The Prevention of HIV/STI among Married Women in Urban India

印度城市已婚妇女艾滋病毒/性传播感染的预防

• 批准号: 7681022
• 负责人: STEPHEN L SCHENSUL
• 金额: $ 61.19万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-19 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7681022
• 关键词: AIDS prevention; Address; Age; Attention; Behavior; Caring; Child Care; Communities; Couples; Data Analyses; Data Collection; Developed Countries; Developing Countries; Distress; Elements; Epidemic; Etiology; Evaluation; Experimental Designs; Family; Feminization; Funding; Gender; Grant; HIV; Health; Health Knowledge, Attitudes, Practice; Health Resources; Health Services; Health Status; Health care facility; Healthcare; Husband; India; Individual; Infection; Infection prevention; Institution; Institutionalization; Intervention; Interview; Knowledge; Left; Life; Link; Maintenance; Marriage; Maternal and Child Health; Medical; Methods; Modeling; National Institute of Mental Health; Nature; Outcome; Pan Genus; Patients; Perception; Phase; Population; Pregnancy; Preventive Intervention; Primary Prevention; Provider; Psyche structure; Public Health; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resources; Risk; Risk Reduction; Self Perception; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Slum; Spouses; Symptoms; Syndrome; Testing; Treatment Efficacy; Urban Health; Wife; Woman; Women' s Health; Women' s Health Services; base; efficacy testing; follow-up; high risk; improved; instrument; male; member; men; prevention service; programs; psychologic; psychological distress; service intervention; sex; social; standard care; standard of care; theories; therapy design; transmission process

DESCRIPTION (provided by applicant): This proposal seeks to develop and evaluate a culturally appropriate, health facility-based intervention to promote primary prevention of HIV and other sexually transmitted infections (HIV/STIs) among married women, ages 18-40, living in an economically marginal community in Mumbai (Bombay), India. The proposal responds to the need to develop effective approaches to the global risk of husband to wife transmission of HIV/STIs. This proposed project utilizes an approach to HIV/STI risk reduction among married women that centers on culturally-based gynecological and related health symptoms that women feel more comfortable discussing and presenting for treatment. The specific aims of this proposal are to: (1) Conduct formative research on the stakeholders and institutions involved in women's health including women in the context of the family, women as patients, husbands and their relationship to the health of their wives, and the nature of health care for women in the community; (2) Develop and implement, based on the formative research, Enhanced Care and Couples' Intervention in an existing public health facility to reduce women's HIV/STI risk within marriage; (3) Test the efficacy of the interventions, through a randomized clinical trial (RCT), to reduce the risk of HIV/STI transmission, to reduce STIs and women's gynecological and related symptoms and to improve women's life situation. The proposed project will be conducted in an urban "slum" community of Mumbai. The project will be organized into three phases: Phase I (Year 1) will involve formative research on health and other service providers, married women, and married couples; analysis of these data; and finalization of the intervention design. Phase II (Years 2-4) involves the establishment of a randomized experimental design that will include: Enhanced Care plus Couples' Intervention; Enhanced Care Only; Standard of Care plus Couples' Intervention; and Standard of Care only; and Phase III (Year 2-5) will evaluate the impact of the interventions on married women. The great majority of women in the world are exposed to HIV/STI risk not through their own agency, but because of the behavior of their spouses. The intent of this study is to develop an approach that will reduce risk among vulnerable married women in these communities and thus serve as a model for India as well as for other vulnerable women in developing and developed countries.

描述（由申请人提供）：本提案旨在制定和评估一种文化上适当的、基于卫生设施的干预措施，以促进居住在 18-40 岁已婚妇女中艾滋病毒和其他性传播感染 (HIV/STI) 的一级预防。印度孟买的一个经济边缘社区。该提案响应了制定有效方法来应对全球丈夫间艾滋病毒/性传播感染风险的需要。该拟议项目采用了一种降低已婚妇女艾滋病毒/性传播感染风险的方法，该方法以基于文化的妇科和相关健康症状为中心，使妇女能够更轻松地讨论和提出治疗。本提案的具体目标是： (1) 对参与妇女健康的利益相关者和机构进行形成性研究，包括家庭中的妇女、作为患者的妇女、丈夫及其与妻子健康的关系，以及妇女健康的关系。社区妇女保健的性质； (2) 在形成性研究的基础上，在现有公共卫生设施中制定和实施加强护理和夫妻干预措施，以减少妇女在婚内感染艾滋病毒/性传播感染的风险； （3）通过随机临床试验（RCT）检验干预措施的有效性，以降低艾滋病毒/性传播感染的风险，减少性传播感染和妇女妇科及相关症状，改善妇女的生活状况。拟议的项目将在孟买的一个城市“贫民窟”社区进行。该项目将分为三个阶段： 第一阶段（第一年）将涉及对卫生和其他服务提供者、已婚妇女和已婚夫妇的形成性研究；分析这些数据；并最终确定干预设计。第二阶段（第 2-4 年）涉及建立随机实验设计，其中包括： 加强护理加夫妻干预；仅加强护理；标准护理加上夫妻干预；仅护理标准；第三阶段（第 2-5 年）将评估干预措施对已婚妇女的影响。世界上绝大多数女性并非通过自己的机构而面临艾滋病毒/性传播感染的风险，而是由于其配偶的行为。本研究的目的是开发一种方法，降低这些社区中弱势已婚妇女的风险，从而为印度以及发展中国家和发达国家的其他弱势妇女树立榜样。