Center for AIDS Intervention Research (CAIR)

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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. 


 

Prevention of HIV Infection in High-Risk Social Networks of African American MSM
Funding Source: National Institute of Mental Health
Principal Investigator: Jeffrey A. Kelly, PhD

HIV infection has always taken a heavy toll on men who have sex with men (MSM) and also on African Americans. However, HIV incidence disparity is most striking of all for MSM who are also African American. Most existing HIV prevention interventions designed for African American MSM have relied on individual or small-group risk reduction counseling. In contrast to individual counseling models, HIV prevention interventions that are directed to social networks of Black MSM in the community and that work through natural influence channels within these networks hold the potential for reaching deeply into hidden and vulnerable populations of African American MSM. This study will determine the comparative effectiveness of a social network intervention on sexual risk, substance use, and STD/HIV incidence assessed with laboratory measures. The study aims to develop and determine the efficacy of an intervention modality capable of reaching and preventing HIV among high-risk African American MSM in the community.

 

Structural and Social Contexts of Substance Use, Violence, and HIV Risk Among Adolescent Gangs
Funding Source: National Institute on Drug Abuse
Principal Investigator: Julia Dickson-Gomez, PhD

Adolescent gang members are involved in a number of risky behaviors including drug use and sales, violence, and high risk sex and victimization. Many of these behaviors also increase gang members' risk of contracting and transmitting HIV. Understanding the social context in which HIV risk and substance abuse occurs, and structural features of gangs that may impact these, are essential to developing effective interventions with this population. This study is designed to address gaps in our knowledge regarding differences in structural characteristics among gangs and the influence of these on the social context of risk behavior and individual member's sexual risk.

 

A Multi-State Analysis of HIV Exposure Laws
Funding Source: National Institute of Mental Health
Principal Investigator: Carol L. Galletly, JD, PhD

The effectiveness of HIV disclosure laws as a public health HIV prevention intervention has not been firmly established, and it is not clear whether the laws increase seropositive status disclosure to prospective sex partners and whether disclosure increases abstinence or safer sex. There are also lingering concerns that the laws may have unintended negative effects on HIV transmission prevention efforts and on the life quality of persons living with HIV or at risk for HIV.  For persons living with HIV, there are concerns that the laws may increase HIV-related stigma and ultimately deter persons living with HIV from disclosing by increasing the nature and severity of consequences of being known as someone who has HIV. For persons at risk for HIV infection but who are seronegative or serostatus-unknown, concerns range from deterring individual from being tested to undermining central HIV prevention messages and fostering false confidence that infected persons are aware of their HIV-positive status and can and will disclose. This study examines the impact of an HIV disclosure law on at-risk (HIV negative or serostatus unknown) persons, as well as the law's impact on HIV-positive persons.

 

Implementation, Effectiveness, and Cost-Effectiveness of an HIV Intervention
Funding Source: National Institute of Mental Health
Principal Investigators: Jill Owczarzak, PhD, and Steve Pinkerton, PhD

Two decades of carefully controlled randomized trials have established that sexual behavior change interventions can significantly reduce intervention participants' risk of acquiring HIV. There is abundant scientific evidence of the efficacy of these interventions when conducted in research settings with well-trained staff, sometimes substantial participant incentives, and the economic, human, and organizational resources that typify NIH-funded intervention research centers. However, the effectiveness of these interventions when implemented by frontline HIV prevention service providers is largely unknown. When implementing an evidence-based intervention, frontline service providers are apt to modify the original intervention in ways that best suit the organization's available resources, goals, and limitations. How these various factors influence the effectiveness of research-based interventions when implemented in the "real world" has received very limited attention. This study will evaluate the effectiveness and cost-effectiveness of the SISTA intervention for African American women, as implemented by eight HIV prevention service providers that have completed the CDC's DEBI training for the SISTA intervention. 
  

Exploring Peer Referral Strategy to Link Recent Latino Immigrants to HIV Testing
Funding Source: National Institute of Mental Health
Principal Investigator: Laura R. Glasman, PhD

The vulnerability to HIV among recent Latino immigrant men (RLIM) has been attributed to structural and motivational factors, including uncertain immigration status, lack of resources, disconnection from services, high levels of stigma, and unawareness of HIV risk, factors that also hamper RLIM's access to venue-based and outreach HIV prevention efforts. Whereas RLIM are not reached by traditional HIV prevention approaches, they form associations with other RLIM to obtain information and referrals to cope with barriers associated with language, skills, and legal status in the U.S. Social network approaches use these associations to penetrate hidden groups and link them to services and research. This project will explore the feasibility of peer chain referral to link RLIM to voluntary counseling and testing, an essential tool to prevent HIV and the cornerstone of test and treat strategies.

 

Repeat STI Patients: Tailored Socio-Contextual Intervention to Reduce HIV Risk
Funding Source: National Institute of Mental Health
Principal Investigator: Lance S. Weinhardt, PhD

Repeat sexually transmitted infections (STI)--such as chlamydia, gonorrhea, trichomoniasis, and syphilis--indicate persistent elevated risk activity for HIV, and repeated STIs increase the likelihood of HIV transmission during exposure. Patients who seek treatment for repeat STIs, by definition, are not adequately served by the prevention services currently provided by STI clinics, and may benefit from additional clinic-based services to reduce their risk of future infections of STI and HIV. This study addresses the limitations of previous research by developing and testing an individually-tailored strengths-based prevention case management intervention strategy that addresses repeat STI patients' social context and other factors that heighten STI and HIV risk among these patients.

 

A Systemic Approach to Seek, Test, and Treat Strategies for Correctional Populations
Funding Source: National Institute on Drug Abuse
Principal Investigator: David W. Seal, PhD

It is estimated that 25% of all HIV-positive people in the U.S. pass through a correctional facility each year. Yet, many correctional systems and facilities do not provide a comprehensive and systemically coordinated approach to HIV testing, treatment, and transitional referral, resulting in many missed opportunities to identify previously undiagnosed cases of HIV and link individuals to treatment and prevention services. To address this gap, this study will comprehensively test people in a state correctional facility being released to a major metropolitan area; (re)link these HIV-positive people into low- or no-cost treatment and case management services; evaluate an innovative network method of HIV testing referral; and conduct cost and cost-effectiveness analyses to assess various aspects of the process.

 

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.

  

 

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