Enhancing HIV Prevention Through Multi-level Community Intervention to Promote Women-Initiated Prevention Options

Research Method: Basic Research
Principal Investigator: Margaret R. Weeks, PhD
Grant: National Institute of Mental Health (NIMH) RO1MH084724-01A1
Dates of Study: 2009-2012

Project Summary
This 4-year study seeks to enhance HIV prevention by increasing community-wide availability, accessibility and support for use of the female condom. The female condom, a polyurethane sheath worn during sex, has been shown to be the most effective woman-initiated barrier method to prevent HIV and other sexually transmitted infections (STI) as well as pregnancy. The study will support the creation and training
of community alliances to develop, implement and evaluate a multi-level community intervention to promote the female condom. The project will be conducted in Hartford.

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Drug Use, Housing Access, Stability and HIV Risk Among Low-Income Urban Residents

Research Method: Basic Research
Principal Investigator: Julia Dickson-Gomez, Ph.D., PI, (Medical College of Wisconsin), Jill Owczarzak, Ph.D., Co-PI, ( Medical College of Wisconsin)
Grant: National Institute on Drug Abuse (DA 024578)
Dates of Study: 2008-2011

Project Summary
The purpose of this 4-year study is to explore the relationship between structural factors of housing (access to housing subsidies and programs, status and stability) and HIV risk among drug users. The project will identify the structural conditions that limit drug users’ access to housing and contribute to their housing instability. The data collected will lead to enhanced interventions to reduce some of the root causes of drug users’ vulnerability to HIV infection, including developing new housing alternatives for active drug users at high risk for homelessness, HIV prevention interventions that address contextual risk factors of homeless drug users, and policy recommendations to improve drug users’ access to housing and overall health.

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MDMA and STD/HIV Risk among Hidden Networks of Ecstasy-Using Young Adults

Research Method: Basic Research
Principal Investigators: Jean J. Schensul, Ph.D., PI; Sarah Diamond, Ph.D, Co-PI
Grant: National Institute on Drug Abuse
Dates of Study: 2007-2010

Project Summary

The purpose of this study is to discover whether and in what ways MDMA contributes to sexual behavior and decision making, and when its use is associated with lack of protection. One component of the study will examine the current status of ecstasy use and distribution, at a time when use appears to be rising, and perceptions of risk are low. In a second, the study will explore beliefs or scripts about MDMA use, where and why it is used and whether it is connected to sexual risk taking. The study also will obtain from current users real life stories of MDMA use and sexual behavior and use new analytic techniques to tease out when MDMA makes a difference in sexual decisions and when it does not. The goal is to build an intervention that  enhances agency by identifying and promoting continued use of protection in situations where protection is typically used, while avoiding situations when it is not. 

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National HIV Behavioral Surveillance in the New Haven Metropolitan Statistical Area (MSA)
Research Method: Surveillance; Basic Research
Principal Investigators: Aaron Roome, Ph.D., PI (CT State Dept. of Public Health); Stephen Schensul, Ph.D., Co-PI (University of Connecticut); Margaret R. Weeks, Ph.D., Co-PI (Institute for Community Research)
Grant: Centers for Disease Control and Prevention Cooperative Agreement
Partners: CT State Dept. of Public Health; University of CT, Department of Community Medicine; Waterbury Health Department; Chemical Abuse Services Agency, Bridgeport; New Haven Health Department, Bridgeport Health Department

Years of Study: 2005-2007

Project Summary

The Centers for Disease Control and Prevention (CDC) is funding a cooperative agreement to conduct HIV behavioral surveillance that will assess risks and utilization of services for HIV prevention, testing, and treatment among high-risk target populations. Twenty-five cities across the United States are participating in the surveillance effort, with annual cycles that target men who have sex with men (MSM), injection drug users (IDUs), and heterosexuals (HET). The Institute for Community Research (ICR) is contracted to conduct NHBS in Connecticut, and will collaborate with the CT Department of Public Health AIDS Division, the University of CT Department of Community Medicine, and local health agencies to annually survey high-risk populations in the New Haven, CT MSA, focusing in the cities of Bridgeport, New Haven, and Waterbury. Participants will also be asked to describe where they regularly access health and social services for HIV prevention information, testing and counseling, or treatment if infected. Each project year includes a formative research phase to establish community connections in the monitored city and assess the composition of the target population, and an interview phase to recruit 500 members of the target population for behavioral surveillance interviews.

