A comprehensive approach to secondary HIV prevention and care among positives

对艾滋病毒阳性者进行二级预防和护理的综合方法

基本信息

批准号：
8662218
负责人：
CARL A LATKIN
金额：
$ 71.75万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8662218
关键词：
AIDS prevention AIDS/HIV problem Address Adherence African American Alcohol or Other Drugs use Appointment Attention Behavior Therapy Caring Chronic Clinical Cognitive Cognitive Dissonance Communication Communities Control Groups Counseling Diffuse Diffusion Diffusion of Innovation Drug usage Drug user Enrollment Environmental Risk Factor Evidence based intervention Goals HIV HIV Infections HIV drug resistance HIV risk Health Educators Health education Human immunodeficiency virus test Individual Injecting drug user Injection of therapeutic agent International Intervention Knowledge Lead Life Mediating Medical Modeling Morbidity - disease rate Nature Outcome Outcome Study Participant Patients Persons Pharmaceutical Preparations Population Prevention Preventive Intervention Primary Health Care Primary Prevention Problem Solving Process Provider Randomized Randomized Controlled Trials Recruitment Activity Rewards Risk Risk Behaviors Risk Reduction Role Schedule Secondary Prevention Secondary to Series Services Sexual Partners Sexual Transmission Social Network Support Groups Test Result Testing Time Training Translating arm base behavior change cost design expectation high risk improved indexing injection drug use intervention effect intervention program member mortality peer prevention service programs racial and ethnic skills social social norm theories transmission process

项目摘要

DESCRIPTION (provided by applicant): This application is a revision to R01DA032217-01. With the growing number of HIV seropositives in the US, there is a need for increasing secondary prevention and optimizing primary HIV medical care. As many seropositives are unaware of their serostatus there is also a need for increased VCT programs that reach high risk individuals. Our prior social network oriented interventions have demonstrated diffusion of risk reduction and the ability to recruit seropositive injection drug users (IDUs). Given the substantial rates of sexual HIV transmission and high levels of drug resistant HIV among IDUs, as well as the chronic nature of injection drug use, there is a need for effective behavioral intervention strategies that address risk behaviors among IDUs and their risk network members that can be sustained.. There is also an urgent need to develop programs to engage and retain vulnerable drug using people living with HIV/AIDS (PLHAs) in primary HIV medical care. Engagement in HIV primary care has been found to predict virologic and clinical outcomes. Low and inconsistent engagement in HIV primary care contributes to African Americans' and IDUs' higher HIV morbidity and mortality rates compared to other HIV racial or exposure groups. The main goal of the proposed study, which builds on our prior interventions is to train IDU PHLAs to be peer health educators will (1) recruit high risk network members for VCT, (2) promote network risk reduction, and (3) promote engagement in HIV care and treatment by encouraging their HIV seropositive network members to schedule and keep HIV primary care appointments, realistic patient-provider role expectations, and social norms of discussing HIV medical care. We propose recruiting and randomly assigning half of 300 IDUs PLHAs (termed indexes), predominantly African American, to an experimental peer health educator training and half to an attention control condition. Participants in both conditions will be encouraged to recruit high ris network members for VCT. We anticipate 270 networks will enroll. To enhance sustainability of intervention effects, experimental participants and their network members will be offered support sessions on HIV care. We expect that the peer health educator role will be perceived as meaningful to IDUs, who have minimal opportunities for prosocial roles, and that social rewards will help sustain peer health education and social diffusion of intervention effects. Moreover this approach can provide PLHA with training in goal setting, problem solving, and communication skills that can be applied to personal and professional situations.

描述（申请人提供）：此申请是对R01DA032217-01的修订版。随着美国艾滋病毒血清蛋白的数量越来越多，需要增加二级预防并优化初级艾滋病毒医疗服务。由于许多血清蛋白尚未意识到他们的血清，因此还需要增加达到高风险个人的VCT计划。我们先前面向社交网络的干预措施表明，降低风险的扩散以及招募血清阳性注射吸毒者（IDU）的能力。鉴于IDU中的性HIV传播和高水平的抗药性HIV以及注射毒品使用的慢性抗药性率，需要有效的行为干预策略来解决IDU及其风险网络成员之间可以维持的风险行为。已经发现参与HIV初级保健可以预测病毒学和临床结果。与其他艾滋病毒种族或接触组相比，在艾滋病毒初级保健中的低和不一致的艾滋病毒初级保健参与会导致非洲裔美国人的艾滋病毒发病率和死亡率更高。拟议的研究的主要目标是基于我们先前的干预措施，是培训IDU PHLAS成为同伴健康教育工作者将（1）招募VCT的高风险网络成员，（（2）促进网络风险降低，以及（3）促进艾滋病毒护理和治疗的参与，鼓励HIV阳性网络成员安排HIV hiv hiv hiv hiv hiv hiv初级护理的医疗培训，并确定艾滋病毒的医疗培训，并确定了现实的医疗培训，并进行了社交范围，并提供了社交服务。我们提议招募300个IDUS PLHA（称为索引），主要是非裔美国人的招聘，并将其分配给实验性的同伴健康教育者培训，并将一半用于注意力控制条件。将鼓励在这两种情况下的参与者为VCT招募高RIS网络成员。我们预计将有270个网络注册。为了增强干预效果的可持续性，将向实验参与者及其网络成员提供有关艾滋病毒护理的支持会议。我们预计，同伴健康教育者的角色将被认为对IDU有意义，他们的亲社会角色机会很小，社会奖励将有助于维持同伴健康教育和干预效果的社会扩散。此外方法可以为PLHA提供目标设定，解决问题以及可以应用于个人和专业情况的培训。