Computer-based HIV Prevention for Seropositive Men

基于计算机的血清阳性男性艾滋病毒预防

• 批准号: 8012737
• 负责人: DOUGLAS W BILLINGS
• 金额: $ 15.86万
• 依托单位: ISA ASSOCIATES, INC.
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2011-12-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8012737
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adopted; Advocate; Belief; Caring; Centers for Disease Control and Prevention (U.S.); Client; Clinic; Clinical; Communities; Computers; Data; Decision Making; Development; Diagnosis; Disclosure; Drops; Drug usage; Effectiveness; Face; Focus Groups; HIV; HIV Infections; HIV Seropositivity; Health; Hour; Human Resources; Incidence; Individual; Infection; Injection of therapeutic agent; Intervention; Lead; Learning; Length; Life; Medical; Methods; Patients; Pharmaceutical Preparations; Phase; Physicians; Prevalence; Prevention; Prevention education; Prevention program; Prevention strategy; Preventive Intervention; Probability; Provider; Randomized; Research; Risk; Risk Behaviors; Secondary Prevention; Services; Sexual Partners; Sexual Transmission; Source; Symptoms; Testing; Time; United States; Vaccines; Visual; Work; base; community setting; cost; design; high risk sexual behavior; man; men; preference; prevent; programs; prototype; public health relevance; response; sex; sexually active; skills; success; therapy design; transmission process; treatment adherence; usability

DESCRIPTION (provided by applicant): Since the late 1990s, the number of new HIV infections has held steady at approximately 50,000 new cases each year. At first glance, this 10-year stability in incidence rate appears to challenge the notion that HIV prevention efforts have been successful. However, antiretrovirals (ARVs) also became widely availability at the same time incidence rates stabilized. By allowing those living with HIV to lead longer and more productive lives, the opportunity for seroconversion grows. Despite this potential, there has not been an increase in overall incidence, and certain methods of transmission (e.g., injection drug use) have seen significant drops. The success of ARVs did alter the prevention landscape, however. While many seropositive individuals reduce their risk behavior after learning of their diagnosis, one-third of those who are sexually active continue to engage in high risk sexual activities. In response, the CDC revised its national prevention strategy by advocating a focus on those who are diagnosed with HIV and their partners. Despite this shift in strategy, only 7 of the 41 prevention programs listed in the CDC compendium of "best evidence" interventions focus on secondary prevention. More troubling is that the average length of time required to complete one of these "best evidence" interventions is over 19 hours of face-to-face time. Clinical and community settings do not have the human resources to implement such intensive programs. Moreover, only one empirically validated intervention was developed specifically for men. Yet, the latest incidence data show that 75% of all new HIV cases in the United States results from sexual contact with an infected man. To address this significant need, we intend to develop a prototype prevention program designed to reduce sexual transmission-related risk behaviors for HIV-positive men (for both MSM and MSW). This prototype will be based on the core components of modules 2 and 3 of the Healthy Living Project (HLP). These core components will be supplemented with prevention education designed to address the unique sociocultural challenges men face in reducing their sexual risk. Additionally, the proposed intervention will adopt a pro- health focus so that it will be perceived as supportive and nonstigmatizing. Finally, it will be computer-based to further increase acceptability among patients and physicians, reduce staff time, lower costs, increase fidelity of treatment delivery, and enhance the probability of widespread dissemination. Development of the Phase I prototype will also be informed by our expert consultants and a focus group of typical end-users to determine their audio/visual preferences, prevention needs and challenges, prevention beliefs, and preferred mode of message delivery. Following this, the prototype will undergo task-based usability testing with men seeking services at community-based provider of HIV/AIDS services. PUBLIC HEALTH RELEVANCE: This project aims to develop a computer-based prevention intervention designed to reduce sexual transmission-related risk behaviors for HIV-positive men. For clinics, this will allow them to provide an empirically validated HIV prevention intervention to their clients without creating additional demands on their already overburdened staff. For men, the skills contained in this program will help them reduce risk behaviors and, ultimately, prevent the spread of HIV.

描述（由申请人提供）：自 20 世纪 90 年代末以来，每年新增艾滋病毒感染人数一直稳定在约 50,000 例新病例。乍一看，发病率十年保持稳定似乎对艾滋病毒预防工作已取得成功的观念提出了挑战。然而，在发病​​率稳定的同时，抗逆转录病毒药物（ARV）也得到了广泛应用。通过让艾滋病毒感染者过上更长寿、更富有成效的生活，血清转化的机会就会增加。尽管有这种潜力，但总体发病率并未增加，并且某些传播方式（例如注射吸毒）已显着下降。 然而，抗逆转录病毒药物的成功确实改变了预防格局。虽然许多血清反应呈阳性的人在得知诊断后减少了危险行为，但三分之一的性活跃者继续从事高风险性活动。作为回应，疾病预防控制中心修订了其国家预防战略，主张重点关注被诊断为艾滋病毒感染者及其伴侣。尽管策略发生了这种转变，但 CDC“最佳证据”干预措施纲要中列出的 41 项预防计划中，只有 7 项重点关注二级预防。更令人不安的是，完成这些“最佳证据”干预措施之一所需的平均时间长度超过 19 个小时的面对面时间。临床和社区环境没有人力资源来实施此类强化计划。此外，只有一种经过经验验证的干预措施是专门针对男性开发的。然而，最新的发病率数据显示，美国所有新发艾滋病毒病例中有 75% 是由与感染者的性接触造成的。 为了满足这一重大需求，我们打算开发一个原型预防计划，旨在减少艾滋病毒阳性男性（MSM 和 MSW）与性传播相关的风险行为。该原型将基于健康生活项目 (HLP) 模块 2 和 3 的核心组件。这些核心组成部分将辅以预防教育，旨在解决男性在降低性风险方面面临的独特社会文化挑战。此外，拟议的干预措施将采取有利于健康的重点，以便被视为支持性的、非侮辱性的。最后，它将以计算机为基础，进一步提高患者和医生的可接受性，减少工作人员时间，降低成本，提高治疗交付的保真度，并提高广泛传播的可能性。 我们的专家顾问和典型最终用户焦点小组还将为第一阶段原型的开发提供信息，以确定他们的音频/视觉偏好、预防需求和挑战、预防信念以及首选的消息传递模式。此后，该原型将接受基于任务的可用性测试，测试对象是在社区艾滋病毒/艾滋病服务提供商处寻求服务的男性。 公共卫生相关性：该项目旨在开发一种基于计算机的预防干预措施，旨在减少艾滋病毒阳性男性的性传播相关风险行为。对于诊所来说，这将使他们能够向客户提供经过经验验证的艾滋病毒预防干预措施，而不会对其已经不堪重负的员工提出额外的要求。对于男性来说，该计划中包含的技能将帮助他们减少危险行为，并最终防止艾滋病毒的传播。