ALCOHOL DEPENDENCE: PSYCHOIMMUNOLOGY AND AIDS RISK

越来越多的证据表明，心理社会过程会影响 免疫系统和这些影响可能参与了发病和病程 疾病的威胁。这些因素，特别是压力和抑郁，在 酒精依赖者，以及酒精的直接影响 可能会严重损害这一人群的免疫功能。饮酒 也与行为去抑制有关，这可以增加高 与艾滋病毒传播有关的危险行为。同时发生的事件 酗酒者的这些因素可能会对公共健康构成重大威胁。 这些相互作用的影响在内部尤为严重 艾滋病毒流行率较高的城市环境。因此，研究是 迫切需要了解可能导致病毒传播的因素 在市中心酗酒者等高危人群中感染艾滋病毒。 拟议研究的总体目标是调查 城区酗酒者艾滋病高危人群心理免疫学分析：1. 市区酒精依赖者与正常人群免疫功能的比较 2.评估特异性抗体的免疫效果。 酗酒者的特征，包括饮酒、压力和 抑郁；以及，3.同时评估艾滋病毒的高危行为 传播和此类行为的决定因素。 150名酒精依赖患者接受动态酒精治疗 没有滥用其他物质的项目和150名匹配的研究对照 将利用横断面和纵向研究进行研究 设计。有内科疾病、肝功能受损的患者， HIV-1抗体阳性，或使用其他药物或药物 不包括在内。受试者将接受关于酒精使用模式的采访， 生活压力和抑郁，筛查体检和 将获得化学成分，并抽取血液用于体外电池 免疫措施。高危性行为对HIV传播和HIV的影响 态度、信仰和同伴规范将被记录在案。科目和 控制措施将在1个月和3个月时重新评估。多变量技术 将分析心理免疫学和其他行为关系。

There is increasing evidence that psychosocial processes influence the immune system and that these effects may contribute to the onset and course of disease. These factors, especially stress and depression, are common in alcohol dependent persons and, together with the direct effects of alcohol may seriously compromise immune function in this population. Alcohol use is also associated with behavioral disinhibition that can increase high risk behaviors linked to the transmission of HIV. The co-occurrence of these factors in alcoholics may pose a substantial public health threat. The implications of these interactions are particularly serious in inner city settings where the prevalence of HIV is high. Research is therefore urgently needed to understand factors that may contribute to the spread of HIV in high risk groups such as inner city alcoholics. The overall goal of the proposed research is to investigate the psychoimmunology of inner city alcoholics at risk for AIDS by: 1. comparing immune function in inner city alcohol-dependent subjects with that of matched controls; 2. assessing the immune effects of specific characteristics of alcoholics, including alcohol use, stress and depression; and, 3. concurrently assessing high risk behaviors for HIV transmission and the determinants of such behaviors. 150 alcohol-dependent patients enrolled in an ambulatory alcohol treatment program who have not abused other substances and 150 matched study controls will be studied utilizing both a cross-sectional and longitudinal study design. Patients with medical disorders, compromised hepatic function, positive for HIV-1 antibody, or using other medications or drugs will be excluded. Subjects will be interviewed concerning patterns of alcohol use, life stress, and depression, screening physical examinations and chemistries will be obtained, and blood drawn for a battery of in vitro immune measures. High risk sexual behaviors for HIV transmission and HIV attitudes, beliefs and peer norms will be documented. Subjects and controls will be re-assessed at 1 and 3 months. Multivariate techniques will analyze the psychoimmunologic and other behavioral relationships.