Couples Motivational Interviewing to reduce drug use and HIV risk in vulnerable male couples

夫妻动机访谈，以减少弱势男性夫妇的吸毒和艾滋病毒风险

基本信息

批准号：
10757544
负责人：
Tyrel J Starks
金额：
$ 73.49万
依托单位：
HUNTER COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-30 至 2028-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10757544
关键词：
AIDS prevention Address Adherence Age Agreement Attention Behavior Therapy Biological Assay Biological Markers Bisexual COVID-19 pandemic Chlamydia Chlamydia Infections Client Cocaine Communication Conflict (Psychology)Counseling Couples Data Development Dose Drug Addiction Drug usage Emotional Event Feedback Frequencies Funding Gays Geography Goals Gonorrhea HIV HIV Infections HIV Seronegativity HIV risk Health Health Insurance Portability and Accountability Act Health Professional Health behavior Heterosexuals Human immunodeficiency virus test Incidence Individual Infection Infrastructure Injections Intervention Investments Ketamine Mediator Medical Mental Health Methamphetamine New York City Outcome Participant Partner in relationship Patient Self-Report Pharmaceutical Preparations Professional counselor Protocols documentation Public Health Randomized Randomized, Controlled Trials Rectum Reporting Research Risk Behaviors Risk Reduction Severities Sex Behavior Sexual Health Sexual Partners Sexually Transmitted Diseases Site Syphilis Testing Time United States Urethra Urine Work aged binge drinking condomless anal sex ecstasy efficacy evaluation efficacy testing efficacy trial evidence base follow up assessment future implementation health care delivery high risk illicit drug use implementation research intervention delivery male couples men men who have sex with men motivational enhancement therapy multi-site trial novel post intervention pre-exposure prophylaxis psychoeducation psychoeducational public health priorities recruit rectal remote assessment research facility satisfaction sexual HIV transmission sexual minority men sexual risk behavior sexual risk taking skills standard of care substance use substance use treatment success telehealth theories therapy development transmission process trial enrollment uptake

项目摘要

Project Summary The development of effective drug use interventions for sexual minority men (SMM) in relationships is a public health priority. SMM – particularly those under age 35 – continue to represent the majority of new HIV infections in the US and 35-68% of these infections are transmitted between main or primary relationship partners. Drug use is a well-established correlate of sexual HIV transmission risk behavior (TRB) for SMM generally and associations between drug use and HIV TRB are comparable for single and partnered SMM. Despite success with individuals and groups, applications of MI with couples are rare and initially produced mixed results. Developed for use with individuals, MI provided relatively little guidance to counselors when partners were not equally ready to change or one partner argued against a health behavior. Dr. Starks (PI) has devoted more than a decade of research to the development of a novel framework for conducting MI with a couple. Our paradigm views the couple (rather than one partner in the relationship) as the client and offers strategies for managing conflict and promoting the development of shared goals and change plans. Our team, which includes experts in behavioral intervention development and HIV prevention with SMM, now proposes an efficacy trial of the Couples Health Project (CHP). CHP is the first multi-session couples MI drug use and HIV risk reduction intervention intended for use by counselors and other mental health professionals who deliver evidence-based substance use treatment to SMM. The project builds directly on the intervention development work and pilot randomized controlled trial (RCT) results of DA043422 (PI- Starks). Results indicated that CHP was associated with significant reductions in drug use and sexual risk taking among couples who were at the highest risk. We now propose a multi-site trial powered to test the efficacy of CHP and evaluate putative moderators (and mediators) identified in our pilot work. Participants include 180 male couples in which at least one partner is age 18 – 34; HIV negative; and reports recent (past 30 day) drug use and sexual HIV TRB. Biological markers for drug use (urine assay) as well as bacterial sexually transmitted infections corroborate self-reported drug use and HIV TRB data. To increase generalizability and feasibility, couples will be recruited online across the US. Following completion of a remote baseline assessment by both partners, the couple is randomized to either the CHP intervention or a single session of couples HIV testing and counseling (the standard of care for male couples’ sexual health) delivered in a telehealth format via HIPAA complaint ZOOM by interventionists based at geographically diverse medical and research facilities (New York City; Detroit, MI; and Charlottesville, VA). SMM complete follow-up assessments (remotely) 3, 6, and 9-months post-intervention.

项目概要针对性少数男性 (SMM) 制定有效的吸毒干预措施是一项重要任务 SMM——尤其是 35 岁以下的人群——仍然是新感染艾滋病毒的大多数。在美国，35-68% 的感染是在主要或主要关系之间传播的对于 SMM 来说，吸毒是与性 HIV 传播风险行为 (TRB) 相关的一个明确的因素。一般来说，对于单一 SMM 和合作 SMM 而言，吸毒与 HIV TRB 之间的关联具有可比性。尽管在个人和团体中取得了成功，但在夫妻中应用 MI 的情况很少见，而且最初 MI 是为个人使用而开发的，它为咨询师提供的指导相对较少。当伴侣没有做好改变的准备或者其中一个伴侣反对斯塔克斯博士的健康行为时。 (PI) 投入了十多年的研究来开发用于进行 MI 的新颖框架我们的范例将这对夫妇（而不是关系中的一个合作伙伴）视为客户，并且提供管理冲突和促进共同目标和变革计划发展的策略。我们的团队包括行为干预开发和艾滋病毒预防方面的专家 SMM现在提议对夫妻健康项目（CHP）进行疗效试验，这是第一个多阶段的项目。夫妻心梗吸毒和艾滋病毒风险降低干预措施，供咨询师和其他心理咨询师使用向 SMM 提供基于证据的药物滥用治疗的卫生专业人员该项目直接建立。关于 DA043422（PI- Starks）的结果表明，CHP 与吸毒和性风险的显着降低有关。在风险最高的夫妇中进行研究。我们现在提出一项多地点试验，旨在测试 CHP 的功效并评估假定的调节剂我们的试点工作中确定了参与者（和调解员），其中包括 180 对男性夫妇，其中至少有一名伴侣。年龄 18 – 34 岁；HIV 阴性；并且报告最近（过去 30 天）吸毒和性 HIV TRB。吸毒标记物（尿液检测）以及细菌性传播感染证实了自我报告为了提高普遍性和可行性，将在网上招募夫妇。在双方完成远程基线评估后，这对夫妇被随机分配到美国。卫生防护中心干预或单次夫妻艾滋病毒检测和咨询（护理标准）男性伴侣的性健康）由干预主义者通过 HIPAA 投诉 ZOOM 以远程医疗形式提供总部位于不同地理位置的医疗和研究机构（纽约市、密歇根州底特律和夏洛茨维尔） VA）。SMM 在干预后 3、6 和 9 个月完成随访评估（远程）。