MOTIVATION AND PATCH TREATMENT FOR HIV POSITIVE SMOKERS

人类免疫缺陷感染者的治疗 病毒(HIV)或患上艾滋病的人已经发展到了这样的地步 死亡不再是诊断的最有可能的结果。组合 抗逆转录病毒疗法和蛋白酶抑制剂的治疗有 使艾滋病毒感染成为一种可控的慢性疾病。努力改进 艾滋病病毒携带者或艾滋病毒感染者的健康和生活质量- 因此，积极是一个高度优先的问题。吸烟有几个问题 艾滋病毒阳性人群特有的健康风险，包括 细菌性肺炎、口腔念珠菌病的风险增加，甚至 增加了发展为全面艾滋病的风险。显然，戒烟 吸烟将有助于改善这些风险状况。然而，到目前为止，没有 已经进行了临床研究，以评估 专为艾滋病毒患者量身定做的戒烟治疗的有效性- 吸烟者人数呈阳性。 在加法设计中，本提案将评估两种治疗方法 四家治疗HIV感染者的门诊戒烟情况 人。目标是招募所有符合条件的吸烟者，无论他们 戒烟动机，纳入研究。患者被随机分成 只要有短暂的治疗条件，医生就会允许他们戒烟。 干预，遵循NCI的短暂戒烟指南 心理咨询。他们还将收到尼古丁贴片的处方。 医生和患者之间将安排一次后续访问，以 检查他们在戒烟方面的进展。患者被随机分成 激励增强条件将收到关于他们在 戒烟。患者被随机分为激励增强组 除两次面对面访问外，条件将接受上述检查 (在两个月的时间内，与患者的常规诊所一致 就诊)与训练有素的健康教育者一起，他将为戒烟量身定做 对患者戒烟动机水平的干预。全 患者将接受2个月、4个月和6个月的随访。点 6个月时的吸烟情况(7天，CO验证)将 成为人们感兴趣的主要结果。我们假设有9%的 在这一点上，激励增强患者将戒烟， 相比之下，在短暂治疗条件下，患者的这一比例为3%。一批 影响治疗结果的重要因素(例如，自我效能、动机 决策平衡)也将被审查，成本效益 将对这些治疗进行评估。这项研究将是第一个检查 HIV阳性人群中不同的戒烟治疗和 这一结果将对重要的具有成本效益的戒烟措施产生影响 临床护理环境中的干预措施。

Treatments for persons who are infected with the Human Immunodeficiency virus (HIV) or who have developed AIDS have advanced to there point where death is no longer the most likely outcome of a diagnosis. Combination anti-retroviral therapies and treatments with protease inhibitors have made HIV-infection a manageable, chronic conditions. Efforts to improve the health and quality of life of persons living with AIDS or who are HIV- positive is therefore a high priority. Cigarette smoking posses several health risks that are unique to the HIV-positive population, including increased risk of bacterial pneumonia, oral candidiasis, and perhaps even increased risk for progression to full-blown AIDS. Clearly, quitting smoking would help to improve these risk profiles. However, to date, no clinical research studies have been conducted to evaluate the effectiveness of stop smoking treatments specifically tailored to the HIV- positive population of smokers. In a additive design, this proposal will evaluate two treatments for smoking cessation in four outpatient clinics which treat HIV-infected persons. The goal is to enroll all eligible smokers, regardless of their motivation to quit smoking, into the study. Patients randomized into the Brief Treatment condition will receive from their physician a stop smoking intervention, following NCI guidelines from brief smoking cessation counseling. They will also receive a prescription for the nicotine patch. One follow-up visit will be scheduled between the physician and patient to check on their progress at quitting smoking. Patients randomized into the Motivational Enhancement condition will receive on their progress in quitting smoking. Patient randomized into the Motivational Enhancement condition will receive the above, in addition to two in-person visits (over a two month period, to coincide with the patient's regular clinic visits) with a trained Health Educator who will tailor the cessation intervention to the patient's level of motivation to quit smoking. All patients will be followed for a 2-, 4-, and 6-month follow-up. Point prevalence smoking status (7-day, CO verified) at the 6-month point will be the primary outcome of interest. We hypothesize that 9% of the Motivational Enhancement patients will have quit smoking at this point, compared to 3% to patients in the Brief treatment condition. A number of important mediators of treatment outcome (e.g., self-efficacy, motivation decisional balance) also will be examined and the cost effectiveness of the treatments will be evaluated. This study will be the first to examine different smoking cessation treatments in an HIV-positive population and the results will have implications for important cost effective cessation interventions into clinical care settings.