Computer-Based HIV Prevention Package for Drug Using African American Women

针对吸毒非裔美国妇女的基于计算机的艾滋病毒预防包

基本信息

批准号：
9133473
负责人：
DOUGLAS W BILLINGS
金额：
$ 51.13万
依托单位：
ISA ASSOCIATES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9133473
关键词：
AIDS prevention AIDS/HIV problem Abstinence Accounting Address Administrator Adopted Affect African American Alcohol or Other Drugs use American Attention Behavior Behavior Control Behavior Therapy Benchmarking Biological Centers for Disease Control and Prevention (U.S.)Chlamydia Client Clinic Clinical Collaborations Communities Computers Development Disease Drug usage Effectiveness Face Female Goals Gonorrhea HIV HIV Infections HIV Seropositivity Health Heterosexuals Human Herpesvirus 2 Incidence Infection Intervention Judgment Latex Maintenance Manuals Marketing Mediation Participant Phase Play Pre-Post Tests Prevention Preventive Preventive Intervention Principal Investigator Program Effectiveness Provider Questionnaires Randomized Randomized Controlled Trials Research Risk Risk Behaviors Role Services Sexually Transmitted Diseases Source Substance abuse problem Surveys Syphilis Test Result Testing Time Vagina Woman base condoms design effective intervention field study genital herpes health disparity injection drug use male man men prevent programs protective behavior prototype sex sex risk skills transmission process usability

项目摘要

DESCRIPTION (provided by applicant): HIV/AIDS has been especially devastating to African American women. The reason for this health disparity can largely be understood within the context of the unique prevention challenges faced by African American women. Specifically, 80% of new infections among women are the result of heterosexual contact, with the primary male partner the chief source of infection.3 In African American women, heterosexual transmission plays an even larger role. Sexually transmitted infections (STIs) also disproportionately affect African American women. The risk of becoming infected with HIV is increased two to five times when infected with an STI. Finally, the impact of HIV on African American women is further augmented among those who use drugs. While this combination of factors accounts for some of the prevention challenges faced by African American women, it does not account for the primary challenge. Beyond abstinence, the most effective way to prevent HIV infection is correct and consistent use of the male latex condom. For men, increasing condom use is a behavior. For women, it is a goal. Therefore, HIV behavioral interventions for women require a special focus on women's lack of power in relationships and their asymmetrical subordination of personal protective behavior in deference to relationship maintenance. This is especially true for African American women. While the challenges are clear, the solutions are not. Of the 84 HIV behavioral interventions identified by the Centers for Disease (CDC) control as effective, only two were developed for drug-using African American women. Neither has an intervention package and neither is being actively disseminated by CDC. To address this substantial need, we intend to computer-enable Female and Culturally Specific Negotiation Intervention (FCSNI), one of the effective interventions identified by the CDC. FCSNI was specifically developed for drug-using African American women who have sex with men. Based on formative research with service providers, we intend to call the computer-enabled version of FCSNI, Safe Sistah. While the scalability of computer-based programs allows for efficient dissemination, clinics still face significant implementation barriers when tryng to deliver empirically-validated interventions. As such, we will develop a second module called Safe Sistah in your Clinic. This module will provide clinics with strategies to help them adopt and integrate Safe Sistah into their clinical offerings. The results of Phase I strongly support the feasibility and potential effectiveness of the programs - far exceeding the three usability benchmarks established in the Phase I proposal. In Phase II we will complete development of the Safe Sistah and Safe Sistah in your Clinic modules. We will test the effectiveness of Safe Sistah in a randomized controlled trial with 120 drug-using African American women. Participants will be randomly assigned to receive either the Safe Sistah program or to an attention control condition. Before, and at two points after random assignment, participants' sexual and drug use behaviors will be assessed.

描述（由申请人提供）：艾滋病毒/艾滋病对非裔美国妇女造成的破坏尤其严重，这种健康差异的原因在很大程度上可以在非裔美国妇女面临的独特预防挑战的背景下理解，具体来说，80% 的新感染者。女性中的感染是异性接触的结果，其中主要男性伴侣是主要感染源。3 在非裔美国女性中，异性传播感染 (STI) 也对非裔美国女性造成更大的影响。成为感染性传播感染后，艾滋病毒感染率会增加两到五倍。最后，艾滋病毒对吸毒者的非洲裔美国妇女的影响进一步加大，而这些因素的结合是非洲裔美国人面临的一些预防挑战的原因。对于女性来说，除了禁欲之外，预防艾滋病毒感染的最有效方法是正确、持续使用男用乳胶安全套，对于男性来说，增加安全套的使用是一种行为，对于女性来说，这是一个目标。因此，针对女性的艾滋病毒行为干预需要采取特殊的措施。关注女性在人际关系中缺乏权力以及她们在维护关系方面的不对称服从，这对于非洲裔美国女性来说尤其如此，尽管挑战很明显，但在 84 项艾滋病毒行为干预措施中，解决方案却并不明确。疾病控制中心 (CDC) 的控制措施虽然有效，但只为吸毒的非裔美国妇女开发了两种干预方案，而且 CDC 也没有积极传播。为了满足这一重大需求，我们打算为女性提供计算机支持。和文化上特定谈判干预 (FCSNI) 是 CDC 确定的有效干预措施之一，是专门针对与男性发生性行为的吸毒非裔美国女性而制定的，我们打算将其称为计算机支持的干预措施。 FCSNI 的版本 Safe Sistah 虽然基于计算机的程序的可扩展性允许有效传播，但诊所在尝试提供经过经验验证的干预措施时仍然面临重大的实施障碍，因此，我们将开发第二个模块。名为 Safe Sistah in your Clinic 该模块将为诊所提供帮助他们采用和实施的策略。将 Safe Sistah 整合到他们的临床产品中。第一阶段的结果有力地支持了该计划的可行性和潜在有效性 - 远远超过第一阶段提案中建立的三个可用性基准。在第二阶段，我们将完成 Safe Sistah 和 Safe 的开发。 Sistah 在您的诊所模块中。我们将在一项针对 120 名吸毒非裔美国女性的随机对照试验中测试 Safe Sistah 的有效性，参与者将被随机分配接受 Safe Sistah 计划或注意力控制条件。在随机分配之前和之后的两个时间点，将评估参与者的性行为和吸毒行为。