Modifying Safer Sex Skill Building (SSB) to Prevent HIV in Alcohol Abusing Women

修改安全性行为技能建设（SSB）以预防酗酒女性感染艾滋病毒

• 批准号: 7167667
• 负责人: DIANE MIMS LANGHORST
• 金额: $ 6.3万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7167667
• 关键词: AIDS education /prevention; African American; HIV infections; alcoholism /alcohol abuse; alcoholism /alcohol abuse education; behavioral /social science research tag; clinical research; clinical trials; curriculum; female; focus groups; high risk behavior /lifestyle; human subject; human therapy evaluation; longitudinal human study; low socioeconomic status; patient oriented research; safe sex /sex abstinence; sex behavior; women' s health

DESCRIPTION (provided by applicant): The lifestyle of alcohol and drug dependent women often places them at increased risk for psychological and medical sequelae. HIV/STD infection is no exception. While participation in substance abuse treatment has been found to be effective in reducing drug use, research to date has demonstrated a relatively low success rate with regard to reducing sexual risk behaviors. Rather, socio-cultural and contextual factors have been reported as barriers to condom use and sexual negotiation. One promising approach, is "Safer Sex Skill Building" (SSB), a 5-session, manual-driven intervention by Schilling and colleagues (1991). Women randomly assigned to SSB reported increased condom use and other safe sex practices compared to women receiving standard HIV education. The SSB intervention, however, was developed primarily for women with one or more illicit drug problems. Much less attention was given to alcohol use disorders and their contribution to high risk sexual behaviors, which are more prevalent. This B-START proposal seeks to further enhance the SSB curriculum by adding "alcohol risk awareness" and "alcohol use context" components to existing modules (SSB+A), enabling women to create a mosaic of the pattern of alcohol and drug use that leads to risky sexual behavior and the social and relationship environment in which this occurs. Using the Rounsaville et al (2001) Stage Model of Behavioral Therapies Research, this B-START application will: a) develop and pilot test SSB+A in a sample of women of childbearing age with alcohol use disorders; b) revise the SSB+A intervention with both participant and expert panel feedback; and c) conduct a small randomized clinical trial comparing SSB+A to a one session standard HIV education group. Subjects will be alcohol abusing or dependent women of childbearing age who are enrolled in residential treatment for their disorder. The target population will be primarily African American, low income women at high risk for HIV/AIDS. Primary outcome measures will be number of unprotected (vaginal or anal) episodes of penetrative intercourse and proportion of unprotected sex occasions within a 6-week follow-up period. It is hypothesized that the SSB+A group will demonstrate significantly lower rates of unprotected sex at follow-up compared with the HIV education group alone. If results prove promising, they will be used to estimate effect sizes for a subsequent full-scale, randomized clinical trial of SSB+A.

描述（由申请人提供）：酒精和毒品依赖妇女的生活方式通常使她们患心理和医学后遗症的风险增加。艾滋病毒/性病感染也不例外。尽管已经发现参与药物滥用治疗可有效减少药物使用，但迄今为止的研究表明，在减少性风险行为方面的成功率相对较低。相反，已经报道了社会文化和背景因素是避孕套使用和性谈判的障碍。一种有希望的方法是“更安全的性技能建设”（SSB），这是Schilling及其同事（1991）的5条，手动驱动的干预措施。与接受标准艾滋病毒教育的妇女相比，随机分配给SSB的妇女报告说，安全套使用和其他安全的性行为。但是，SSB干预主要是针对一种或多种非法药物问题的妇女开发的。对酒精使用障碍的关注及其对高风险性行为的贡献更少，这更为普遍。该B-start提案旨在通过在现有模块（SSB+A）中添加“酒精风险意识”和“酒精使用环境”组件来进一步增强SSB课程，使妇女能够对酒精和毒品使用的模式进行镶嵌，从而导致风险的性行为行为行为和社交和关系环境。使用Rounsaville等人（2001）行为疗法研究的阶段模型，该B启动应用将：a）在患有酒精饮酒障碍的育龄妇女样本中开发和驾驶测试SSB+A； b）修改SSB+与参与者和专家小组反馈的干预；和c）进行一项小型随机临床试验，将SSB+A与一个会话标准HIV教育组进行了比较。受试者将是虐待或受育龄妇女的育龄妇女，这些妇女因其疾病而接受住院治疗。目标人群将主要是非裔美国人，低收入妇女患艾滋病毒/艾滋病风险。主要的结局指标将是在6周的随访期内未受保护的（阴道或肛门）发作的数量（阴道或肛门）发作的数量。假设SSB+A组在随访时与仅与HIV教育组相比，无保护性别的率将明显降低。如果结果证明有希望，它们将用于估算随后的SSB+a的全尺度，随机临床试验的效应大小。