HIV Prevention Among SMI in Transitional Housing

过渡性住房中的 SMI 的艾滋病毒预防

• 批准号: 6315881
• 负责人: KATHLEEN J SIKKEMA
• 金额: $ 14.5万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-04-01 至 2003-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6315881
• 关键词: AIDS education /prevention; HIV infections; behavioral /social science research tag; clinical research; cognitive behavior therapy; community health services; comorbidity; data collection methodology /evaluation; drug addiction; group therapy; health behavior; health care model; homeless; human subject; human therapy evaluation; institutional care facility; interview; longitudinal human study; mental disorders; outcomes research; peer group; psychological reinforcement; questionnaires; sex behavior; social support network

DESCRIPTION (APPLICANT'S ABSTRACT): HIV infections increasingly occur in persons with severe mental illness (SMI). Although descriptive studies have established high rates of HIV risk behavior among those with SMI, only a small body of research has shown that intensive cognitive-behavioral small group interventions can promote short-term change in HIV sexual risk practices. This application requests three years of support to evaluate the effectiveness of a community level intervention for people with SMI or those dually-diagnosed with SMI and substance abuse disorders (DD), who are formerly homeless, living in transitional housing programs (THPs). The intervention model integrates social cognitive theory (Bandura, 1986) and diffusion of innovation theory (Rogers, 1983). The community intervention will include three key components: 1) HIV risk reduction skills training group intervention appropriately tailored for SMI; 2) community norm change intervention mediated by popular opinion leaders living in THPs to created models, norms, and reinforcement supports for HIV risk reduction; and 3) THP staff training on HIV prevention approaches. Twelve THPs (320 residents across 6 demographically matched pairs) will be randomly assigned to the community-level intervention or the skills training group intervention only comparison condition. Assessments collected at baseline, post-group intervention, and 6- and 9-month follow-up points will be used to determine intervention outcome effects. It is hypothesized that, relative to participants in the group intervention-only THPS, participants in the community-level intervention THPs will exhibit at all follow-up points: a) lower levels of HIV sexual risk behavior; b) lower levels of alcohol and substance use behavior; and c) higher levels of HIV-related knowledge and normative perceptions, intentions, attitudes and beliefs concerning risk reduction and avoidance. If successful, this research will identify a community-level intervention for reducing and maintaining HIV risk reduction among formerly homeless persons with SMI or DD living in THPS. Since transitional housing is a common component of integrated systems of care for those with SMI or DD, the potential for broad dissemination of research findings throughout programs nationally is substantial.

描述（申请人摘要）：艾滋病毒感染越来越多地发生在 严重精神病患者（SMI）。虽然描述性研究 在SMI患者中建立了高艾滋病毒风险行为率，只有一小部分 大量研究表明，密集的认知行为小组 干预措施可以促进艾滋病毒性风险做法的短期改变。这 申请要求三年的支持，以评估一个 社区层面的干预措施，为患有SMI或双重诊断的人， 重度精神障碍和物质滥用障碍（DD），他们以前无家可归， 过渡性住房计划（THP）。干预模式整合了社会 认知理论（Bandura，1986）和创新扩散理论（Rogers， 1983年）。社区干预将包括三个关键组成部分：1）艾滋病毒 减少风险技能培训小组干预措施， （2）以民间意见领袖为中介的社区规范改变干预 生活在THP中的人为艾滋病毒创建模型，规范和加强支持 减少风险;以及3）THP工作人员艾滋病毒预防方法培训。十二 THP（6对人口统计学匹配的320名居民）将被随机 分配到社区一级的干预或技能培训小组 仅干预比较条件。基线时收集的评估， 组后干预，以及6个月和9个月的随访时间点将用于 确定干预效果。据推测，相对于 参与者在小组干预，只有THPS，参与者在 社区一级的干预THP将在所有随访点展示：a） 降低艾滋病毒性风险行为水平; B）降低酒精水平， 物质使用行为;以及c）更高水平的艾滋病毒相关知识， 关于风险的规范性认识、意图、态度和信念 减少和避免。如果成功，这项研究将确定一个 减少和维持艾滋病毒风险降低的社区一级干预措施 居住在THPS的患有重度精神障碍或残疾的前无家可归者。以来 过渡性住房是综合照料系统的一个共同组成部分， 那些患有重度精神障碍或DD的人，广泛传播研究成果的潜力 在全国范围内的方案中，发现的问题是实质性的。