Behavioral Intervention to Enhance HIV Test/Treat

加强艾滋病毒检测/治疗的行为干预

• 批准号: 8256859
• 负责人: SETH C KALICHMAN
• 金额: $ 67.01万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8256859
• 关键词: 18 year old; AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Alcohol or Other Drugs use; Anus; Appointment; Area; Attention; Behavior Therapy; Behavioral; Caring; Case Management; Cellular Phone; Clinic; Clinical Services; Clinical Trials; Cognitive; Communicable Diseases; Communication; Communities; Community Services; Conflict (Psychology); Consent; Contracts; Counseling; Decision Making; Drug usage; Epidemic; Financial compensation; HIV; HIV Infections; HIV Seropositivity; Health; Human immunodeficiency virus test; Infection; Informed Consent; Intervention; Interview; Investigation; Life; Loneliness; Measures; Mediating; Medical; Mental Health; Modeling; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Prevention; Prevention strategy; Procedures; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Relapse; Research; Resources; Risk; Risk Behaviors; Risk Reduction; Rural; Services; Severities; Sexually Transmitted Diseases; Social isolation; Social support; Technology; Testing; Time; Transportation of Patients; Vagina; Viral Load result; Woman; alcohol and other drug; antiretroviral therapy; base; computerized; cost; design; effective intervention; follow-up; improved; intervention effect; mathematical model; medication compliance; meetings; men; negative mood; pill; prevent; programs; response; routine care; safer sex; service utilization; sex risk; success; theories; therapy adherence; transmission process; treatment adherence

DESCRIPTION (provided by applicant): Prevention strategies that aim to test and treat people for HIV infection are undermined by HIV treatment non-adherence and sexually transmitted co-infections (STI). Scalable interventions are urgently needed to sustain low infectiousness by improving HIV treatment adherence and reducing risks for transmitting HIV. This application proposes to test a theory-based behavioral intervention to simultaneously improve HIV treatment adherence and reduce HIV transmission risk behaviors in people living with HIV/AIDS who use alcohol and other drugs. Grounded in Conflict Theory of Decision Making, the intervention will be delivered in a mixed format, with one office-based counseling session followed by four cell phone delivered counseling sessions. The intervention will be conducted in Atlanta and surrounding impoverished areas. Men (n = 250) and women (n = 250) receiving HIV treatment will be recruited from AIDS services and infectious disease clinics. Following informed consent and baseline assessments, participants will be randomly assigned to either an (a) integrated HIV treatment adherence - risk reduction intervention or (b) a time-matched non-contaminating attention control condition. Participants will be followed for 12-months using office-based computerized interviews, unannounced pill counts, and medical chart abstraction. The study will test the hypothesis that a unified, integrated theory-based HIV treatment and risk reduction intervention will reduce HIV transmission risk behaviors, improve HIV treatment adherence, reduce viral load and prevent new STI. The study will also examine the influence of theoretical constructs and structural barriers on intervention outcomes. Factors that predict relapse to non-adherence and risk behaviors in relation to changes in viral load and STI over the 12-month follow-up period will also be a focal point of the study. The intervention under investigation will be among the first to simultaneously address treatment adherence and risk behavior in an integrated model for substance using HIV positive men and women. If shown effective, the intervention model will be ready for immediate dissemination to community and clinical services for people living with HIV/AIDS. PUBLIC HEALTH RELEVANCE: Prevention strategies that aim to test and treat people for HIV infection are undermined by HIV treatment non-adherence and sexually transmitted co-infections (STI). The proposed study will test a theory-based behavioral intervention to reduce HIV infectiousness by simultaneously improving HIV treatment adherence and reducing sexually transmitted co-infections in people living with HIV-AIDS who use alcohol and other drugs. The intervention is delivered in a single office-based counseling session followed by 4 cell phone delivered counseling sessions in a model that will be ready for immediate dissemination to case management and clinical services for people living with HIV/AIDS in resource constrained settings.

描述（由申请人提供）：旨在测试和治疗艾滋病毒感染的旨在测试和治疗艾滋病毒感染的预防策略受到艾滋病毒治疗的不遵守和性传播的共同感染（STI）的破坏。迫切需要进行可扩展的干预措施，以通过改善HIV治疗依从性并降低传播HIV的风险来维持低传染性。该应用建议测试一种基于理论的行为干预措施，以同时改善艾滋病毒治疗的依从性，并减少使用酒精和其他药物的艾滋病毒/艾滋病患者的艾滋病毒传播风险行为。基于冲突的决策理论，干预措施将以混合格式进行，其中一项基于办公室的咨询会议，然后进行四个手机提供咨询会议。干预将在亚特兰大和周围贫困地区进行。男性（n = 250）和女性（n = 250）将从艾滋病服务和传染病诊所招募接受HIV治疗的男性（n = 250）。遵循知情同意和基线评估，将将参与者随机分配给（a）综合的HIV治疗依从性 - 降低风险降低干预措施或（b）时间匹配的非抗激心注意控制条件。参与者将使用基于办公室的计算机访谈，未宣布的药丸计数和医疗图表抽象来进行12个月的时间。该研究将检验以下假设：统一的，基于理论的艾滋病毒治疗和降低风险干预将减少艾滋病毒传播风险行为，改善艾滋病毒治疗依从性，减少病毒载荷并防止新的性病。该研究还将研究理论构建体和结构障碍对干预结果的影响。在12个月的随访期内，预测与病毒负荷和STI变化有关的不遵守和风险行为复发的因素也将是研究的重点。所调查的干预措施将是第一个使用HIV阳性男性和女性的综合模型中同时解决治疗依从性和风险行为的方法之一。如果显示有效，干预模型将准备好立即为艾滋病毒/艾滋病患者的社区和临床服务传播。 公共卫生相关性：旨在测试和治疗艾滋病毒感染的旨在测试和治疗艾滋病毒感染的预防策略因艾滋病毒治疗不遵守和性传播的共同感染而受到破坏。拟议的研究将测试一种基于理论的行为干预措施，以同时改善HIV治疗依从性并减少使用酒精和其他药物的HIV-AID患者的性传播共同感染来降低HIV感染性。该干预措施是在一个基于办公室的咨询会议上进行的，然后在模型中进行了4部手机提供咨询会议，该咨询会准备在资源约束设置中为患有艾滋病毒/艾滋病的人立即传播给病例管理和临床服务。