HIV Prevention Among SMI in Transitional Housing

简介(申请人摘要)：爱滋病病毒感染在 严重精神病患者(SMI)。尽管描述性研究已经 在患有SMI的人中，艾滋病毒危险行为的确定率很高，只有一小部分 大量研究表明，密集的认知-行为小群体 干预措施可以促进艾滋病毒性风险做法的短期改变。这 应用程序需要三年的支持以评估 对重度精神分裂症患者或双重诊断为精神分裂症患者的社区干预 SMI和药物滥用障碍(DD)，以前无家可归，生活在 过渡性住房计划(THPS)。干预模式整合了社会 认知理论(班杜拉，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 减少风险技能培训团体干预适当量身定做 SMI；2)由舆论领袖调解的社区规范改变干预 生活在THPS中，创建艾滋病毒模型、规范和增援支持 减少风险；以及3)关于艾滋病毒预防方法的THP工作人员培训。十二 THPS(6对人口统计匹配的320名居民)将是随机的 分配到社区一级的干预或技能培训小组 干预只比较条件。在基线收集的评估， 团体干预后，6个月和9个月的随访点将用于 确定干预结果效果。据推测，相对于 仅限团体干预的THPS的参与者， 社区一级干预THPS将在所有随访点展示：a) 较低水平的艾滋病毒性行为；b)较低水平的酒精和 物质使用行为；以及c)更高水平的艾滋病毒相关知识和 关于风险的规范性认知、意图、态度和信念 减少和避免。如果成功，这项研究将确定一种 降低和维持降低艾滋病毒风险的社区干预措施 在居住在THPS的患有SMI或DD的前无家可归者中。自.以来 过渡性住房是综合照料系统的一个共同组成部分。 那些有SMI或DD的人，有广泛传播研究的潜力 在全国范围内的项目中，调查结果是大量的。

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.