PLH and their families.