HEALTH RELATED INTERVENTIONS FOR PERSONS LIVING WITH HIV

该项目的目标是设计和测试一种干预措施，以减少 1200例HIV感染者的性行为和注射行为危险行为调查 男性和女性，以降低艾滋病毒携带者 会将感染传播给其他人，并促进其他与健康相关的 PLH的行为改变。这项研究将集中在三个HIV+ 亚组：女性、男男性行为者(MSM)和注射毒品 用户(IDU)。研究将在四个地点进行：洛杉矶， 纽约、旧金山和密尔沃基。该项目将以一个 为期一年的形成阶段第一阶段研究，使用150个PLH(30 每个站点)使用定性和生活史访谈来描述 影响风险的物质、社会和人际环境 PLH的行为；了解对血清状态的适应阶段；以及 确定实施更安全的性行为和积极的医疗保健的障碍 行为和生活质量。形成研究阶段还将允许 美国将量身定做指导社会行动的理论模型 采取干预措施，解决影响每个亚群的问题。跟随 在形成性研究阶段，将为 15个单独提供的会议的干预，分成三个 具有针对健康促进、传播风险的组件的模块 减少，以及心理应对/关系问题。在阶段中 2个主要干预试验，三个亚组的HIV感染者 最近从事高危行为的人将被平等地招募 每个地点产生艾滋病毒+妇女样本的数量(N=400)， 男男性接触者(N=400)和注射毒品(N=400)。总共有1,200个公共卫生计划项目将 在每个子组内以相等的数量随机分配给一个 立即干预条件或滞后干预控制 条件。在两次基线访谈之后，参与者将被 在接下来的35个月中每隔5个月进行一次评估。除了……之外 预测主要风险行为(传播风险行为)和 随时间推移的次要结果(卫生保健行为和生活质量) 针对每个模块，我们将检查调解的影响 来自社会行动理论的因素(应对技能、社会 支持、解决问题、艾滋病毒相关的态度/信念，以及 风险行为的环境背景)以及参与者背景 影响因素(性别、种族、传播行为史) 主要和次要结果。这项研究将通过一个 由四个地点组成的联合体，以提供足够的样本量 评估干预措施的影响；增强可推广性 研究结果；并利用每项研究的专门知识 一队。成本效益分析和传播计划如下 是这项研究的一部分。

The goal of this project is to design and test an intervention to reduce sexual and injection practice risk behaviors among 1,200 HIV-infected men and women in order to decrease the likelihood that persons with HIV will transmit infection to others and to promote other health-related behavior changes in PLH. The research will be focused on three HIV+ subgroups: women, men who have sex with men (MSM), and injection drug users (IDUs). The study will be undertaken at four sites: Los Angeles, New York, San Francisco, and Milwaukee. The project will begin with a one-year period of formative Phase I studies conducted with 150 PLH (30 per site) using qualitative and life-history interviews to characterize the physical, social, and interpersonal contexts that influence risk behavior among PLH; understand stages of adaptation to serostatus; and identify barriers to implementation of safer sex, positive health care acts, and quality of life. The formative research phase will also allow us to tailor the social action theoretical model guiding the intervention to address issues affecting each subpopulation. Following the formative research phase, a manual will be prepared for an intervention of 15 individually-delivered sessions organized into three modules with components that target health promotion, transmission risk reduction, and psychological coping/relationship issues. In the Phase 2 main intervention trial, three subgroups of HIV-infected persons who have recently engaged in high-risk behavior will be recruited in equal numbers at each site yielding study-wide samples of HIV+ women (N=400), MSM (N=400), and IDUs (N=400). Altogether, 1,200 PLHs project-wide will be randomly assigned in equal numbers within each subgroup to an immediate intervention condition or to a lagged intervention control condition. Following two baseline interviews, participants will be evaluated at 5-month intervals for the next 35 months. In addition to anticipating changes in the primary (transmission risk acts) and secondary (health care behaviors and quality of life) outcomes over time and in response to each module, we will examine the impact of mediating factors emerging from social action theory (coping skills, social support, problem solving, HIV-related attitudes/beliefs, and environmental context of risk acts), as well as participant background factors (gender, ethnicity, history of transmission behaviors) on primary and secondary outcomes. The study will be implemented by a consortium of four sites in order to provide sufficient sample sizes to assess the impact of the intervention; to enhance generalizability of the findings; and to utilize the specialized expertise of each research team. Cost-effectiveness analyses, and dissemination are planned as part of this study.