Brief couples-based alcohol intervention for HIV-infected MSM and their primary partners

对感染艾滋病毒的男男性行为者及其主要伴侣进行简短的基于夫妻的酒精干预

• 批准号: 9345106
• 负责人: Kristi E Gamarel
• 金额: $ 24.58万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-10 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9345106
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Alcohol consumption; Alcohols; Bisexual; Counseling; Couples; Data; Development; Drug usage; Elements; Foundations; Future; Gays; Goals; HIV; Health; Health behavior; Heavy Drinking; Individual; Intervention; Interview; Link; Liver diseases; Manuals; Modeling; Motivation; Outcome; Participant; Patients; Population; Preventive Intervention; Procedures; Protocols documentation; Public Health; Publishing; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Resources; Risk; Sample Size; Self Efficacy; Specialist; Structure; Subgroup; Substance Use Disorder; Target Populations; Testing; Time; Training; Treatment Efficacy; United States; Viral; Viral Load result; Work; alcohol abstinence; alcohol abuse therapy; alcohol intervention; antiretroviral therapy; arm; base; behavior change; brief motivational intervention; cognitive function; comparative efficacy; cost effectiveness; drinking; drinking behavior; evidence base; follow-up; improved; informant; insight; intervention participants; liver function; male; member; men; men who have sex with men; mortality; motivational intervention; problem drinker; recruit; reduced alcohol use; satisfaction; sex; sex risk; sexual risk taking; skills; social; theories; therapy adherence; therapy development; uptake; viral detection

Project Summary Heavy alcohol use in HIV-infected patients contributes to suboptimal adherence to antiretroviral therapy (ART), greater sexual risk taking, higher viral loads, and worsened liver and cognitive functioning. Gay, bisexual, and other men who have sex with men (MSM) continue to represent almost half of all HIV/AIDS cases in the United States, and heavy drinking is particularly high among this HIV-infected sub-group. Brief motivational interventions have been shown to reduce alcohol consumption among HIV-infected MSM; however, these individual-level interventions have demonstrated only modest effects in reducing drinking in this population, indicating that sustained behavior change requires attending to social and interpersonal contexts as well. To date, there are no existing brief, couples-based interventions to address heavy alcohol use among HIV-infected MSM and their primary partners that do not require alcohol abstinence treatment goals. Furthermore, there are no published data on the extent to which changes in couples alcohol use relate to key HIV-related outcomes (ART adherence, viral suppression, sexual risk). The overall aim of this project is to develop and test the feasibility, acceptability, and preliminary efficacy of a brief couples-based motivational intervention to address heavy alcohol use among HIV-infected MSM and their primary partner. This treatment development project builds on our individual-level motivational intervention (MI) with HIV- infected MSM by using components from our significant other-involved motivational intervention (SO-MI) and couples-based HIV prevention interventions, and seeks to provide insights into the mechanisms of couple-level behavior change, including motivation, individual and dyadic self-efficacy, and partner support. A two-step sequence of treatment development will be used to achieve these aims. Stage 1a includes interviews with key informants (N = 15 couples), manual development, therapist training, and a one-arm pilot with qualitative exit interviews (N = 12 couples). Stage 1b consists of a small-randomized clinical trial in which 50 heavy drinking HIV-infected MSM will be randomly assigned to either couples intervention, which involves participation of their partner, or to the existing individual intervention, which does not. Both conditions will consist of four sessions conducted over a one-month period. Participants will be interviewed at baseline, and 3-months and 6-months. Findings will provide data on the feasibility, acceptability and preliminary efficacy of the couples-based motivational intervention to reduce alcohol use among HIV- infected MSM and their primary partners. If this research shows initial promise, we will use findings to support an R01 application to test the intervention efficacy in a fully powered randomized controlled trial. This research could provide a foundation for improving the health of HIV-infected heavy drinking MSM.

项目摘要 艾滋病毒感染患者的大量饮酒有助于对抗逆转录病毒疗法的依从性 （ART），更大的性风险服用，更高的病毒负荷以及肝脏和认知功能恶化。同性恋， 双性恋和其他与男性发生性关系的男人（MSM）继续代表所有艾滋病毒/艾滋病的一半 在美国的艾滋病毒感染的亚组中，美国的病例和大量饮酒尤其高。简短的 已显示动机干预措施可减少感染HIV感染的MSM的酒精消耗； 但是，这些个人水平的干预措施仅在减少饮酒时仅表现出适度的影响 这个人群表明持续行为改变需要参加社交和人际关系 上下文也是如此。迄今为止，还没有现有的简短，基于夫妻的干预措施来解决大量酒精 在不需要戒酒治疗的HIV感染的MSM及其主要合作伙伴中使用 目标。此外，没有关于夫妻饮酒的变化程度的公开数据 与关键的HIV相关结果（艺术依从性，病毒抑制，性风险）有关。总体目的 项目将开发和测试基于简短夫妇的可行性，可接受性和初步功效 激励干预措施解决HIV感染的MSM及其主要伙伴之间的大量酒精使用。 该治疗开发项目以HIV-的个人水平动机干预（MI）为基础 通过使用我们重要的其他影响动机干预（SO-MI）的组件感染MSM 以及基于夫妻的艾滋病毒预防干预措施，并寻求提供有关机制的见解 夫妇级别的行为改变，包括动机，个人和二元自我效能感以及伴侣的支持。 将使用两步的治疗开发序列来实现这些目标。第1A阶段包括 与主要线人（n = 15对夫妇），手动开发，治疗师培训和一臂之力的访谈 试点定性退出访谈（n = 12对夫妇）。第1B期由一项小型临床试验组成 哪50个大量饮酒HIV感染的MSM将被随机分配给任何一对夫妇干预措施，其中 涉及其伴侣或现有的个人干预措施的参与。两个都 条件将包括一个月内进行的四个会议。参与者将接受采访 在基线，3个月和6个月。调查结果将提供有关可行性，可接受性和 基于夫妻的动机干预措施的初步疗效，以减少HIV- 感染了MSM及其主要合作伙伴。如果这项研究表现出最初的承诺，我们将使用调查结果 支持R01应用程序在全功率的随机对照试验中测试干预功效。 这项研究可以为改善HIV感染的大量饮酒MSM的健康提供基础。