Current Research Projects at CAIR
CAIR researchers investigate a wide variety of issues related to HIV/AIDS. Currently, investigators are conducting studies with a number of different populations, in different locations, with different intervention approaches. The following summaries describe several of CAIR's current research projects.
Accuracy and Compliance in Daily Reports of Risk Behavior
Funding Source: National Institute of Mental Health
Principal Investigator: Timothy L. McAuliffe, PhD
Although most HIV behavioral research has relied on persons' retrospective reports of their sexual risk behavior, daily diaries have the potential to provide data relatively free of recall error. In spite of this major advantage, diaries have had limited use in HIV behavioral and prevention research because of the difficulty in verifying participant compliance with daily diary completion, missing or inconsistent diary recording, lack of control over the diary reporting process, and costs of managing large numbers of paper diaries. This study examines the feasibility of using electronic diaries for collecting daily sexual behavior self-reports.
Behavioral Intervention to Reduce Novel Antipsychotic Medication Risk Behavior
Funding Source: National Institute of Mental Health
Principal Investigator: Jeffrey A. Kelly, PhD
The emergence of AIDS as a public health crisis 25 years ago and recognition that HIV risk can be reduced through behavior changes stimulated the development of new behavioral intervention strategies. The approaches used in the HIV prevention field are now being applied to other health problems. For example, the PATH project adapts intervention models originally used in HIV prevention to the increasing problem of health-threatening weight gain among persons with serious mental illness on novel antipsychotic medications. The study, conducted in group homes, utilizes small-group and community-level intervention components to decrease high-calorie food intake and increase physical activity.
Communication Technology to Disseminate Evidence-Based HIV Interventions to NGOs
Funding Source: National Institute of Mental Health
Principal Investigator: Jeffrey A. Kelly, PhD
Research on HIV prevention interventions can benefit public health only when those approaches shown effective in research studies are transferred to public health service providers and are successfully used. Such dissemination efforts are necessary on a global scale. This study (GAIN2) examines the relative impact of distance training (Internet-based) versus traditional face-to-face training methods in transferring an HIV prevention intervention to nearly 100 non-governmental organizations in Eastern Europe, Central Asia, and Russia.
Cost-Effectiveness of Preventing Acute-Phase HIV Transmission
Funding Source: National Institute of Mental Health
Principal Investigator: Steven D. Pinkerton, PhD
Behavior changes made during the period of initial, highly infectious stage of HIV infection could prevent a significant number of new infections, but the ultimate impact of these interventions depends upon the actual extent of HIV transmission that occurs during the acute phase, as well as the cost-effectiveness of potential interventions to reduce that transmission. This project seeks to develop mathematical models to estimate the annual number of HIV infections due to acute-phase transmission and uses modeling research to assess the efficiency and cost-effectiveness of various strategies for identifying people with acute HIV infection.
Culturally-Tailored HIV Risk Reduction for African American MSM
Funding Source: Centers for Disease Control and Prevention
Principal Investigator: David W. Seal, PhD
African American MSM account for a disproportionately high percentage of total AIDS cases and HIV infections in the United States. This project is comparing the relative effectiveness of a rapid HIV counseling and testing (HCT) intervention to an enhanced experimental approach that combines HCT with a theory-based and culturally-tailored group intervention designed to reduce HIV and STD risk behaviors.
Drug Use, Housing Access, Stability, and HIV Risk among Low-Income Urban Residents
Funding Source: National Institute on Drug Abuse
Principal Investigator: Julia B. Dickson-Gomez, PhD
This project explores the relationship between structural factors of housing (access to housing subsidies and programs, status, and stability) and HIV risk among drug users. It builds on results from an exploratory research project in which longitudinal, qualitative interviews were conducted with active drug users and key informant interviews were conducted with service providers, and it explores the relationships among housing policy, housing status and stability, and HIV risk.
Experimental Analysis of HIV Risk Assessment Reactivity in South African Clinics
Funding Source: National Institute of Mental Health
Principal Investigator: Lance S. Weinhardt, PhD
This project examines the reactivity effects of HIV risk behavior assessment in a sample of STD clinic patients in Cape Town, Republic of South Africa. The study is designed to disentangle the influence of baseline assessements from that of an HIV prevention intervention, to explore the cognitive and interpersonal processes by which assessment reactivity occurs, and to identify factors that moderate behavior change following self-reports of risk behavior. The results may be relevant to microbicide trials, which often employ repeated, detailed behavioral assessments that may themselves increase perceived risk of HIV infection and inadvertently affect product usage.
Fostering an AIDS Research and Training Center Infrastructure in Russia
Funding Source: National Institute of Mental Health
Principal Investigator: Yuri A. Amirkhanian, PhD
This research infrastructure development grant award establishes the "Interdisciplinary Center for AIDS Research and Training" (ICART) in a collaboration between CAIR and Botkin Hospital for Infectious Diseases in St. Petersburg, Russia. ICART brings together a team of Russian behavioral, social, and medical scientists to work together in the conduct of HIV primary and secondary prevention projects, and to train new Russian investigators in the field. ICART's scientific leadership is linked with CAIR investigators and core resources to support their research and training initiatives.
High Risk Crack Use Settings and HIV in El Salvador
Funding Source: National Institute on Drug Abuse
Principal Investigator: Julia B. Dickson-Gomez, PhD
This project conducts formative research on the social context of crack use and sexual risk-taking in targeted communities in the San Salvador, El Salvador, metropolitan area. Investigators hope to identify and describe structural differences within and across three types of low-income communities; examine the relationships among drug distribution systems, drug use settings, drug user networks, and HIV risk; and estimate HIV prevalence among crack users in the San Salvador metropolitan area.
HIV Prevention with High-Risk Social Networks in Eastern Europe
Funding Source: National Institute on Drug Abuse
Principal Investigators: Jeffrey A. Kelly, PhD, and Yuri A. Amirkhanian, PhD
Communities vulnerable to HIV/AIDS are often hard-to-reach and distrustful of outside authorities, especially in former communist countries. This project--undertaken in Russia, Bulgaria, and Hungary--uses social structural analysis to identify highly-interconnected influence leaders of social networks and then trains these network leaders to function as risk reduction behavior change advisors to other network members.
Pathways Linking Poverty, Food Insecurity, and HIV in Rural Malawi
Funding Source: National Institute of Child Health and Human Development
Principal Investigator: Lance S. Weinhardt, PhD
What role does economic change have on HIV-related risk, prevention behaviors, and their distribution in a population? This project seeks to answer those questions in rural Malawi by exploring the relationships among microfinance programs, increased food production and security, and HIV risk. Specifically, the project compares the mechanisms, processes, and magnitude of impact of an economic and food security intervention carried out by CARE Malawi on HIV vulnerability and certain economic outcomes.
Simulation Tool for HIV/STD Cost-Effectiveness Analysis
Funding Source: National Institute for Mental Health
Principal Investigator: Steven D. Pinkerton, PhD
Because funds to support HIV/STD prevention service programs are limited, information about the cost-effectiveness of HIV/STD prevention interventions is needed to ensure that the most economically efficient interventions are implemented and that HIV/STD prevention resources are used to maximum benefit. This study extends existing mathematical models to better estimate the impact of HIV/STD prevention interventions by taking into account the relative timing of sexual partnerships and sexual acts within those partnerships, and by extending these models to incorporate time-varying or population-distributed factors that influence HIV/STD transmission.