Intervention to Reduce Internalized Stigma (IRIS) among People Living with HIV who use Substances

减少使用药物的艾滋病毒感染者的内在耻辱 (IRIS) 的干预措施

• 批准号: 10548369
• 负责人: Jesse Bradford Fletcher
• 金额: $ 21.21万
• 依托单位: FRIENDS RESEARCH INSTITUTE, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10548369
• 关键词: Address; Adult; African American; Anxiety; Belief; Bisexual; Clinical; Cocaine use disorder; Cognitive Therapy; Data; Depressed mood; Discrimination; Distal; Effectiveness; Ethnic Origin; Evidence based intervention; Exercise; Face; Feedback; Foundations; Funding; Future; Gays; HIV; HIV Seropositivity; Health; Individual; Intervention; Interview; Learning; Learning Skill; Literature; Low income; Measures; Mental Depression; Mental Health; Meta-Analysis; Modeling; Online Systems; Outcome; Pamphlets; Participant; Patient Self-Report; Persons; Pilot Projects; Population; Population Intervention; Prejudice; Preparation; Process; Public Health; Publishing; Race; Randomized Clinical Trials; Reporting; Research; Sampling; Self Concept; Sex Orientation; Social Identification; Stereotyping; Stigmatization; Stress; Substance Use Disorder; Suggestion; Target Populations; Testing; Toxic effect; Toxicology; Urine; Viral Load result; acceptability and feasibility; antiretroviral therapy; base; coping; depressive symptoms; design; evidence base; experience; follow-up; improved; improved functioning; informant; innovation; internalized stigma; intervention delivery; intervention effect; learning strategy; marginalized population; men; opioid use disorder; perceived stress; physical conditioning; pilot test; service delivery; skills; social cognitive theory; social stigma; study population; substance use; therapy adherence; treatment as usual; virtual; virtual delivery; virtual intervention

ABSTRACT Different facets of stigma (anticipated, enacted, internalized) associated with substance use disorder (SUD) and with HIV positive status impede cessation of substance use and HIV health outcomes including antiretroviral therapy adherence and viral load suppression.1-6 Although public stigma is pervasive surrounding both, individuals can learn to reduce its internalization and mitigate stigma’s negative impacts on their health. However, interventions promoting this are non-existent in the published literature. To this end, we propose to adapt an evidence-based stigma-impact reduction intervention, Ending Self- Stigma (ESS) to reduce stigma and its negative impacts on health. ESS has shown efficacy in reducing internalized and anticipated stigma in populations experiencing mental health conditions.7 The 9-session group-based intervention, which uses cognitive behavioral therapy strategies and social cognitive theory constructs, employs didactic learning and interactive activities to facilitate reductions in internalized and anticipated stigma. The purpose of the proposed study is to adapt the ESS intervention for people living with HIV (PLWH) who also have opioid use disorder (OUD) and/or cocaine use disorder (CUD). In the first year, we will use an iterative process that starts with formative interviews with service delivery key informants and people living with PLWH with OUD and/or CUD, and ends with two successive pilot studies with the study population. Through this process, intervention content will be adapted for this population and intervention delivery will be adapted for a virtual format via a web-based platform. Then, in years 2-3, a small randomized clinical trial of the resulting Ending Self-Stigma intervention adapted for PLWH with Substance Use disorder (ESS-HSU) will be conducted with 70 participants to determine its feasibility and acceptability in addition to collecting data on proximal outcomes including internalized and anticipated stigma, depressive symptoms, anxiety and perceived stress associated with stigma. We will also measure distal outcomes including ART adherence, viral load and substance use (SU) at 6-month follow-up. The ESS-HSU intervention has the potential for high public health impact by reducing the negative effects of internalized and anticipated stigma resulting from the pervasive public stigmatization of HIV seropositive status and SUD on HIV health outcomes and cessation of SU. ESS-HSU would be the first virtual intervention of this type to be evaluated in a randomized clinical trial. If results are promising, we will seek R01 funding for a full-scale test of this innovative intervention to determine its effects on a range of health outcomes and characterize mechanisms of intervention effects.

抽象的 与物质使用障碍（SUD）相关的污名（预期，颁布，内部化）的不同方面 并以艾滋病毒的阳性状态阻碍了药物使用和艾滋病毒健康结果的停止 抗逆转录病毒疗法的依从性和病毒负荷抑制。1-6尽管公共污名无处不在 两个人都可以学会减少其内在化，并减轻污名对健康的负面影响。 但是，在已发表的文献中不存在促进这种情况的干预措施。 为此，我们建议调整基于证据的污名降低干预措施，结束自我 污名（ESS）减少污名及其对健康的负面影响。 ESS显示了降低的效率 人口中的内在化和预期的污名会经历精神健康状况。7 采用认知行为疗法策略和社会认知理论的基于小组的干预措施 构建，员工教学学习和互动活动，以促进内在化和 预期的污名。 拟议的研究的目的是适应艾滋病毒（PLWH）的人的ESS干预措施 还患有绿化障碍（OUD）和/或可卡因使用障碍（CUD）。在第一年，我们将使用 迭代过程始于与服务交付关键线人的形成性访谈和与之相关的人 带有OUD和/或CUD的PLWH，并以两项成功的研究人群进行了研究。通过 此过程，将为此人群调整干预内容，并将调整干预措施 通过基于Web的平台进行虚拟格式。然后，在2 - 3年中，一项小的随机临床试验 结束适合PLWH的自我污名干预（ESS-HSU）将是 除了收集数据外，还与70名参与者一起确定其可行性和可接受性 近端结果，包括内在和预期的污名，抑郁症状，焦虑和感知 与污名相关的压力。我们还将衡量远端结果，包括艺术依从性，病毒载荷和 在6个月的随访中使用物质（SU）。 ESS-HSU干预有可能通过减少负面影响来对高公共卫生产生影响 艾滋病毒血清阳性的普遍性污名产生的内在和预期的污名 艾滋病毒健康结果和苏斯的状态和苏联。 ESS-HSU将是第一个虚拟干预 在随机临床试验中进行评估的这种类型。如果结果很有希望，我们将寻求R01资金 对这种创新干预措施的全面测试，以确定其对一系列健康结果的影响 表征干预效果的机制。