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National HIV Behavioral Surveillance in the New Haven Metropolitan Statistical Area (MSA): Pilot High-Risk Heterosexual Cycle
Research Method: Basic/ Surveillance Research
Principal Investigator: Aaron Roome, Ph.D., (CT State Dept. of Public Health); Stephen Schensul, Ph.D., Co-PI (University of Connecticut); Margaret R. Weeks, Ph.D., Co-PI (Institute for Community Research)
Grant: Centers for Disease Control and Prevention Cooperative Agreement
Partners: CT State Dept. of Public Health; University of CT, Department of Community Medicine; City of New Haven Health Department and City of Bridgeport Health Department

Dates of Study: 2006-2007

Project Summary

The third phase in each cycle of the CDC National Health Behavioral Surveillance project is conducted with heterosexuals. Participants eligible for this phase are people with a physical or social connection to a “high risk area”—a census tract with high rates of heterosexually acquired HIV infection, other sexually transmitted diseases and poverty—who had sex with at least one opposite-sex partner in the past year.  The NHBS conducts behavioral surveillance through community observation, organizational partnerships, and surveys.  Targeted recruitment for this phase to be surveyed in 2006-2007 includes 750 non-injecting heterosexuals from the New Haven Metropolitan Statistical Area (MSA—New Haven and Fairfield Counties), focusing recruitment in New Haven and Bridgeport.  The New Haven MSA NHBS uses respondent-driven sampling to recruit participants, whereby those interviewed refer members of their networks to the study.

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High Risk Crack Use Settings and HIV in El Salvador

Research Method: Basic Research

Principal Investigator:  Julia Dickson-Gomez, Ph.D., Principal Investigator;

Margaret Weeks, Ph.D., Co-Principal Investigator; Mauricio Gaborit, Ph.D., Co-Principal Investigator; Ernesto Alfonso Selva-Sutter, Ph.D., Co-Investigator

Grant:  National Institute on Drug Abuse R01 DA 020350

Partners:  Fundación Antidrogas de El Salvador (FUNDASALVA); Universidad Centroamericana José Simeon Cañas

Dates of Study: 2006-2010

Project Summary

In collaboration with local partners and communities, this four-year study will combine qualitative and quantitative research methods to examine the intersection of community structural factors, the micro-social context of crack use and sales, and HIV risk among crack users in metropolitan San Salvador. In the project’s first phase, staff will conduct community observations, focus groups and in-depth interviews in nine communities. The ethnographic findings will be presented to residents and advisory/working groups formed in each of the nine communities. The formative  research will inform the development of a quantitative survey during the second phase that will be administered to 540 crack smokers including a follow-up interview after 6 months. In the final phase of the project, staff will collaborate with the community advisory/working groups to develop a multi-level intervention that will be tested for acceptability and feasibility through focus groups with community leaders and crack users. 

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National HIV Behavioral Surveillance in the New Haven MSA: IDU Cycle
Research Method: HIV/AIDS Surveillance
Principal Investigator: Aaron Roome, Ph.D., PI (CT State Dept. of Public Health); Stephen Schensul, Ph.D., Co-PI (University of Connecticut); Margaret R. Weeks, Ph.D., Co-PI (Institute for Community Research)
Grant: Centers for Disease Control and Prevention Cooperative Agreement
Partners: CT State Dept. of Public Health; University of CT, Department of Community Medicine; Waterbury Health Department; Chemical Abuse Services Agency, Bridgeport

Dates of Study: 2005

Project Summary

The United States Centers for Disease Control and Prevention (CDC) conducts behavioral surveillance of injection drug users (IDU) every three years as part of its National Health Behavioral Surveillance (NHBS) project.  ICR contracted through the University of Connecticut Department of Community Medicine with the CT Department of Public Health to implement the surveillance project with IDUs in 2005. Collaborating with local health organizations in Waterbury and Bridgeport, CT, ICR conducted community observation, built organizational partnerships, and conducted behavioral surveillance surveys of 496 IDUs.  Participants were recruited through respondent-driven sampling, whereby those interviewed refer members of their networks to the study. The 2005 NHBS project was designed to assess HIV risk behaviors and services used by IDUs in the New Haven Metropolitan Statistical Area (MSA).

