Addressing alcohol misuse in HIV prevention and care: The Brown University Alcohol Research Center on HIV (ARCH)

解决艾滋病毒预防和护理中的酒精滥用问题：布朗大学艾滋病毒酒精研究中心 (ARCH)

• 批准号: 10531745
• 负责人: Christopher W. Kahler
• 金额: $ 14.1万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10531745
• 关键词: AIDS prevention; Address; Adherence; Adolescent; Adult; Advisory Committees; Alcohol consumption; Alcohols; Behavior Therapy; Behavioral; Caring; Clinical; Clinical effectiveness; Collaborations; Complement; Continuity of Patient Care; Country; Data; Data Analyses; Decision Making; Diagnosis; Effectiveness; Effectiveness of Interventions; Epidemic; Federally Qualified Health Center; Fostering; Funding; Funding Opportunities; Future; Grant; HIV; Health Care Costs; Heavy Drinking; Hepatitis; Human Resources; Human immunodeficiency virus test; Hybrids; Incidence; Individual; Infection; Inflammation; Institution; Interdisciplinary Study; International; Intervention; Intervention Studies; Investigation; Knowledge; Laboratories; Liver diseases; Longevity; Measures; Methods; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive Deficit; Outcome; Pathway interactions; Patients; Persons; Phase; Pilot Projects; Population; Population Heterogeneity; Postdoctoral Fellow; Prevention; Prevention approach; Probiotics; Public Health; Recording of previous events; Research; Research Activity; Research Methodology; Research Personnel; Research Priority; Resources; Risk; Role; Sampling; South Africa; Structure; Technology; Testing; Training; Training Programs; Translating; Universities; Viral; Work; alcohol intervention; alcohol misuse; alcohol research; alcohol screening and brief intervention; antiretroviral therapy; base; co-infection; comorbidity; data management; effectiveness implementation trial; effectiveness research; effectiveness testing; high risk sexual behavior; home test; implementation framework; implementation research; implementation science; implementation trial; infection risk; innovation; interdisciplinary approach; men who have sex with men; mortality; motivational intervention; novel; post-doctoral training; programs; relating to nervous system; self testing; sex risk; sexual risk behavior; social; telehealth; text messaging intervention; therapy adherence; transmission process; trial design; video coaching; viral transmission; web-based intervention; web-enabled

Overall Project Summary Alcohol misuse impacts the depth and breadth of the HIV epidemic, both domestically and globally, through multiple pathways—increasing sexual risk behaviors, reducing adherence to antiretroviral therapy, and increasing the risk for HIV-associated comorbidities and mortality. To reduce the incidence of HIV, approaches must be developed that concurrently address alcohol misuse in the context of HIV testing and behavioral and biomedical prevention approaches. Likewise, to increase rates of HIV viral suppression and reduce HIV-related comorbidities, alcohol misuse must be addressed effectively in diverse populations across a spectrum of HIV care settings. The Brown University Alcohol Research Center on HIV (ARCH) has been supporting collaborative research to develop scalable alcohol-HIV interventions, including video counseling, telehealth, and web-enabled applications, that can be delivered broadly and efficiently using centralized personnel and technological resources. This application to renew the Brown ARCH is organized around the central theme that in order to achieve population impact, interventions addressing alcohol misuse in HIV prevention and care need to be evaluated with an emphasis on real-world effectiveness, scalability, and sustainability, according to the principles of implementation science. Specifically, we propose three projects that leverage our unique strengths in (a) training professionals in alcohol misuse interventions, (b) utilizing video counseling and telehealth as scalable means of reaching populations and providing continuing care, and (c) utilizing behavioral intervention technologies to provide alcohol interventions and ongoing support for change. Research Component 1 (MPI: Wray and Monti) extends our work on the role of alcohol use in HIV transmission among men who have sex with men (MSM) by testing the effectiveness of a web-based intervention that addresses both alcohol use and sex risk in MSM completing HIV self-testing. Research Component 2 (PI: Kahler) extends our work on behavioral telehealth interventions to reduce alcohol misuse in HIV-infected MSM by testing our previously developed video counseling and text messaging interventions in a diverse sample of patients in HIV care at four large, urban federally-qualified health centers. Research Components 1 and 2 share a Hybrid Type 1 effectiveness-implementation trial design, providing data on real-world effectiveness while gathering data related to implementation to inform future studies. Research Component 3 (MPI: Becker and Kuo) complements these projects by conducting an implementation trial that evaluates a cascading training model to promote alcohol screening and brief intervention across HIV care settings in South Africa. Together, these projects—supported by an Administrative Core, Research Methods Core, and Program Advisory Committee and complemented by an outstanding training program in alcohol-HIV research with robust pilot funding opportunities—will make a substantial impact in translating basic and applied knowledge on alcohol and HIV into scalable approaches to reducing the negative impact of alcohol misuse on HIV prevention and care.

总体项目摘要 滥用酒精会影响艾滋病毒流行的深度和广度，无论是田园还是全球， 多种途径 - 增加性风险行为，降低对抗逆转疗法的依从性，并 增加了与艾滋病毒相关的合并症和砂浆的风险。 必须在艾滋病毒测试和行为上同时开发同时解决酒精滥用 同样的生物医学预防方法。 合并症，滥用酒精必须有效地在一系列HIB的各种人群中得到有效解决 护理环境。 合作研究以开发可扩展的酒精-HIV国际，包含视频咨询，远程医疗， 和支持网络的应用程序，可以使用集中的人员和尼尔提供Broady和有效的应用程序 技术资源是在棕色的 为了实现人口影响，国际滥用艾滋病毒和护理中的酒精滥用 需要对现实世界的有效性，可伸缩性和可持续性进行评估。 实施科学的原则。 （a）在滥用酒精干预方面的培训专业人员的优势，（b）利用视频咨询和 远程医疗是达到人口并提供持续护理的可扩展手段，并且（c）利用行为 间隔技术提供酒精干预和对变革的持续支持 组件1（MPI：WRAY和MONTI）扩展了我们在酒精使用在HIV传播中的作用的工作 通过测试基于网络的干预措施的有效性来解决与男性发生性关系的男性 MSM组件2（PI：Kahler）的酒精使用和性风险延伸 通过测试我们的行为远程医疗干预措施，通过测试我们 在各种Hib的患者中，目前开发了视频咨询，文字和文字汇报干预措施 在四个大型城市联邦合格的健康中心的护理。 1个有效性实施试验设计，在收集数据时提供有关现实世界有效的数据 与实施有关未来研究的实施。 通过执行Imparachatil来评估级联培训模型来汇编这些项目 在南非的蜂巢艾滋病毒护理环境中促进酒精筛查和简短的国际。 项目 - 由行政核心，研究方法核心和计划咨询委员会支持 并由酒精企业飞行员飞行员资助的出色培训计划进行编译 机会 - 将对酒精和hib的基本知识和应用知识产生重大影响 进入可扩展的方法，以减少滥用酒精对HIB预防和护理的负面影响。