BETTER ANTIRETROVIRAL ADHERENCE: HIV+ AMPHETAMINE USERS

描述：(改编自申请者摘要)对遵守 抗逆转录病毒疗法处于艾滋病毒护理的前沿。这种担忧是 甲基苯丙胺和其他药物依赖者中的派拉蒙， 不遵守的风险很高。限制使用新的疗法是一种常见的做法 HIV临床医生的反应，至少在稳定戒毒之前 药物，但复发率很高，几乎没有数据可以指导 治疗方面的努力。这项研究有两个目的。第一，进行一项 三臂随机临床试验比较常规医疗护理的疗效 到两个促进坚持抗逆转录病毒药物的替代方案 艾滋病毒感染者、甲基苯丙胺依赖者早期康复。一 干预是单独的坚持训练，另一种是坚持训练相结合 使用兴奋剂预防复发进行训练。第二个目标是联系 坚持神经认知状态，抗逆转录病毒经验，生活逆境， 精神障碍和药物使用。 建议的依从性和刺激性复发预防干预措施基于 论信息-动机-行为技能模型主题(N=75英寸 每个手臂)将被随机分为八周的常规医疗护理，或 两种实验性治疗中的任何一种(坚持训练、日常护理与 坚持训练，兴奋剂，预防复发，日常护理)。药效将 在治疗结束时(例如，基线后2个月)确定；以及 基线后四个月和六个月。 在基线、治疗结束以及基线后四个月和六个月 调查人员将测量自我报告的依从性，艾滋病毒RNA，尿毒学， 物质使用、生活质量和神经精神状态。坚持 抗逆转录病毒药物将通过持续的电子监测进行测量 (药物事件监测系统-MEMS)和血清抗逆转录病毒药物 浓度。研究人员推测，坚持训练会复发 预防优于坚持训练，坚持训练优于坚持训练 比平时的护理更出色。他们假设神经认知障碍和 兴奋剂的使用将预示不遵守，反社会人格也将如此 精神障碍、情绪障碍、反社会人格和药物使用可预测 不坚持，随后血浆HIV RNA升高，生活质量下降。

DESCRIPTION: (Adapted from Applicant's Abstract) Concern about adherence to anti-retroviral therapy is at the forefront of HIV care. This concern is paramount in methamphetamine and other drug-dependent individuals, who are at high risk for non-adherence. Restriction in use of newer therapies is a common response among HIV clinicians, at least until there is stable abstinence from drugs, but relapse rates are high and few data are available to guide therapeutic efforts. This study has two objectives. First, to conduct a three-arm randomized clinic trial comparing the efficacy of Usual Medical Care to two alternatives for facilitating adherence to anti-retrovirals in HIV-infected, methamphetamine-dependent persons in early recovery. One intervention is Adherence Training alone, and the other combines Adherence Training with Stimulant Relapse Prevention. The second objective is to relate adherence to neurocognitive status, anti-retroviral experience, life adversity, psychiatric disorder and substance use. The proposed Adherence and Stimulant Relapse Prevention Interventions are based on the Information-Motivation-Behavioral Skills Model (IMB). Subjects (N=75 in each arm) will be randomized into eight weeks of Usual Medical Care, or into either of two experimental treatments (Adherence Training + Usual Care vs. Adherence Training + Stimulant Relapse Prevention + Usual Care). Efficacy will be determined at conclusion of treatment (e.g., 2 months post-baseline), and four and six months post-baseline. At baseline, end of treatment, and four and six months after baseline the investigators will measure self-report adherence, HIV RNA, urine toxicology, substance use, life quality, and neuropsychiatric status. Adherence to anti-retrovirals will be measured by continuous electronic monitoring (Medication Event Monitoring System-MEMS), and serum anti-retroviral drug concentrations. The investigators hypothesize that Adherence Training + Relapse Prevention will outperform Adherence Training, and Adherence Training will outperform Usual Care. They hypothesize that neurocognitive impairment and stimulant use will predict non-adherence, as will antisocial personality disorder, mood disorder, antisocial personality, and substance use predict non-adherence, and subsequent elevated plasma HIV RNA and reduced life quality.