SKILLS AND SELF HELP TO REDUCE HIV AND DRUG USE IN WOMEN

减少女性艾滋病毒和毒品使用的技能和自助

• 批准号: 2749075
• 负责人: ROBERT F SCHILLING
• 金额: $ 60.98万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1999-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2749075
• 关键词: AIDS; AIDS education /prevention; African American; Hispanic Americans; behavior modification; behavioral /social science research tag; coping; disease /disorder proneness /risk; drug abuse chemotherapy; female; field study; group counseling; human subject; intravenous drug abuse; longitudinal human study; methadone; problem solving; self help organization; sex behavior; sexually transmitted diseases; social support network; substance abuse related disorder; women's health

Women of African-, Caribbean-, and Latin/Hispanic-American descent are among the fastest growing segments of the population infected with the human immunodeficiency virus. Although injection drug use remains a critical element in the epidemiology of HIV transmission, heterosexual contact has recently eclipsed this mode of HIV exposure among women with diagnosed AIDS. Condom use remains low among female injection drug users. Some evidence points to a reduction in needle sharing and injecting among this population, but protective sexual practices have been adopted less readily. This study responds to the observed need for improved drug treatment as a means of slowing the spread of AIDS among women. Methadone maintenance reduces drug users' risk of contracting or transmitting HIV; yet sexual risk behavior, substance use, and program attrition remain serious problems among such patients. Needed are adjunctive interventions to boost the efficacy of methadone maintenance, while providing patients with skills to avoid contracting or HIV. Skills-training holds promise as a means of both improving drug treatment outcomes, and equipping individuals with the skills to avoid risk behavior. Twelve-step and other self-help approaches, once philosophically estranged from methadone maintenance, are increasingly seen as possible adjuncts to methadone maintenance treatment programs. Although a few studies have tested self- help approaches in methadone settings, few, if any such studies have developed interventions designed specifically for female patients at risk for AIDS. The investigation will test self-help as a strategy for slowing the spread of HIV among African-American and Latina women on methadone. In a randomized repeated measures design, the study will evaluate the processes, outcomes, and replicability of two forms of AIDS prevention groups: AIDS information with traditional 12-step fellowship support; and AIDS/relapse skills with structured self-help groups. The latter begin with sessions led by project, and continue with groups led and controlled by methadone clinic patients. A 12 month developmental/pilot period is followed by a 48 month intervention trial. Self-report, performance, and biological outcome measures, administered at baseline and on three follow-up will quantify cognitive, behavioral, and behavioral variables related to sexual risk-taking, drug use, and retention in program.

非洲，加勒比海和拉丁/西班牙裔美国人的妇女是 在感染的人群中增长最快的人群中 人类免疫缺陷病毒。尽管注射药物使用仍然是 HIV传播流行病学的关键元素，异性恋 接触最近使这种艾滋病毒暴露方式黯然失色 诊断为艾滋病。女性注射吸毒者的使用避孕套仍然很低。 一些证据表明，针头共享和注射减少 这个人口，但采用保护性的性行为 容易。这项研究响应观察到的改善药物的需求 治疗是减缓艾滋病在女性中传播的一种手段。美沙酮 维持降低吸毒者的染上或传播艾滋病毒的风险； 然而性风险行为，吸毒和计划流失仍然存在 此类患者的严重问题。需要的是辅助干预措施 为了提高美沙酮维持的功效，同时为患者提供 具有避免收缩或艾滋病毒的技能。技能培训具有希望 作为改善药物治疗结果和装备的一种手段 具有避免风险行为的技能的人。十二步和其他 自助接近，曾经在哲学上与美沙酮疏远 维护越来越被视为美沙酮的辅助 维护治疗计划。尽管一些研究已经测试了自我 在美沙酮环境中的帮助方法，如果有任何这样的研究 开发了专门为有危险的女性患者设计的干预措施 艾滋病。调查将测试自助力作为放缓的策略 艾滋病毒在非洲裔美国人和拉丁裔女性中的传播在美沙酮上。 在随机重复测量设计中，该研究将评估 预防艾滋病的两种形式的过程，结果和可复制性 小组：通过传统的12步奖学金支持的援助信息；和 辅助/复发技巧与结构化的自助群体。后者开始 由项目主持的会议，并继续进行LED和控制的小组 由美沙酮诊所患者。一个12个月的发育/试点期是 然后进行48个月的干预试验。自我报告，性能和 生物结局指标，在基线和三个 随访将量化认知，行为和行为变量 与性冒险，吸毒和计划中的保留有关。