Library

Resource

International HIV Prevention Research at the Center for AIDS Prevention Studies, University of California San Francisco

The principal objective of the International Core at the Center for AIDS Prevention Studies (CAPS) is to facilitate high quality international research by creating effective and productive partnerships between CAPS scientists and HIV prevention researchers from developing countries. The International Core brings together CAPS scientists and alumni of the Collaborative Prevention Research in Developing Countries Program, a training program for new developing country researchers (described below). CAPS has successfully developed a broad portfolio of small-scale international research projects conducted by CAPS scientists and Program alumni. Together we have made important contributions toward understanding how to prevent HIV transmission and how to care for the HIV-infected in the developing world.

Resource

Black women

Black women and men in the US are hard hit by HIV, and have been since the beginning of the epidemic. In 2006, Black women accounted for 61% of new HIV cases among women, but make up only 12% of US female population. The rate of HIV diagnoses for Black women is 15 times the rate for White women. Black women also have high rates of sexually transmitted diseases (STDs), which can facilitate transmission of HIV. Among Black women in 2006, the rate of chlamydia was 7 times higher, gonorrhea 14 times higher, and syphilis 16 times higher than the rate among White women. These numbers and statistics, however, don’t show the richness and diversity of Black women’s lives. Black women can be White collar and working class, Christians and Muslims. They live in inner-city and suburban neighborhoods, are the descendants of slaves and recent Caribbean immigrants. They work, go to school, raise families, fall in love. HIV among Black women is not simply about individual behavior, but a complex system of social, cultural, economic, geographic, religious and political factors that combine to affect health.

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Childhood sexual abuse (CSA)

Childhood sexual abuse may be defined in many ways, but this fact sheet refers to unwanted sexual body contact prior to age 18, the age of consent to engage in sex. CSA is a painful experience on many levels that can have a profound and devastating effect on later physiological, psychosocial and emotional development. CSA experiences can vary with respect to duration (multiple experiences with the same perpetrator), degree of force/coercion or degree of physical intrusion (from fondling to digital penetration to attempted or completed oral, anal or vaginal sex). The identity of the perpetrator–ranging from a stranger to a trusted figure or family member–may also impact the long-term consequences for individuals. To distinguish CSA from exploratory sexual experimentation, the contact should be unwanted/coerced or there should be a clear power difference between the victim and perpetrator, often defined as the perpetrator being at least 5 years older than the victim. Many more children are sexually abused than are reported to authorities. Estimates of the prevalence of CSA in the US are about 33% for females under the age of 18 and 10% in males under 18 years of age. Men are significantly less likely than women to report CSA when it occurs. CSA is more likely to occur in families under duress. Children are at risk for CSA in families that experience stress, poverty, violence and substance abuse and whose parents and relatives have histories of CSA.

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Abuso sexual infantil

El abuso sexual infantil (ASI) tiene muchas definiciones, pero en esta hoja informativa nos referimos al contacto corporal no deseado antes de los 18 años, que es la edad en que se considera que una persona puede dar su consentimiento para tener contacto sexual. El ASI es una experiencia dolorosa a muchos niveles que puede tener, posteriormente, efectos profundos y devastadores en el desarrollo psicológico, psicosocial y emocional. Las experiencias de ASI pueden variar respecto a: duración (varios incidentes con el mismo agresor), grado de fuerza/coerción o grado de intrusión física (desde una caricia, a la penetración digital o al sexo oral, anal o vaginal intentado o consumado). La identidad del agresor/a (que podría ser un desconocido, una persona de confianza o un familiar) también puede influir en las consecuencias a largo plazo para las víctimas. Lo que distingue el ASI de la experimentación sexual exploratoria es el contacto indeseado o forzado o la clara desproporción de poder; comúnmente, se determina como agresor/a alguien que resulte por lo menos 5 años mayor que la víctima. El número de abusos sexuales infantiles excede el número de casos reportados a las autoridades. Se calcula que la prevalencia del ASI en EE.UU. es del 33% entre chicas menores de 18 años y del 10% entre chicos menores de 18 años. Los hombres son considerablemente menos propensos a reportar un incidente de ASI que las mujeres. La probabilidad de que el ASI ocurra aumenta en familias que sufren mucha tensión. Los niños están en riesgo de ser abusados sexualmente en familias que padecen estrés, pobreza, violencia y consumo de alcohol o drogas y cuyos padres y parientes tienen antecedentes de ASI.

Research Project

Application of Weighted Time-Series to Address Bias in Evaluation of Clinic- and Community-Level Research

This study will use simulation to develop, test and apply new analytic methods (weighted time-series) for evaluation of community-level interventions. It will then compare results using weighted time-series and conventional methods within the context of a clinic-level intervention to provide family-centered HIV care, voluntary counseling and testing (VCT) and prevention services at Family AIDS Care and Education Services (FACES), a community-based organization in Kenya. Because FACES includes observational data on virtually all patients in care at participating clinics, it provides an excellent platform to evaluate the effectiveness of this intervention using both cohort and time-series methods. The results of this study will be used to seek funding to test the broader application of these methods in both community- and clinic-level interventions. The specific aims of the proposed project are:

To provide the rationale and framework for applying weighted time-series to serial cross-sectional data.
To use simulation (created data) to apply and test the use of weighted time-series in a setting where the distribution of demographic characteristics and the health status of the population changes over time.
To use existing clinical data to compare the effect of introducing family-centered HIV care, VCT and prevention services on the transmission of HIV among the families served by participating clinics using cohort analysis, time-series analysis and weighted time-series.