Client-Centered Counseling During Routine/Opt-Out HIV-Testing in Uganda

乌干达常规/退出艾滋病毒检测期间以客户为中心的咨询

• 批准号: 7803696
• 负责人: Susan Maria Kiene
• 金额: $ 15.85万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7803696
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adopted; Adult; Advocate; Affect; Area; Award; Behavior; Behavioral; Behavioral Sciences; Biological; Biological Markers; Caring; Client; Cognitive; Communities; Counseling; Country; Data; Discipline; Disinhibition; Effectiveness; Epidemic; Fatigue; Feedback; Future; Goals; Government; HIV; HIV Seropositivity; Health; Health Personnel; Health care facility; Hospitals; Human immunodeficiency virus test; Incidence; Individual; Infection; Infectious Disease Epidemiology; International; Intervention; Intervention Trial; Knowledge; Literature; Medical; Mentors; Methods; Outcome; Outpatients; Paint; Patient Self-Report; Patients; Persons; Population; Prevalence; Prevention; Prevention Research; Prevention approach; Prevention strategy; Preventive; Preventive Intervention; Primary Prevention; Principal Investigator; Procedures; Process; Provider; Public Health; Randomized Controlled Trials; Recommendation; Request for Applications; Research; Research Personnel; Research Support; Resources; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Roentgen Rays; Rural Hospitals; Secondary Prevention; Services; Sex Behavior; Sexual Partners; Sexually Transmitted Diseases; Structure; Testing; Time; Training; Uganda; base; behavior change; career; clinical care; cohort; condoms; cost; direct application; experience; high risk sexual behavior; mortality; multidisciplinary; novel strategies; prevent; programs; psychosocial; response; routine care; scale up; sex risk; skills; social; stem; success; theories; therapy design; transmission process; uptake

DESCRIPTION (provided by applicant): The applicant's long-term goal is to build a career as an independent investigator in multidisciplinary international health research focusing on HIV/AIDS research in resource-limited settings to help reduce the global HIV epidemic. In this award the candidate will build on her behavioral science background by developing knowledge and skills in public health, epidemiology, and infectious diseases with direct applications to international HIV/AIDS prevention research. The goals of this mentored award are to obtain training in these disciplines, gain expertise in methods and analysis for using biological outcomes in intervention trials, and experience conducting international HIV prevention research. The proposed research program will adapt an effective theory-based brief client-centered prevention for positives intervention designed to decrease risky sexual behavior (the OPTIONS Project), to the primary prevention setting of outpatient routine/opt-out HIV testing and counseling (RTC) in Uganda. Uganda is one of the countries most affected by the HIV epidemic and approximately 80% of those who are HIV-positive are unaware of their status. In an effort to address this situation, Uganda is expanding RTC programs. The structure and content of counseling during RTC differs dramatically from that offered during opt-in HIV-testing. Recommendations for counseling during RTC call for abandoning the client-centered counseling approach advocated in opt-in testing, in place of providing brief information and referrals for support and care services. Furthermore, unlike other HIV-counseling and testing programs, RTC places little emphasis on reducing sexual risk behavior, which is a missed opportunity for prevention. The aims of the research are: 1) conduct formative research to understand the dynamics of sexual risk behavior and elicit recommendations for adapting the intervention, 2) adapt, pilot-test, and refine the brief client-centered RTC intervention, and 3) investigate behavior change processes following RTC to identify psychosocial, social-cognitive and behavioral factors that explain short and long term sexual risk behavior change. The research will also explore the concordance between self- report and biological markers of unprotected sexual behavior and estimate the potential effect size of the brief client-centered RTC intervention on preventing new sexually transmitted infections (STIs). The proposed research will prepare the candidate to test the effects of the resultant intervention on reducing STI incidence and risky sexual behavior in a future large randomized controlled trial. This research is especially timely in Uganda and elsewhere as RTC is being scaled up. If a future trial of the proposed intervention shows it to be an effective HIV-prevention approach it is well situated to be adopted as the standard-of-care for RTC in Uganda and hopefully throughout the world as well.

描述（由申请人提供）：申请人的长期目标是在多学科国际健康研究中建立独立研究者，重点是资源有限的环境中的艾滋病毒/艾滋病研究，以帮助减少全球艾滋病毒的流行。在该奖项中，候选人将通过开发公共卫生，流行病学和传染病方面的知识和技能，直接应用于国际艾滋病毒/艾滋病预防研究，以其行为科学的背景为基础。该指导奖的目标是获得在这些学科中的培训，在干预试验中使用生物学结果的方法和分析方面的专业知识，并经验进行国际艾滋病毒预防研究。拟议的研究计划将适应一个有效的基于理论的简短以客户为中心的预防，用于旨在降低风险性行为的积极干预（期权项目），以适应乌干达在门诊常规/退出艾滋病毒测试和咨询（RTC）的主要预防设置。乌干达是受艾滋病毒流行影响最大的国家之一，大约80％的艾滋病毒阳性的国家没有意识到其地位。为了解决这种情况，乌干达正在扩大RTC计划。 RTC期间咨询的结构和内容与选择艾滋病毒测试期间提供的咨询差异很大。在RTC期间提出的咨询建议，要求放弃在选择加入测试中提倡的以客户为中心的咨询方法，以替代提供简短的信息和推荐支持和护理服务。此外，与其他艾滋病毒赛和测试计划不同，RTC几乎不强调减少性风险行为，这是预防的错过的机会。该研究的目的是：1）进行形成性研究以了解性风险行为的动态，并提出适应干预的建议，2）适应，试点测试，并完善以客户为中心的以客户为中心的RTC干预措施，3）研究RTC后RTC后的行为变化过程，以识别识别心理，社交认知和长期性风险行为的行为改变。该研究还将探讨自我报告与无保护性行为的生物学标志物之间的一致性，并估算以短暂客户为中心的RTC干预对防止新的性传播感染（STIS）的潜在效应大小。拟议的研究将使候选人在未来的大型随机对照试验中测试最终干预对减少性传播感染发生率和风险性行为的影响。随着RTC的扩大规模，这项研究在乌干达和其他地方尤其及时。如果未来对拟议的干预措施的试验表明这是一种有效的艾滋病毒预防方法，则可以很好地将其作为乌干达RTC的护理标准，并希望在全球范围内采用。