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Alcohol, Sexual Risk and HIV Prevention in Mumbai, India
Research Method: Basic Research
Principal Investigators: Jean Schensul, Ph.D., ICR (PI); Co-Principal Investigators Kamla Gupta, Ph.D., International Institute for Population Studies; S.K. Singh, Ph.D., International Institute for Population Studies; Subrata Lahiri, Ph.D., International Institute for Population Studies; Stephen Schensul, Ph.D., University of Connecticut Health Center (Co-PI)

Grant: National Institute on Alcohol Abuse and Alcoholism
Partners: International Institute for Population Sciences (IIPS), University of Connecticut Health Center (UCHC)

Dates of Study: 2005-2008

This three-year study will investigate how alcohol may contribute to  risky sexual activities that lead to HIV transmission among married and unmarried men and their sexual partners in three low income slums in the Mumbai metropolitan area. As data are collected, stakeholders from these communities are partnering with researchers to develop culturally specific interventions that simultaneously address HIV transmission rates on the individual, family and community levels. In particular, researchers will explore the role that migration (from rural areas to Mumbai) plays in exposing networks of men to alcohol, drugs and unprotected sex and the role of long term residence in Mumbai as a risk factor. Unique features of the study are its attention to social scripting of drinking and sex and the role of social geography in contributing to drinking and associated sexual behaviors and social risk. The study will also strengthen the capacity of Mumbai’s International Institute for Population Sciences to integrate qualitative and quantitative research. 

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Sustained Safer Behavior (Female Condom Use) in High-Risk Women to Prevent HIV
Research Method: Basic Research
Principal Investigator: Margaret R. Weeks, Ph.D.
Grant: National Institute for Mental Health (NIMH)RO1 MH069088-01A2
Dates of Study: 2004-2007

Project Summary:
This 4-year study explores the factors that facilitate or impede female condom use among high-risk urban women, particularly whether participants continue using the female condom after initial barriers (lack of free or low-cost access and information) have been reduced. In Hartford, CT, project staff will conduct a behavioral and attitudinal survey with 575 women at 3 points in time regarding their HIV risk and prevention efforts, as well as their expectations and experiences with female and male condoms. We also will explore the experiences and perspectives of 75 women and their male partners who try the female condom together for 2 weeks.

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Housing Status/Stability and HIV Risk Among Drug Users

Research Method: Basic Research
Principal Investigators: Julia Dickson-Gomez, Ph.D., (PI), Margaret R. Weeks, Ph.D., (Co-PI)

Grant: National Institute on Drug Abuse

Dates of Study: 2004-2005

The role of structural factors in HIV prevention research with drug users requires further study. An area that may have significant impact on the context in which drug and sex-related HIV risk occurs, is housing status and the role of housing policies in limiting drug users' access to stable housing. This study uses qualitative research to examine the relationship between housing policy, neighborhood characteristics, and personal factors that affect drug users' housing status and stability, and the relationship between housing status and stability and HIV risk.

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RISHTA: Male Sexual Concerns and Prevention of HIV/STDs in India

Research Method: Basic Research, Intervention Research

Principal Investigators: Stephen L. Schensul, Ph.D., University of Connecticut School of Medicine, (PI); Bonnie K. Nastasi, Ph.D., ICR (Co-PI), Dr. Ravi Verma, Population Council, New Delhi, India (Co-PI); Drs. T. K. Roy, G. Rama Rao, & N. Saggurti, International Institute for Population Studies, Mumbai, India (Co-PIs).
Grant: National Institute of Mental Health

Partners: University of Connecticut School of Medicine, International Institute for Population Studies (Mumbai, India)

Dates of Study: 2002-2007

HIV/STD rates in India are increasing at a dramatic rate, causing health officials and national policy makers to seek new approaches to prevention and treatment. This  study addresses the difficulty encountered in trying to engage males in reproductive health education, sexual risk and early HIV/STD treatment in three urban communities in Mumbai, India. The project is testing an intervention approach that addresses culturally- based perceptions of masculinity, vitality, sexual performance and fertility as HIV/STD risk indicators.

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