Using Technology to Prevent HIV in Indian Wine Shops

在印度葡萄酒商店中利用技术预防艾滋病毒

• 批准号: 8139287
• 负责人: DAVID D. CELENTANO
• 金额: $ 16.07万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-10 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8139287
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adult; Africa; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; Attention; Awareness; Behavior; Coitus; Communities; Counseling; Data; Drug usage; Education; Elements; Environment; Epidemiology; Ethnography; Government; HIV; HIV-1; Happiness; Health; Health Promotion; Health Services Accessibility; Housing; India; Individual; Intervention; Knowledge; Life; Literature; Measures; Mechanics; National Institute of Mental Health; Outcome Study; Participant; Pattern; Persons; Policies; Policy Maker; Population; Prevalence; Prevention; Preventive Intervention; Process; Psychotherapy; Public Health; Randomized; Recruitment Activity; Reporting; Research; Respondent; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Services; Technology; Testing; Time; Training; Unsafe Sex; Violence; Visual; Wine; Work; alcohol services; base; behavior change; brief intervention; care seeking; condoms; drinking; experience; help-seeking behavior; high risk; low socioeconomic status; meetings; men; novel strategies; prevent; responsible alcohol use; sex; social; theories; therapy design; tool

DESCRIPTION (provided by applicant): As we enter the third decade of HIV prevention, evidence suggests the important role of individual alcohol use in facilitating the risk of HIV and STD acquisition. With 2.5 million adults living with HIV, India, after Africa, has the highest burden of HIV infected persons. Alcohol use, particularly among men, is gaining increasing attention from HIV prevention programmers and policy makers here as a risk factor amenable to change. While the strength of and existence of the association between alcohol use and risky sex has been debated in the scholarly literature, what is clear is the need to address venues where alcohol is used as a locus for HIV prevention efforts. In India, wine shops - community- based alcohol outlets- hold potential for a venue-based intervention. Our team - Johns Hopkins and YRG Center for AIDS Research (YRG CARE) in Chennai, India - has been working in wine shops implementing an individual-focused opinion leader-led social norm change HIV prevention intervention (NIMH U10MH 681543-01) in Chennai since 2000. In this study, we found high burden of HIV among patrons - 3% (over nine times higher than the national rate of 0.3%); high rates (>50% of participants) of unprotected sex and alcohol use before sex and high levels of harmful alcohol use measured by more than five drinks per sitting (65%). We also found that venue patrons have minimal access to care for either HIV or alcohol use. Individual factors such as information of harmful drinking patterns, positive attitudes and towards seeking help and perceived drinking norms that have been shown to motivate care seeking and promote responsible alcohol use are little understood in India. Further, venue-level factors such as trained service staff, supportive alcohol serving policies, availability of care seeking and prevention tools such as referral information that have worked elsewhere are yet unexplored in India. This understanding is critical to obtain in wine shops as this is where high risk (for HIV and harmful alcohol use) patrons meet regularly and socialize. In this study, based on person-environment theory of behavior change, we seek to understand and modify the environment of the wine shop that will help patrons seek care for HIV/STDs and harmful alcohol use. PUBLIC HEALTH RELEVANCE: This intervention has high public health significance. By exploring the feasibility of a venue- based intervention using technology and server training in high risk alcohol use outlets, we hope to gather preliminary data that will further our understanding of the mechanics of targeting HIV prevention beyond the individual. We also propose to collaborate with the government to implement the first of its kind partnership to intervene in alcohol service venues in Chennai, India.

描述（由申请人提供）：随着我们进入艾滋病毒预防的第三个十年，有证据表明个人饮酒在增加艾滋病毒和性病感染风险方面发挥着重要作用。印度有 250 万成年人感染艾滋病毒，是仅次于非洲的艾滋病毒感染者负担最高的国家。饮酒，尤其是男性的饮酒，作为一个可以改变的风险因素，越来越受到艾滋病毒预防规划者和政策制定者的关注。虽然学术文献中对饮酒与危险性行为之间关联的强度和存在存在争议，但明确的是需要解决使用酒精作为艾滋病毒预防工作场所的问题。在印度，葡萄酒商店（以社区为基础的酒类销售点）具有进行基于场所的干预的潜力。我们的团队 - 位于印度金奈的约翰霍普金斯大学和 YRG 艾滋病研究中心 (YRG CARE) - 一直在金奈的葡萄酒商店工作，实施以个人为中心的意见领袖主导的社会规范改变艾滋病毒预防干预措施 (NIMH U10MH 681543-01)自 2000 年以来。在这项研究中，我们发现顾客中的艾滋病毒负担很高 - 3%（比全国 0.3% 的比率高出九倍多）；无保护性行为和性行为前饮酒的比例很高（>50%的参与者），并且有害酒精的使用水平很高，以每次饮酒超过五杯来衡量（65%）。我们还发现，场馆顾客获得艾滋病毒或酗酒护理的机会极少。在印度，人们对有害饮酒模式信息、积极态度以及寻求帮助和认知饮酒规范等个人因素知之甚少，这些因素已被证明可以激励寻求护理和促进负责任的饮酒。此外，印度尚未探索场地层面的因素，例如训练有素的服务人员、支持性酒精服务政策、寻求护理的可用性和预防工具（例如在其他地方有效的转介信息）。这种了解对于在葡萄酒商店中获得至关重要，因为这里是高风险（艾滋病毒和有害酒精使用）顾客定期聚会和社交的地方。在这项研究中，基于行为改变的人-环境理论，我们试图了解和改变葡萄酒商店的环境，这将有助于顾客寻求艾滋病毒/性病和有害酒精使用的护理。公共卫生相关性：该干预措施具有很高的公共卫生意义。通过探索在高风险饮酒场所使用技术和服务器培训进行场馆干预的可行性，我们希望收集初步数据，以进一步了解针对个人以外的艾滋病毒预防机制。我们还建议与政府合作，实施首个此类合作伙伴关系，以干预印度钦奈的酒精服务场所。