Texting intervention to sustain HIV prevention in women in high-drug-use contexts

短信干预以维持高吸毒环境中女性的艾滋病毒预防

• 批准号: 9461499
• 负责人: Thomas L. Patterson
• 金额: $ 63.16万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9461499
• 关键词: AIDS prevention; Address; Adherence; Age; Alcohol consumption; Alcohol or Other Drugs use; Anal Sex; Behavior; Behavior Therapy; Behavior assessment; Behavioral; Body Weight decreased; Car Phone; Caring; Characteristics; Cities; Client; Cognitive; Collaborations; Contracts; Counseling; Country; Data; Development; Drug Addiction; Drug abuse; Drug usage; Environmental Risk Factor; Equipment; Exposure to; Frequencies; Gender; General Population; Goals; HIV; HIV Infections; HIV/STD; Health; Health behavior; High Risk Woman; Incidence; Income; Individual; Information Technology; Injections; International; Intervention; Maintenance; Mediating; Mental Depression; Mexican; Mexico; Pattern; Pharmaceutical Preparations; Preventive Intervention; Process; Randomized; Relapse; Reporting; Research; Risk Reduction; Safe Sex; Schedule; Self Efficacy; Sex Behavior; Sex Counseling; Sexual abuse; Sexually Transmitted Diseases; Site; Spouses; Technology; Testing; Text; Text Messaging; Time; Treatment Efficacy; United States National Institutes of Health; Unsafe Sex; Vagina; Woman; Women' s Health; Work; Workplace; base; behavior change; behavioral construct; condoms; cost effective; cost-effectiveness evaluation; design; disorder later incidence prevention; efficacy testing; evidence base; experience; female sex worker; follow-up; individualized prevention; innovation; innovative technologies; intervention effect; male; new technology; non-drug; primary outcome; programs; public health relevance; scale up; secondary outcome; sex; skills; smoking cessation; theories; therapy design; treatment as usual; treatment effect; treatment program

 DESCRIPTION (provided by applicant): Treatment effects of health behavior interventions erode, often with relapse rates greater than 50% within 6 months, perhaps because the constructs that sustain behavior change differ from those that favor behavior acquisition. The overarching aim of this study is to evaluate the efficacy of Mujer Segura Siempre (MSS, Always Healthy Woman), a safer-sex behavior maintenance intervention delivered by means of tailored text messaging. MSS will use theory-based, individually tailored text messages that are designed to maintain the positive effects of an evidence-based counseling intervention (Mujer Más Segura, R01 DA023877) that was shown to be efficacious in reducing HIV/STI incidence by more than 60% among both drug-using and non- drug-using female sex workers (FSWs) in Tijuana and Ciudad (Cd.) Juarez, Mexico. The content of the text messages will be based on constructs from behavior-maintenance theory. Our specific aims are to: (1) deter- mine if the theory-based MSS text-messaging intervention is associated with the long-term (24-month) mainte- nance of significant reductions in HIV/STI incidence (primary outcome) among drug-using and non-drug-using FSWs in Tijuana and Cd. Juarez relative to a time-equivalent control condition; (2) determine if the MSS intervention is associated with greater reductions in unprotected vaginal and anal sex with male clients, better attendance at regularly scheduled STI screenings, and reduced sharing of drug paraphernalia for FSW-IDUs (secondary outcomes) relative to a time-equivalent control condition; (3) determine if substance use factors (frequency, intensity, and patterns of alcohol and drug use) mediate or moderate the efficacy of the interven- tion, taking into account environmental risk factors (e.g., drugs in the workplace), maintenance constructs (e.g., maintenance self-efficacy), and personal characteristics (e.g., age, sexual abuse, depression); and (4) evalu- ate the cost-effectiveness of MSS compared to the control condition, to Mujer Más Segura alone (data from previous studies), and to usual care in Mexico. To meet these aims, we will deliver the brief Mujer Más Segura counseling intervention to 600 HIV-negative FSWs (300 in Tijuana, 300 in Cd. Juarez) who report unsafe sex with at least one client in the previous 6 months, and randomize them to either Group 1 (n=300), the MSS text- messaging maintenance program for 24 months post-counseling (since relapse is most likely to occur within this period) or Group 2 (control condition, n=300), general health text messages for 24 months post-counsel- ing. Both groups will undergo follow-up behavioral assessments and STI testing at 6, 12, 18, and 24 months. This study will advance the use of commonly available information technology to empower high-risk women in lower- to middle-income countries (LMICs) to prolong the benefit of an efficacious HIV prevention intervention. It also addresses the goals of the Office of Research on Women's Health to incorporate gender into the design and development of new technologies for HIV prevention among high-risk women, and to personalize prevention messages that will maintain positive behavioral change.

 描述（由适用提供）：健康行为干预措施的治疗效果侵蚀，通常在6个月内大于50％，这可能是因为维持行为的结构改变了不同于偏爱行为的构造。这项研究的总体目的是评估Mujer Segura Siempre（MSS，Whisems Healthy Woman）的有效性，这是一种安全性性别行为维持干预措施，该干预措施通过量身定制的文本消息传递的含义提供。 MSS will use theory-based, individually tailored text messages that are designed to maintain the positive effects of an evidence-based counseling intervention (Mujer Más Segura, R01 DA023877) that was shown to be efficient in reducing HIV/STI incident by more than 60% among both drug-using and non-drug-using female sex workers (FSWs) in Tijuana and Ciudad (Cd.) Juarez, Mexico.文本消息的内容将基于行为维护理论的构造。我们的具体目的是：（1）确定基于理论的MSS文本密码干预是否与蒂华纳和CD中毒品使用和未毒品的FSW中的HIV/STI事件（主要结果）显着减少的长期（24个月）保持相关。华雷斯相对于时间等效的控制条件； （2）确定MSS干预措施是否与未受保护的阴道和与男性客户的肛交减少相关，在定期安排的STI筛查中更好地出席，以及相对于时间等效的控制条件，FSW-IDUS（次要结局）的药物书写量减少； （3）确定物质使用因子（频率， Intensity, and patterns of alcohol and drug use) mediate or moderate the efficiency of the intervening, taking into account environmental risk factors (e.g., drugs in the workplace), maintenance constructs (e.g., maintenance self-effectiveness), and (4) evaluation-attempt the cost-effectiveness of MSS compared to the control condition, to Mujer Más Segura alone (data from previous studies), and to usual care In Mexico.为了满足这些目标，我们将向600个HIV-MásSegura咨询干预提供简短的HIV负FSW（300个在蒂华纳（Tijuana in Tijuana），Cd。Juarez中的300个），他们在过去6个月中与至少一个客户报告不安全的性行为，并将其随机地在第1组（N = 300）中随机进行，M = 300个月（n = 300），既有24个月（n = 300）。周期）或第2组（控制条件，n = 300），幕后24个月的一般健康文本消息。两组将在6、12、18和24个月进行随访行为评估和STI测试。这项研究将推动使用常见的信息技术来赋予低风险中等收入国家（LMIC）的高危妇女，以延长有效的HIV预防干预措施的好处。它还解决了妇女健康研究办公室的目标，即将性别纳入高风险妇女的新技术的设计和开发，并将预防信息个性化，以维持积极的行为改变。