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

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）： 该应用程序解决了 (06) 使能技术的广泛挑战领域和特定挑战主题 06-OD(OBSSR)-101 使用新技术提高治疗依从性。对于艾滋病毒/艾滋病患者来说，严格遵守抗逆转录病毒药物治疗是必要的，以实现充分的病毒抑制以减缓疾病的发展，而饮酒是药物依从性的已知障碍。酒精中毒会影响记忆、注意力和其他基本认知功能，这些功能显然与缺少药物有关。此外，由于宿醉障碍，饮酒会影响醉酒后第二天的依从性。人们对与酒精相关的信念如何干扰治疗知之甚少，例如当个人认为他们应该停止服药以避免将药物与酒精混合时。相信酒精与药物混合会导致不良反应（交互毒性信念）可能会导致患者故意停止艾滋病毒治疗。因此，饮酒的艾滋病毒阳性者可能会因为对酒精的信念而经历长期且危险的治疗中断。关于酒精预期（包括交互毒性信念）与药物依从性的关系的研究很少。我们提议进行一项为期 12 个月的前瞻性队列研究，以检验与 HIV 治疗依从性相关的交互毒性信念。我们的模型预测，饮酒的数量和频率将与不遵守艾滋病毒治疗有关。我们还预测，认为酒精和艾滋病毒药物混合有毒的饮酒者会在饮酒时中断治疗。我们假设，除了与不依从性相关的常见因素（包括饮酒的数量和频率）之外，交互毒性信念将预测不依从治疗。该研究将包括可靠和有效技术的创新组合，用于客观监测艾滋病毒治疗依从性和饮酒量。一个由 200 名男性和女性组成的队列将被纳入为期 12 个月的前瞻性队列，他们 (a) 正在服用 HIV 药物并且 (b) 报告在上个月饮酒。参与者的酒精和其他药物使用情况以及艾滋病毒治疗依从性将使用基于手机的评估技术进行监测。为了监测 HIV 治疗依从性，我们将每 3 至 4 周进行一次未公布的药物计数。酒精和其他药物的使用将通过日常交互式语音应答技术进行监控。多级建模将测试一年内与饮酒和药物依从性相关的交互毒性信念模型。我们的研究结果将为解决饮酒的艾滋病毒/艾滋病患者的饮酒和艾滋病毒治疗依从性问题提供干预措施。艾滋病毒治疗的好处只有通过持续严格的坚持才能实现，而酒精是药物依从性的已知障碍。酒精中毒会影响记忆、注意力和其他基本认知功能，这显然会导致漏服药物。此外，认为酒精与药物混合会导致不良反应（交互毒性信念）的信念可能会导致特别危险的艾滋病毒治疗长期中断。对酒精和艾滋病毒治疗的信念可能会导致耐药病毒的发展和传播，对公共健康和个人健康构成重大威胁。