Process Analysis of Rapid Testing (PART)

快速测试过程分析（部分）

• 批准号: 6892719
• 负责人: NICOLAS M SHEON
• 金额: $ 27.64万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-01 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6892719
• 关键词: AIDS /HIV diagnosis; AIDS /HIV test; AIDS education /prevention; HIV infections; anxiety; audiotape; behavioral /social science research tag; clinical research; counseling; education evaluation /planning; experience; health behavior; health care personnel; health services research tag; high risk behavior /lifestyle; homosexuals; human subject; male; patient care personnel relations; sex behavior; social organization

DESCRIPTION (provided by applicant): The proposed study addresses a major gap in our understanding of the process of HTV counseling and testing for men who have sex with men (MSM). Rapid HIV testing is currently being implemented in counseling and testing (C&T) programs nationwide as part of an initiative to increase testing among high-risk populations outside of clinical settings. Given that the majority of high-risk men also frequent bathhouses, these are ideal venues in which to provide C&T. Rapid testing represents a revolution in the practice of C&T because it compresses the pre- and post-test session separated by a week into one session. While rapid testing will ensure that clients receive their results, it will increase the level of tension in the session because neither the counselor nor the client will have time to prepare for the result. Experience from post-test counseling suggests that the anxious period before receiving life-altering diagnostic news is not the best time to engage clients in a discussion of their risk behavior, yet this is what rapid testing will entail. The challenges of implementing rapid testing provide an opportunity to examine what actually transpires in C&T sessions. Although C&T has been widely promoted as a risk-reduction intervention in the U.S., outcome studies have found that MSM testing three or more times not only continue to report high-risk behavior but actually seroconvert at higher rates than previously untested clients. Previous C&T process analysis has examined either the counseling interaction, the client's or the counselor's experience independently. This is the first study to examine C&T process from all three perspectives. 70 test sessions will be digitally audio-recorded to describe patterns and variations in counselors' strategies for providing risk reduction counseling in both rapid and standard C&T. Follow-up interviews with the same clients and counselors will elicit narratives about the test experience. Interviews with 30 men who have not tested in the last 2 years will examine reasons for not testing. By developing new measures for evaluating the process of C&T, the proposed study will make a major methodological contribution to the evaluation of HIV prevention interventions and provide tools for counselor training and supervision based on empirical observation of real-world practice.

描述（由申请人提供）：拟议的研究解决了我们对男男性行为者 (MSM) 的 HTV 咨询和检测过程的理解上的一个重大差距。目前，快速 HIV 检测正在全国范围内的咨询和检测 (C&T) 项目中实施，作为在临床环境之外增加对高危人群进行检测的计划的一部分。鉴于大多数高危男性也经常去澡堂，这些是提供 C&T 的理想场所。 快速测试代表了 C&T 实践的一场革命，因为它将相隔一周的测试前和测试后会话压缩为一个会话。虽然快速测试将确保客户收到结果，但它会增加会议中的紧张程度，因为咨询师和客户都没有时间为结果做准备。测试后咨询的经验表明，在收到改变生活的诊断消息之前的焦虑期并不是让客户讨论其风险行为的最佳时机，但这正是快速测试所需要的。 实施快速测试的挑战提供了一个机会来检查 C&T 会议中实际发生的情况。尽管 C&T 在美国已被广泛推广为一种降低风险的干预措施，但结果研究发现，MSM 检测三次或以上不仅会继续报告高风险行为，而且实际上比以前未检测过的客户的血清转化率更高。 之前的 C&T 流程分析已独立检查咨询互动、来访者或咨询师的经验。这是第一项从所有三个角度审视 C&T 过程的研究。 70 次测试课程将以数字方式录音，以描述咨询师在快速和标准 C&T 中提供降低风险咨询的策略的模式和变化。对相同客户和辅导员的后续访谈将引出有关测试经历的叙述。对过去 2 年内未进行检测的 30 名男性进行访谈，以调查未进行检测的原因。 通过制定评估 C&T 过程的新措施，拟议的研究将为艾滋病毒预防干预措施的评估做出重大方法论贡献，并为基于对现实世界实践的实证观察的咨询师培训和监督提供工具。