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

• 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
• 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

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.

项目摘要 在人际关系中为性少数族裔男性（SMM）开发有效的药物使用干预措施是 公共卫生优先。 SMM - 特别是35岁以下的SMM - 继续代表大多数新艾滋病毒 美国的感染和这些感染的35-68％是在主要关系或主要关系之间传播的 合作伙伴。药物使用是SMM的性HIV传播风险行为（TRB）的公认相关性 通常，药物使用和HIV TRB之间的关联对于单个和合作的SMM是可比的。 尽管在个人和群体方面取得了成功，但MI与夫妻的应用很少见，最初是 产生了混合的结果。 MI开发供个人使用，为计数提供了相对较少的指导 当合作伙伴还没有准备好改变时，或一个伴侣反对健康行为。斯塔克斯博士 （PI）专门研究了十多年的研究，以开发用于进行MI的新框架 有一对。我们的范式将这对夫妇（而不是关系中的一个合作伙伴）视为客户 提供管理冲突并促进共同目标和变更计划的制定的策略。 我们的团队，包括行为干预开发和预防艾滋病毒的专家 SMM，现在建议对夫妻健康项目（CHP）进行效率试验。 CHP是第一个多课程 夫妻MI吸毒和艾滋病毒风险降低干预措施旨在供柜台和其他精神 为SMM提供基于证据的药物使用治疗的卫生专业人员。该项目直接构建 关于DA043422的干预开发工作和试验随机对照试验（RCT）结果（PI- 斯塔克斯）。结果表明，卫星与药物使用和性风险的显着减少有关 在处于最高风险的夫妇中。 现在，我们提出了一项多站点试验，该试验旨在测试CHP的效率并评估推定的主持人 （和调解员）在我们的飞行员工作中确定。参与者包括180位男性夫妇，其中至少一个伴侣 年龄18至34岁；艾滋病毒阴性；并报告最近（过去30天）的药物使用和性HIV TRB。生物 药物使用标记（尿液测定）以及性传播感染的细菌自我报告 药物使用和HIV TRB数据。为了提高普遍性和可行性，将在线招募夫妇 美国。在完成双方的远程基线评估后，这对夫妇被随机分配给 CHP干预措施或一场夫妻艾滋病毒测试和咨询（ 男性夫妇的性健康）通过干预主义者通过HIPAA投诉Zoom以远程医疗形式交付 位于地理上多样化的医学和研究设施（纽约市；密歇根州底特律；和夏洛茨维尔， VA）。 SMM完成干预后3、6和9个月的完整随访评估。