Research That Matters (January 17 - 20, 2008)
|Friday, January 18, 2008: 2:00 PM-3:45 PM|
|Blue Room (Omni Shoreham)|
|[H/D] HIV Prevention Research in Diverse Contexts: From Relationship- Building to Adapting and Testing Interventions in Brazil, Mongolia and Kazakhstan|
|Symposium Organizer:||Rogério Pinto, PhD, LCSW, Columbia University|
|A Pilot Trial of a Couples-Based HIV Prevention Intervention among Idus in Kazakhstan: Project Renaissance|
Louisa Gilbert, MSW
|Adapting Evidence-Based Interventions to Reduce HIV Risk among Street Sex Workers in Mongolia|
Susan Witte, PhD
|Using a 5-Step Framework for International HIV Prevention Research Collaboration in Brazil|
Rogério Pinto, PhD, LCSW, Clecy Schmidt, MD, Paulo Rodriguez, MD, Renata Solano, RN
Purpose: The HIV pandemic has prompted myriad research projects in “developing” countries. Few models for international research have been developed by social workers, and those available provide little insight into the phases of international research. This symposium will 1) provide a framework for establishing international research partnerships, 2) demonstrate how to conduct a needs assessment to inform the development of HIV interventions, and 3) how to develop and test the feasibility of HIV interventions. Three papers will be presented; each focusing on a different part of the world – Brazil, Mongolia and Kazakhstan.
Methods: The first paper will focus on five steps for international research. This model reflects the work of all presenters, and fosters relationship-building that can help sustain international partnerships. Each step will be explored as they relate to a project for examining how health professionals deliver in-home services in Brazil. The next two papers will be framed by the five steps. The second paper will show how 48 females were recruited for a needs assessment in Mongolia. These women supported themselves and their dependents by exchanging sex for money. Two group interviews (24 women in each) were conducted in two cities. Participants completed individual questionnaires assessing alcohol use, HIV risk behaviors, mental health needs, alcohol treatment accessibility, use and service needs. Grounded in our model, the third paper will show how 80 individuals were recruited to participate in an HIV prevention intervention in Kazakhstan. Forty couples enrolled in the study and completed a baseline interview. 20 couples were randomized to the intervention and 20 to a control group. Participants were assessed with repeated measures at 3-month post intervention follow-up.
Results: Steps: 1) Contextualize the host country; 2) Identify collaborators; 3) Seek endorsement from gate keepers; 4) Match the expertise, needs, and interests of all partners; 5) Establish commitment for future collaboration. The steps will be demonstrated with examples from a project in Brazil. The needs assessment in Mongolia shows that 85% of participants indicated harmful alcohol use, and 39% exceeded depression level norms. 70% reported using condoms inconsistently, and 83% using alcohol before sex. 98% percent reported that if available, they would participate in alcohol and mental health treatments. Our work in Kazakhstan shows that at baseline, participants reported 10 (SD=4.7) unprotected acts of vaginal sex, sharing needles with an average of 3.7 (SD=2.0) individuals, and using unclean needles 63% of the times they injected in the past 30 days. From baseline to 3-month follow-up, intervention participants were significantly more likely to report higher condom use, fewer numbers of unprotected sex, lower numbers of shared injection acts, and fewer people with whom they shared needles.
Implications: This symposium will demonstrate that a 5-step conceptual framework can guide several phases of international research. The model embraces both social work philosophy and the key elements of participatory research. Together, the papers will show that, grounded in a framework, researchers can use different designs to conduct needs assessments, and to develop and test HIV prevention interventions.