Intervening with Haitian HIV+ Alcohol Abusers: An Environmental Psychosocial Fram

对海地艾滋病毒酗酒者进行干预：环境心理社会框架

• 批准号: 8274910
• 负责人: JESSY G DEVIEUX
• 金额: $ 40.92万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8274910
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Acute; Address; Adherence; Adult; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Behavior; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Chronic; Civil Disorders; Clinic; Clinical; Clinical Research; Cognitive; Cognitive Therapy; Cohort Studies; Collaborations; Communicable Diseases; Communication; Communities; Comorbidity; Conflict (Psychology); Consensus; Coping Skills; Country; Developing Countries; Dimensions; Disadvantaged; Discipline; Drug usage; Drug user; Economics; Elements; Environment; Epidemic; Equilibrium; Evidence based intervention; Female; Funding; Gap Junctions; Grant; Guidelines; HIV; Haiti; Health; Health Promotion; Health behavior; Healthcare; Hour; Housing; Individual; Institution; International; Intervention; Kaposi Sarcoma; Laws; Life; Low Income Population; Measurement; Mediating; Modeling; Motivation; National Institute on Alcohol Abuse and Alcoholism; Opportunistic Infections; Outcome; Patients; Pharmaceutical Preparations; Pilot Projects; Play; Policies; Population; Population Heterogeneity; Population Intervention; Poverty; Prevention; Preventive; Preventive Intervention; Probability; Problem Solving; Provider; Psychiatric Social Work; Psychosocial Factor; Randomized; Research; Research Design; Research Personnel; Research Training; Resources; Risk; Risk Reduction; Role; Rural Community; Safe Sex; Sampling; Self Management; Sentinel; Sexual Transmission; Social support; Specific qualifier value; Staging; Stress; Stress and Coping; System; Testing; Therapeutic; Time; To specify; Translating; Translational Research; Translations; Trauma; Treatment Factor; Trust; United States National Institutes of Health; Urban Population; Urbanization; Violence; Virus; Work; abstracting; alcohol abstinence; alcohol and other drug; alcohol intervention; base; clinical practice; clinical research site; community based treatment; community setting; condoms; contextual factors; coping; design; disorder control; evidence base; experience; follow-up; high risk; high risk behavior; improved; indexing; intervention effect; knowledge base; male; medication compliance; parent grant; primary outcome; psychosocial; public health relevance; randomized trial; safer sex; scale up; secondary outcome; sex risk; skills; social; stress management; success; theories; transmission process

Project Summary/Abstract The proposed study is an adaptation and randomized trial of a Cognitive-Behavioral Stress Management (CBSM) intervention for simultaneously enhancing safer sex practices, adherence to ARV medication, and reducing alcohol or other drugs (AOD) use, in a predominantly poor urban population in Haiti. With our on- site clinical research partner, the GHESKIO Centers, a key focus will be how HIV intervention outcomes are influenced by Environmental and PsychoSocial (Env-Psy-Soc) factors. Performing this study in Haiti with GHESKIO presents a unique opportunity to contribute an EnvPsySoc dimension to the HIV/AIDS prevention and treatment scale-up that is ongoing there and in the region. GHESKIO is unique and unparalleled in Haiti and the region as a socially trusted infectious disease control institution that has been there since the discovery of the HIV virus and that has successfully adapted an academically disciplined HIV/AIDS clinical research and training model into the urban and rural communities of Haiti. GHESKIO operates using an integrated care model similar to a typical U.S. VA center, and serves a population reflective of the fault lines of the epidemic in resource-constrained countries: poverty and disempowerment, the trauma and violence of chaotic urbanization and frequent civil disorder and inadequate rule of law. Using the vehicle of CBSM, a potentially efficacious prevention intervention for reducing HIV transmission risk among People Living with HIV (PLWH) in this clinical venue enhances the probability of success. CBSM-A, the adapted intervention to be evaluated, is based on an NIH pilot study in Haiti that was guided by Information-Motivation-Behavior (IMB) theory. It is a small-group design for HIV+ AOD using populations, which also addresses their cognitive/self management and coping barriers that may impede sustainable outcomes, particularly in resource-constrained settings as Haiti. HLM/SEM analyses will be used to explore adherence to safer sex and ARV medication guidelines as well as how intervention effects are influenced by traditional IMB variables, AOD use, and EnvPsySoc factors. The proposed project responds to the NIH priority on integrating environmental-psychosocial research and on bridging clinical research and practice, by adapting and translating effective research-based intervention strategies for the "real world" conditions faced by community based providers. If successful, this research will present an HIV intervention strategy that can be practically implemented for HIV+ adults with high risk behaviors (alcohol use and unsafe sexual practices) in Haiti and other resource-constrained settings, while advancing the knowledge base of how to tailor interventions for such settings.

