Library
Resource
Mother-to-child transmission (MTCT)
In 2012, there were 2.3 million new HIV infections globally. A large proportion of people newly diagnosed with HIV worldwide are in their reproductive years and these men and women are likely to want children in the future. Addressing the sexual and reproductive health and rights of this population is critical to addressing the spread of HIV because HIV infection in childbearing women is the main cause of HIV infection in children. Treatment for those who are already infected is also central to stopping the spread of HIV to infants and to uninfected sexual partners.
Resource
Needle exchange programs (NEP)
More than a million people in the US inject drugs frequently, at a cost to society in health care, lost productivity, accidents, and crime of more than $50 billion a year. People who inject drugs imperil their own health. If they contract HIV or hepatitis, their needle-sharing partners, sexual partners and offspring may become infected. It is estimated that half of all new HIV infections in the US are occurring among injection drug users (IDUs). For women, 61% of all AIDS cases are due to injection drug use or sex with partners who inject drugs. Injection drug use is the source of infection for more than half of all children born with HIV. Injection drug use is also the most common risk factor in persons with hepatitis C infection. Up to 90% of IDUs are estimated to be infected with hepatitis C, which is easily transmitted and can cause chronic liver disease. Hepatitis B is also transmitted via injection drug use. Needle exchange programs (NEPs) distribute clean needles and safely dispose of used ones for IDUs, and also generally offer a variety of related services, including referrals to drug treatment and HIV counseling and testing.
Research Project
HIV Prevention Intervention for HIV-Positive Men in China
In China, sexual transmission has become the major driving force behind the HIV epidemic, accounting for more than half (52%) of the estimated 700,000 people currently living with HIV. Men who have sex with men (MSM) may contribute to the rapid acceleration of the epidemic throughout China. Studies with Chinese MSM have documented an increasing HIV prevalence, a high HIV incidence, and high rates of unprotected intercourse and sexually transmitted infections (e.g., syphilis) known to facilitate sexual transmission of HIV. Moreover, our work found that HIV-transmission risk behavior is highly prevalent among HIV-positive MSM in China. Nonetheless, no HIV prevention interventions have targeted HIV-positive Chinese MSM. Several interventions have demonstrated efficacy in reducing sexual risk behaviors among HIV-positive MSM in the U.S. Adapting such interventions for HIV-positive MSM in China would help accelerate the process of developing an efficacious intervention for this risk group. The proposed three-year study (R34) will adapt and pilot-test currently available evidence-based behavioral interventions to reduce HIV-transmission risk behavior among HIV-positive MSM in Chongqing, China. This study will be implemented in five phases, guided by Wainberg et al.’s intervention adaptation model. In Step 1, we will identify core components of efficacious interventions (e.g., key theoretical constructs, intervention messages, delivery modes) through the review of the literature. In Step 2, we will explore cultural, psychosocial, and contextual factors associated with sexual risk behaviors and generate ideas for intervention strategies for HIV-positive MSM by conducting 15 key informant interviews with individuals knowledgeable about HIV-positive MSM and 30 in-depth interviews with HIV positive MSM. In Step 3, we will adapt efficacious interventions through reviewing the core elements of efficacious interventions identified in Step 1 and collating those elements with qualitative data collected in Step 2 with an intervention adaptation working group of 10 health professionals and MSM lay workers who serve HIV-positive MSM. In Step 4, we will pilot-test the adapted intervention with 16 HIV-positive MSM and refine the intervention if necessary. In Step 5, we will test the feasibility of implementing and assessing the intervention refined in Step 4 by conducting the intervention with 50 HIV-positive MSM and having these 50 men complete baseline and 3-month surveys.
Research Project
ASHA Improving Health and Nutrition of Indian Women with AIDS and Their Children
The overall goal of this study is to enhance the physical and mental health of rural Indian women living with AIDS and their children. We will achieve these goals through the use of trained village women as Accredited Social Health Activists (ASHA) to enhance the health of women and children through improved ART adherence, CD4 levels, and physical and mental health. This Indo-US collaboration between University of California, Los Angeles, University of California, San Francisco and All India Institutes of Medical Sciences (AIIMS) builds on our previous work with rural women living with AIDS and our successful ASHA program. Specific objectives include: Using a 2x2 factorial design, we plan to assess the effects of nutrition training and/or food supplements on primary outcomes for rural women living with AIDS in improving body composition and immune status (CD4 levels) as assessed at 6-, 12- and 18-month follow-up. Examining the effects of the program arms and their interaction on adherence to ART, psychological health, nutritional adequacy, and lipid profile over time.
Research Project
Influence of Stigma and Discrimination on HIV Risk among Men in China
This is a three-phase study to identify the specific mechanisms by which MSM stigma affect sexual risk behaviors among MSM in Beijing, China.
- In Phase 1, we will explore the range of management strategies used to cope with MSM stigma via 30 in-depth qualitative interviews with MSM.
- In Phase 2, we will develop, using Phase 1 qualitative data and adapting existing quantitative scales, culturally-relevant measures of explanatory constructs of interest (e.g., MSM stigma management) to establish reliability and validity (N=170).
- In Phase 3, we will examine potential mediators (e.g., stigma management strategies, psychological distress, sexual contexts/situations) that explain how MSM stigma are linked to sexual risk for HIV with a respondent-driven sample of 500 MSM who will complete baseline and two follow-up assessments at 6 and 12 months.