Freya Spielberg

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OBJECTIVE To determine strategies to overcome barriers to HIV testing among persons at risk. METHODS We developed a survey that elicited testing motivators, barriers, and preferences for new strategies among 460 participants at a needle exchange, three sex venues for men who have sex with men, and a sexually transmitted disease clinic. RESULTS Barriers(More)
OBJECTIVE The objective of this study was to compare reporting between audio computer-assisted self-interview (ACASI) and clinician-administered sexual histories. GOAL The goal of this study was to explore the usefulness of ACASI in sexually transmitted disease (STD) clinics. STUDY The authors conducted a cross-sectional study of ACASI followed by a(More)
This study sought to identify factors influencing HIV testing decisions among clients at a sexually transmitted disease clinic, gay men, and injection drug users. Focus group and intensive interview data were collected from 100 individuals. The AIDS Risk Reduction Model was adapted to describe factors that affect test decisions. Testing barriers and(More)
OBJECTIVE Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. DESIGN Longitudinal randomized controlled trial. SETTINGS An academic HIV clinic and a community-based organization in Seattle. SUBJECTS In a total of 240 HIV-positive adults on ART, 209 completed 9-month follow-up (87%(More)
Self-testing has the potential to be an innovative component to community-wide HIV-prevention strategies. This testing method could serve populations who do not have access to standard voluntary counselling and testing services or because of privacy concerns, stigma, transport costs, or other barriers do not use facility-based, standard HIV testing. This(More)
OBJECTIVE Previous research links high rates of unprotected anal intercourse (UAI) with men who go to bathhouses; however, the literature provides no prevalence estimates. An exit survey of a probability sample was conducted to describe the prevalence of risk activity at the bathhouse. METHODS Data are from a 2-stage probability sample of men exiting a(More)
OBJECTIVE To assess the feasibility and acceptability of bimonthly home oral fluid (OF) and dried blood spot (DBS) collection for HIV testing among high-risk individuals. DESIGN A total of 241 participants [including men who have sex with men (MSM), injecting drug users (IDU), and women at heterosexual risk] were recruited from a randomly selected subset(More)
OBJECTIVES We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington. METHODS We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time-venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify(More)
BACKGROUND Adherence problems with coitally dependent, female-initiated HIV prevention methods have contributed to several trials' failure to establish efficacy. Continuous use of a cervical barrier with once-daily cleaning and immediate reinsertion may simplify use for women and improve adherence. We assessed the acceptability and safety of precoital and(More)
The efficacy of behavioral HIV prevention interventions has been convincingly demonstrated in a large number of randomized controlled phase 3 research outcome trials. Little research attention has been directed toward studying the effectiveness of the same interventions when delivered by providers to their own clients or community members, however. This(More)