项目概要/摘要 拟议的研究是认知行为压力管理的适应性和随机试验 （CBSM）干预措施，同时加强安全性行为、坚持抗逆转录病毒药物治疗，以及 减少海地主要贫困城市人口的酒精或其他药物 (AOD) 使用。随着我们的 现场临床研究合作伙伴 GHESKIO 中心，重点关注艾滋病毒干预结果如何 受环境和社会心理 (Env-Psy-Soc) 因素的影响。在海地进行这项研究 GHESKIO 提供了一个独特的机会，可以为艾滋病毒/艾滋病预防贡献 EnvPsySoc 维度 那里和该地区正在扩大治疗规模。 GHESKIO 在海地是独一无二的 该地区自疫情爆发以来一直是社会信任的传染病控制机构 HIV 病毒的发现，并成功适应了学术纪律的 HIV/AIDS 临床 海地城乡社区的研究和培训模式。 GHESKIO 使用 类似于典型的美国退伍军人事务部中心的综合护理模式，并为反映了断层线的人群提供服务 资源有限国家的流行病：贫困和剥夺权能、创伤和暴力 混乱的城市化、频繁的内乱和法治不完善。使用CBSM的车辆， 降低艾滋病病毒感染者传播风险的潜在有效预防干预措施 HIV（艾滋病毒感染者）在这个临床场所提高了成功的可能性。 CBSM-A，适应性干预 待评估的数据基于 NIH 在海地进行的一项试点研究，该研究以信息-动机-行为为指导 （IMB）理论。这是针对 HIV+ AOD 使用人群的小组设计，也解决了他们的问题 可能阻碍可持续成果的认知/自我管理和应对障碍，特别是在 资源有限的环境，如海地。 HLM/SEM 分析将用于探索安全性行为的遵守情况 和 ARV 用药指南以及传统 IMB 变量如何影响干预效果， AOD 使用和 EnvPsySoc 因素。拟议的项目响应了 NIH 的整合优先事项 环境心理社会研究以及通过适应和衔接临床研究和实践 将有效的基于研究的干预策略转化为社区面临的“现实世界”条件 为基础的提供商。如果成功，这项研究将提出一种可实际应用的艾滋病毒干预策略 在海地和其他国家，针对有高危行为（饮酒和不安全性行为）的艾滋病病毒感染者实施 其他资源有限的环境，同时推进如何针对此类情况制定干预措施的知识库 设置。

项目成果

The impact of disaster on HIV in Haiti and priority areas related to the Haitian crisis.

• DOI: 10.1016/j.jana.2010.02.002
• 发表时间: 2010-05
• 期刊: JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE
• 影响因子: 2
• 作者: Malow, Robert;Rosenberg, Rhonda;Lichtenstein, Bronwen;Devieux, Jessy G.
• 通讯作者: Devieux, Jessy G.

Determinants of HIV serostatus disclosure to sexual partner among HIV-positive alcohol users in Haiti.

• DOI: 10.1007/s10461-013-0685-8
• 发表时间: 2014-06
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Conserve DF;King G;Dévieux JG;Jean-Gilles M;Malow R
• 通讯作者: Malow R

The Continuing Challenge of Reducing HIV Risk among Haitian Youth: The Need for Intervention.

• DOI: 10.1177/2325957411418119
• 发表时间: 2015-05-01
• 期刊: Journal of the International Association of Providers of AIDS Care
• 作者: Devieux, Jessy G;Rosenberg, Rhonda;Malow, Robert M
• 通讯作者: Malow, Robert M

The Effects of Childhood Sexual Abuse: The Role of Anxiety and Alcohol Use among Haitian Women Living with HIV.

童年性虐待的影响：焦虑和酗酒对感染艾滋病毒的海地妇女的影响。

• DOI: 10.1080/10538712.2020.1801939
• 发表时间: 2020
• 期刊: Journal of child sexual abuse
• 影响因子: 1.9
• 作者: Villalba,Karina;Attonito,Jennifer;Jean-Gilles,Michele;Rosenberg,Rhonda;Sanchez,Mariana;Devieux,Jessy
• 通讯作者: Devieux,Jessy

Alcohol abuse and HIV infection: role of DRD2.

• DOI: 10.2174/1570162x12666140721115045
• 发表时间: 2014
• 期刊: Current HIV research
• 影响因子: 1
• 作者: Agudelo M;Khatavkar P;Yndart A;Yoo C;Rosenberg R;Devieux JG;Malow RM;Nair M
• 通讯作者: Nair M