Positive Choices Research Project

积极选择研究项目

基本信息

批准号：
6591103
负责人：
Mark L Williams
金额：
$ 49.49万
依托单位：
UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-06-01 至 2008-05-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): The study proposed in this application, Positive Choices Research Project builds on and continues work we began as part of a grant, "Condom use among drug users receiving antiretroviral medications, "R03 DA12318-01. The purpose of the Positive Choices Research Project is to evaluate the efficacy of a risk reduction protocol designed to reduce the sexual transmission of HIV by crack cocaine smokers receiving medical treatment for HIV disease. Specially, the purpose of the risk reduction protocol is to increase condom use during vaginal/anal intercourse. To evaluate the efficacy of the risk reduction protocol, we will implement a randomized clinical field trial. The trial will compare the Positive Choices risk reduction intervention to the current standard intervention for drug users in non-clinical settings. Bandura's Social Cognitive Theory (SCT) is the theoretical framework underpinning the Positive Choices intervention and the study design. The intervention methodology is cognitive mapping, a strategy that has been successfully used in drug treatment and is very compatible with SCT. Assessment of the effectiveness of the intervention will be based on data collected at completion of the intervention and at 3 and 9 months after completion of the intervention. This is the first study of which we are aware of that will investigate the efficacy of an intervention to increase condom use targeting HIV+ crack cocaine smokers. The Positive Choices Research Project has important scientific and pubic health implications. As the comparatively small number of studies in this areas shows, less than half of any sample of HIV positive (HIV+) drug users consistently use condoms. The psychosocial precursors that influence adoption of risk reduction practices may not be the same as those that influence maintenance of long-term behaviors. It is difficult to generalize from studies focusing on MSM. As a recent review of the literature concludes, heterosexual men are socialized to believe that only unprotected vaginal sex is sex. The Positive Choices Research Project will be tested in Houston, Texas. Houston is the nation's fourth largest city and has the sixth highest AIDS caseload. The city's caseload reflects the makeup of its population. Forty-five percent of cases are White, 38% African American, and 17% Hispanic. Seventeen percent of the caseload is female. Since 1994, more heterosexuals had been diagnosed with AIDS in Houston than any other group. The city has the unpleasant distinction of having the highest rate of new heterosexual infections in the United States. The epidemic among heterosexuals in Houston is focused in the African American community. About one-third of newly infected African Americans are women. The disease in the African American community is directly and indirectly linked to the crack cocaine epidemic.

描述（由申请人提供）：在本申请中提出的研究，积极的选择研究项目是基于赠款的一部分开始的，并继续进行工作：“接受抗逆转录病毒药物的药物用户的使用” R03 DA12318-01。积极选择研究项目的目的是评估降低风险降低方案的功效，旨在减少可卡因吸烟者接受艾滋病毒疾病医疗治疗的可卡因吸烟者的性传播。特别是，降低风险方案的目的是增加阴道/肛门性交期间的避孕套。为了评估降低风险方案的功效，我们将实施一项随机临床现场试验。该试验将将降低风险干预的积极选择与非临床环境中吸毒者的当前标准干预进行比较。班杜拉（Bandura）的社会认知理论（SCT）是基于积极选择干预和研究设计的理论框架。干预方法是认知映射，该策略已成功用于药物治疗，并且与SCT非常兼容。评估干预措施的有效性将基于干预完成时收集的数据以及完成干预措施后的3和9个月。这是我们意识到的第一个研究，将研究干预措施增加针对HIV+裂纹可卡因吸烟者的避孕套的功效。积极的选择研究项目具有重要的科学和公共健康影响。由于在这一领域的研究数量相对较少，因此，在任何艾滋病毒阳性（HIV+）吸毒者样本中，只有一半始终使用避孕套。影响采用降低风险实践的社会心理前体可能与影响长期行为维持的心理前体可能不一样。从关注MSM的研究中很难概括。正如对文献的最新评论得出的结论一样，异性恋者被社会化，认为只有无保护的阴道性是性别。积极选择研究项目将在德克萨斯州休斯敦进行测试。休斯顿是美国第四大城市，拥有第六大艾滋病案件。该市的案件反映了其人口的构成。 45％的案件是白人，38％的非裔美国人和17％的西班牙裔。 17％的案件是女性。自1994年以来，与其他任何群体相比，在休斯顿有更多的异性恋被诊断出患有艾滋病。该市具有令人不愉快的区别，即美国新异性恋感染率最高。休斯顿异性恋者之间的流行集中在非裔美国人社区。大约三分之一的新受感染的非洲裔美国人是女性。非裔美国人社区的疾病与可卡因流行直接与间接有关。