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）：酒精和药物依赖女性的生活方式往往使她们面临更大的心理和医疗后遗症风险。 HIV/STD 感染也不例外。虽然参与药物滥用治疗已被发现可有效减少药物使用，但迄今为止的研究表明，在减少性危险行为方面的成功率相对较低。相反，据报道，社会文化和背景因素是安全套使用和性谈判的障碍。一种有前途的方法是“安全性行为技能建设”（SSB），这是由 Schilling 及其同事进行的为期 5 次的手动干预（1991 年）。与接受标准艾滋病毒教育的女性相比，随机分配到 SSB 的女性报告了更多的安全套使用和其他安全性行为。然而，SSB 干预措施主要是针对患有一种或多种非法药物问题的妇女而制定的。人们对酒精使用障碍及其对高风险性行为的影响的关注要少得多，而这种行为更为普遍。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“酒精使用背景”组件来进一步增强 SSB 课程，使女性能够创建酒精和毒品使用模式的镶嵌图，导致危险的性行为以及发生这种行为的社会和关系环境。使用 Rounsaville 等人 (2001) 行为治疗研究阶段模型，该 B-START 应用程序将： a) 在患有酒精使用障碍的育龄妇女样本中开发并试点测试 SSB+A； b) 根据参与者和专家小组的反馈修改 SSB+A 干预措施； c) 进行一项小型随机临床试验，将 SSB+A 与单次标准 HIV 教育组进行比较。受试者将是因酗酒或受抚养的育龄妇女，她们因疾病而参加住院治疗。目标人群主要是非裔美国人、感染艾滋病毒/艾滋病高风险的低收入妇女。主要结果指标是 6 周随访期内无保护（阴道或肛门）性交次数以及无保护性交次数的比例。据推测，与单独的艾滋病毒教育组相比，SSB+A 组在随访中将表现出显着较低的无保护性行为率。如果结果证明有希望，它们将用于估计 SSB+A 随后的全面随机临床试验的效应大小。