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C omputer- A ssisted R isk assessment & E ducation: ‘ CARE ’ for HIV/STI. Development team : Resources Online (Jim Larkin; Seattle) A. Kurth, F. Spielberg (Univ. of Washington) J.D. Fortenberry (Indiana Univ.) C.K. Malotte, S. Padilla (Calif. State Long Beach)

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c omputer a ssisted r isk assessment e ducation care for hiv sti
Computer-Assisted Risk assessment & Education: ‘CARE’ for HIV/STI

Development team:

  • Resources Online(Jim Larkin; Seattle)
  • A. Kurth, F. Spielberg(Univ. of Washington)
  • J.D. Fortenberry(Indiana Univ.)
  • C.K. Malotte, S. Padilla(Calif. State Long Beach)
  • J. St. Lawrence,M. McFarlane (CDC)
why provide hiv std risk assessment and counseling

Why Provide HIV/STD Risk Assessment and Counseling?

> 200,000 people in US, & millions globally, are unaware of their HIV+ status

Proven models of brief HIV/STI health behavior change counseling

Many sites do not have staff to deliver evidence-based HIV/STI prevention counseling

how are we doing
How are we doing?
  • Missed Opportunity

< 1/3 MDs routinely screen for STDs(St.Lawrence, et al. ‘02)

70% MDs believe counseling ineffective (Ashton et al., ‘02)

  • Barriers

Lack of time, tools, $; pt risk assumptions, provider discomfort , clinician beliefs (benefits, negative pt reactions, time constraints)? (Montano et al ‘02)

  • Yet clients want to talk(Bennett et al ‘99)
    • Clients willing to disclose sex, drug risks when asked(Gerbert et al. ‘99)
health behavior change model
Health Behavior Change Model
  • Interactive, responsive to client
  • Heighten risk perception
  • Support prior behavior change attempts
  • Identify/develop client goals
  • Negotiate realistic detailed plan

(Project Respect, Kamb ‘98)

what s needed
What’s Needed?

An Interactive HIV/STD Computer Counseling Tool

  • Standardization of risk assessment and counseling.
  • More disclosure with ACASI format - feasible among low literacy populations
  • Allows clinics to provide HIV/STD testing when providers unavailable or makes counseling more efficient.
  • Allows outreach organizations to provide HIV/STD testing services when staff turn-over out-paces available counseling training.
care overview c omputer a ssisted r isk assessment e ducation care for hiv stis
CARE overviewComputer-Assisted Risk assessment & Education: ‘CARE’ for HIV/STIs
  • Risk Assessment
  • Risk Feedback & Synthesis
  • Prevention Plan
  • Printout (option to share)

Rapid HIV test log, Consent

Videos

Rapid HIV result follow-up

care videos
CARE Videos

Skills-building Videos(~30 minutes total)

Routed based on risk, or can click on:

  • Abstinence
  • Sexual initiation (hetero & MSM) / Coming out
  • Sexual safety negotiation (new / existing partner, hetero & MSM)
  • Safer sex alternatives
  • Male / female condom (hetero & MSM)
  • Testing(hetero & MSM)
what s next
What’s next?
  • Phase 2 = September 2003 to 2005.
      • Additional features:
        • Longitudinal follow-up & rapid HIV testing modules
        • Tablet PC version
        • Additional videos
      • Extensive field evaluation:
        • Usability testing with staff & clients in 3 US cities
        • Longitudinal RCT in 3 clinics in Seattle
        • Evaluation of rapid HIV testing CARE in Emergency Department Clinic
      • Dissemination plan
  • Planned versions:
    • CARE+ for persons living with HIV
    • CARE-Chemical Dependency for substance users
contact information
Contact information

Jim LarkinResources Online206.283.8300jim@ronline.com