Alcohol Beliefs and HIV Adherence

酒精信仰和艾滋病毒依从性

• 批准号: 7940977
• 负责人: SETH C KALICHMAN
• 金额: $ 49.51万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7940977
• 关键词: 18 year old; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adverse reactions; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic Intoxication; Alcohols; Anti-Retroviral Agents; Area; Attention; Behavioral Research; Belief; Cellular Phone; Cohort Studies; Communities; Development; Disease; Dose; Drug usage; Educational workshop; Enrollment; Expectancy; Frequencies; HIV; HIV Infections; HIV Seropositivity; HIV therapy; Health; Impairment; Individual; Interruption; Intervention; Interview; Intoxication; Lead; Life; Link; Memory; Methods; Modeling; Monitor; Participant; Patients; Pattern; Perception; Pharmaceutical Preparations; Procedures; Public Health; Recruitment Activity; Regimen; Reporting; Research; Resistance; Series; Structure; Technology; Technology Assessment; Telephone; Testing; Time; Toxic effect; Variant; Viral; Virus; Voice; Woman; alcohol and other drug; alcohol expectancy; alcohol response; antiretroviral therapy; base; cognitive function; cohort; computerized; drinking; experience; hangover; improved; innovation; innovative technologies; medication compliance; meetings; men; multilevel analysis; new technology; pill; programs; prospective; response; skills; theories; therapy design; treatment adherence; 18 year old; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adverse reactions; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic Intoxication; Alcohols; Anti-Retroviral Agents; Area; Attention; Behavioral Research; Belief; Cellular Phone; Cohort Studies; Communities; Development; Disease; Dose; Drug usage; Educational workshop; Enrollment; Expectancy; Frequencies; HIV; HIV Infections; HIV Seropositivity; HIV therapy; Health; Impairment; Individual; Interruption; Intervention; Interview; Intoxication; Lead; Life; Link; Memory; Methods; Modeling; Monitor; Participant; Patients; Pattern; Perception; Pharmaceutical Preparations; Procedures; Public Health; Recruitment Activity; Regimen; Reporting; Research; Resistance; Series; Structure; Technology; Technology Assessment; Telephone; Testing; Time; Toxic effect; Variant; Viral; Virus; Voice; Woman; alcohol and other drug; alcohol expectancy; alcohol response; antiretroviral therapy; base; cognitive function; cohort; computerized; drinking; experience; hangover; improved; innovation; innovative technologies; medication compliance; meetings; men; multilevel analysis; new technology; pill; programs; prospective; response; skills; theories; therapy design; treatment adherence

DESCRIPTION (provided by applicant): This application addresses the broad challenge area of (06) Enabling Technology and the specific challenge topic 06-OD(OBSSR)-101 Using new technologies to improve treatment adherence. Strict adherence to antiretroviral medications is necessary for people living with HIV/AIDS to achieve sufficient viral suppression to slow disease and alcohol use is a known barrier to medication adherence. Alcohol intoxication effects memory, attention, and other basic cognitive functions that are obviously linked to missing medications. In addition, drinking can affect adherence the day after intoxication due to hangover impairments. Less is known about how alcohol-related beliefs interrupt treatment, such as when individuals believe that they should stop taking their medications to avoid mixing them with alcohol. Believing that mixing alcohol with medications leads to adverse reactions (interactive toxicity beliefs) can result in patients deliberately stopping their HIV therapy. Thus, HIV positive individuals who drink may experience prolonged and dangerous treatment interruptions due to their beliefs about alcohol. There are few studies of alcohol expectancies, including interactive toxicity beliefs, in relation to medication adherence. We propose a 12- month prospective cohort study to examine interactive toxicity beliefs in relation to HIV treatment adherence. Our model predicts that quantity and frequency of alcohol intake will be associated with non- adherence to HIV treatments. We also predict that drinkers who believe that mixing alcohol and HIV medications is toxic will interrupt their therapy when drinking. We hypothesize that interactive toxicity beliefs will predict non-adherence to treatment over and above common factors associated with non- adherence, including quantity and frequency of alcohol consumption. The study will include an innovative combination of reliable and valid technologies for objectively monitoring HIV treatment adherence and alcohol consumption. A cohort of 200 men and women who are (a) taking HIV medications and (b) report drinking alcohol in the previous month will be enrolled in a 12-month prospective cohort. Participant's alcohol and other drug use as well as HIV treatment adherence will be monitored using cell-phone-based assessment technologies. To monitor HIV treatment adherence, we will use unannounced pill counts conducted every 3 to 4 weeks. Alcohol and other drug use will be monitored using daily interactive voice response technology. Multilevel modeling will test a model of interactive toxicity beliefs in relation to alcohol use and medication adherence over a one year period. Our findings will inform interventions to address alcohol use and HIV treatment adherence in HIV/AIDS patients who drink. The benefits of HIV treatment are only realized with persistent strict adherence and alcohol is a known barrier to medication adherence. Alcohol intoxication effects memory, attention, and other basic cognitive functions that obviously lead to missing medication doses. In addition, beliefs that mixing alcohol with medications will result in adverse reactions (interactive toxicity beliefs) may cause particularly hazardous prolonged interruptions in HIV treatment. Beliefs about alcohol and HIV treatments may contribute to the development and spread of treatment resistant virus representing a significant threat to public health as well as personal health.

