Young Women-Focused HIV Prevention: Seek & Test in NC Clinics

以年轻女性为重点的艾滋病毒预防：寻求

• 批准号: 9323370
• 负责人: WENDEE M WECHSBERG
• 金额: $ 89.39万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9323370
• 关键词: AIDS prevention; Address; African American; Age; Alcohol or Other Drugs use; Behavior; Behavioral; Biological; Caring; Cellular Phone; Chlamydia; Clinic; Communities; Comorbidity; Counseling; County; Drug usage; Elements; Ensure; Gender; Goals; Gonorrhea; HIV; Health; Health Services; Healthcare; Human immunodeficiency virus test; Incidence; Infection prevention; Intervention; Link; Measures; Methods; Modeling; National Institute of Drug Abuse; North Carolina; Outcome; Participant; Pharmaceutical Preparations; Pregnancy Outcome; Prevention program; Public Health; Randomized; Readiness; Recruitment Activity; Reproductive Health; Resources; Risk; Risk Reduction; Services; Sexual Partners; Sexually Transmitted Diseases; Structure; Substance abuse problem; Technology; Testing; Training; Treatment Efficacy; Woman; Women' s Health; aged; arm; condoms; cost; design; efficacy testing; empowerment; follow up assessment; follow-up; handheld mobile device; health disparity; health empowerment; healthy lifestyle; high risk; innovation; intervention program; mHealth; mobile computing; primary outcome; public health relevance; response; sexually active; skills; social stigma; substance abuse treatment; tool; treatment program; young woman

 DESCRIPTION (provided by applicant): In response to RFA-DA-15-019 to develop and test the delivery of age-appropriate HIV-focused models within the seek, test, treat, and retain (STTR) framework, this application proposes to reach young substance-using, sexually at-risk, HIV naïve, African American women aged 18 to 25 years old in North Carolina. High incidence of HIV and sexually transmitted infections (STIs) among these young women is driven by drug use, poor condom use, and structural factors such as stigma and lack of age-appropriate services for HIV/STI prevention and treatment. Most HIV/STI clinics are not equipped to provide substance abuse counseling or to effectively link young women to substance abuse treatment. Many of these young women continue to abuse substances, have recurring STIs, and remain at high risk for HIV due to a lack of protective skills and other comorbid and contextual conditions. We propose a mixed-methods approach to develop and test the efficacy and examine two delivery strategies of an age-appropriate, woman-focused HIV intervention initiated in HIV testing clinics that will provide risk reduction, empowerment skills, and linkage to substance abuse treatment. Consistent with NIDA's seek and test aspects of the STTR framework, we will seek young sexually active and drug-using African American women aged 18 to 25 in low-resource communities in three counties who have not tested recently or ever for HIV. To examine the efficacy of the interventions, we will collect measures on behavioral (i.e., drug and sexual risk, comorbidity, reproductive health, empowerment, treatment) and biological (i.e., HIV, STIs [gonorrhea, chlamydia], drug use, and pregnancy) outcomes. We will test the woman-focused intervention conducted in two formats, face- to-face and mHealth, within HIV clinics in three counties using a three-arm cluster-randomized design in which counties are randomized to (1) HIV counseling and testing (HCT) as the control, (2) the face-to-face format by HCT staff who will be trained to deliver the intervention (including activities to sensitize staff to age- an gender-related issues, stigma, and other structural barriers that reduce these young women's access to HIV/STI services and substance abuse treatment); and (3) the mHealth format that will be delivered on smartphones using an interactive app, an innovation that can be easily integrated into participants lives once they complete HIV testing. We plan to estimate the costs and examine structural outcomes regarding the acceptability and sustainability of the new face-to-face (in the clinic) and mHealth (on smartphones) interventions from both staff and participants. The overall impact of both of these formats, relative to HCT, will offer alternative gender-focused strategies as "HIV prevention models" in a new structure for young, substance-using African American women, and determine whether the new intervention is a more viable strategy for ensuring intervention sustainability and producing positive behavior and biological results.

 描述（由申请人提供）：响应RFA-DA-15-019，以使用EEK，测试，治疗和保留（STTR）框架来开发和测试以适合年龄的艾滋病毒为中心的艾滋病毒模型的交付，本申请建议在北卡罗来纳州，在北卡罗来纳州18至25岁的非洲裔美国妇女到达年轻物质，艾滋病毒幼稚的妇女。缺乏适合艾滋病毒/性传播疾病的艾滋病毒和治疗的服务。由于缺乏保护技能，其他合并症和XTUAL条件，我们提出了一种混合方法，以开发和测试疗效，并检查两种适合年龄的女性艾滋病毒诊所滥用疗法。我们将收集有关行为的措施（即药物和性风险，合并症，繁殖健康，治疗）和生物学（即艾滋病毒，hiv，stis [gonorrhea，gonorrhea，chlamydia]和妊娠）。艾滋病毒县在吉奇县使用树臂聚类随机设计内的两种格式，即面对面和MHealth，随机分为（1）测试（HCT）作为控制权，（2）面对面格式愿意提供干预的HCTT员工（将工作人员置于年龄相关的问题，结构性障碍，将这些年轻妇女的艾滋病毒/服务和药物滥用待遇降低）；智能手机使用前进性应用程序完成HIV测试。为HCT提供的格式将提供替代性性别的策略作为新的结构中的“艾滋病毒预防模型”，用于使用新干预措施，并确定新干预措施是否是一种更可行的关于可持续性和产生积极性的更可行的。行为和生物周围结果。