描述（由申请人提供）： 该申请通过（06）启用技术和特定挑战主题06-OD（obssr）-101的广泛挑战领域使用新技术来提高治疗依从性。严格遵守抗逆转录病毒药物对于患有艾滋病毒/艾滋病的人以实现足够的病毒抑制以减缓疾病和饮酒是已知的药物遵守障碍。酒精中毒会影响记忆，注意力和其他基本认知功能，显然与缺少药物有关。此外，由于宿醉障碍，饮酒在中毒后的第二天可能会影响依从性。关于酒精相关的信念如何中断治疗，例如个人认为应该停止服用药物以避免将其与酒精混合在一起时，知之甚少。认为将酒精与药物混合会导致不良反应（互动毒性信念）会导致患者故意停止其HIV疗法。因此，由于对酒精的信念，饮酒的艾滋病毒阳性人可能会经历长时间和危险的治疗中断。关于药物依从性的酒精期望值，包括互动毒性信念，几乎没有研究。我们提出了一项为期12个月的前瞻性队列研究，以检查与HIV治疗依从性有关的互动毒性信念。我们的模型预测，酒精摄入量的数量和频率将与非遵守HIV治疗有关。我们还预测，那些认为混合酒精和艾滋病毒药物的饮酒者在喝酒时会中断他们的治疗。我们假设交互式毒性信念将预测与非依从性相关的常见因素（包括酒精消耗的数量和频率），而不是对治疗的不遵守。该研究将包括可靠和有效技术的创新组合，用于客观监测HIV治疗依从性和饮酒。 （a）服用艾滋病毒药物的200名男性和女性组成的队列和（b）报告上个月饮酒将被招收12个月的前瞻性队列。参与者的酒精和其他药物使用以及HIV治疗依从性将使用基于手机的评估技术来监测。为了监测HIV治疗依从性，我们将使用每3至4周进行一次未经通知的药丸计数。酒精和其他药物使用将使用每日互动语音反应技术进行监控。多级建模将在一年内测试与酒精使用和药物依从性有关的互动毒性信念模型。我们的发现将为您的艾滋病毒/艾滋病患者的饮酒和艾滋病毒治疗依从性提供干预措施。艾滋病毒治疗的好处只有持续的严格依从性和酒精是依从性的障碍。酒精中毒会影响记忆，注意力和其他基本认知功能，这显然导致缺失药物剂量。此外，人们认为将酒精与药物混合会导致不良反应（交互式毒性信念）可能会导致艾滋病毒治疗中的危险长期中断。关于酒精和艾滋病毒治疗的信念可能有助于抗治疗病毒的发展和传播，这代表了对公共卫生和个人健康的重大威胁。