Positive Choices Research Project

积极选择研究项目

• 批准号: 6751645
• 负责人: Mark L Williams
• 金额: $ 48.81万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6751645
• 关键词: AIDS education /prevention; African American; HIV infections; behavior therapy; behavioral /social science research tag; clinical research; clinical trials; communicable disease transmission; computer program /software; condoms; crack cocaine; drug abuse; gender difference; high risk behavior /lifestyle; human subject; human therapy evaluation; longitudinal human study; patient oriented research; questionnaires; safe sex /sex abstinence; sex behavior; sex education; substance abuse related behavior

DESCRIPTION (provided by applicant): The study proposed in this application, Positive Choices Research Project builds on and continues work we began as part of a grant, "Condom use among drug users receiving antiretroviral medications, "R03 DA12318-01. The purpose of the Positive Choices Research Project is to evaluate the efficacy of a risk reduction protocol designed to reduce the sexual transmission of HIV by crack cocaine smokers receiving medical treatment for HIV disease. Specially, the purpose of the risk reduction protocol is to increase condom use during vaginal/anal intercourse. To evaluate the efficacy of the risk reduction protocol, we will implement a randomized clinical field trial. The trial will compare the Positive Choices risk reduction intervention to the current standard intervention for drug users in non-clinical settings. Bandura's Social Cognitive Theory (SCT) is the theoretical framework underpinning the Positive Choices intervention and the study design. The intervention methodology is cognitive mapping, a strategy that has been successfully used in drug treatment and is very compatible with SCT. Assessment of the effectiveness of the intervention will be based on data collected at completion of the intervention and at 3 and 9 months after completion of the intervention. This is the first study of which we are aware of that will investigate the efficacy of an intervention to increase condom use targeting HIV+ crack cocaine smokers. The Positive Choices Research Project has important scientific and pubic health implications. As the comparatively small number of studies in this areas shows, less than half of any sample of HIV positive (HIV+) drug users consistently use condoms. The psychosocial precursors that influence adoption of risk reduction practices may not be the same as those that influence maintenance of long-term behaviors. It is difficult to generalize from studies focusing on MSM. As a recent review of the literature concludes, heterosexual men are socialized to believe that only unprotected vaginal sex is sex. The Positive Choices Research Project will be tested in Houston, Texas. Houston is the nation's fourth largest city and has the sixth highest AIDS caseload. The city's caseload reflects the makeup of its population. Forty-five percent of cases are White, 38% African American, and 17% Hispanic. Seventeen percent of the caseload is female. Since 1994, more heterosexuals had been diagnosed with AIDS in Houston than any other group. The city has the unpleasant distinction of having the highest rate of new heterosexual infections in the United States. The epidemic among heterosexuals in Houston is focused in the African American community. About one-third of newly infected African Americans are women. The disease in the African American community is directly and indirectly linked to the crack cocaine epidemic.

描述（由申请人提供）：本申请中提出的研究，积极选择研究项目建立并继续我们作为资助的一部分开始的工作，“接受抗逆转录病毒药物的吸毒者使用安全套”，R03 DA12318-01。积极选择研究项目的目的是评估一项减少风险议定书的效力，该议定书旨在减少接受艾滋病毒治疗的快克可卡因吸烟者通过性行为传播艾滋病毒。特别地，降低风险方案的目的是在阴道/肛门性交时增加避孕套的使用。为了评估风险降低方案的有效性，我们将实施一项随机临床现场试验。该试验将比较Positive Choices降低风险干预与目前针对非临床环境下吸毒者的标准干预。班杜拉的社会认知理论（SCT）是积极选择干预和研究设计的理论框架。干预方法是认知映射，这是一种已成功用于药物治疗的策略，与SCT非常兼容。干预措施有效性的评估将基于干预措施完成时以及干预措施完成后3个月和9个月收集的数据。这是我们所知道的第一项研究，将调查针对艾滋病毒+快克可卡因吸烟者增加避孕套使用的干预效果。积极选择研究项目具有重要的科学和公共卫生意义。在这一领域相对较少的研究表明，在任何HIV阳性（HIV+）吸毒者的样本中，只有不到一半的人坚持使用避孕套。影响采取降低风险做法的心理社会前驱可能与影响维持长期行为的心理社会前驱不同。很难从关注男男性行为者的研究中得出结论。正如最近一篇文献综述所总结的那样，异性恋男性被社会化了，认为只有无保护的阴道性交才是性。积极选择研究项目将在德克萨斯州的休斯顿进行测试。休斯顿是美国第四大城市，艾滋病病例数量排名第六。这个城市的案件数量反映了它的人口构成。45%的病例是白人，38%是非裔美国人，17%是西班牙裔。17%的病例是女性。自1994年以来，休斯顿被诊断患有艾滋病的异性恋者比其他任何群体都多。这个城市有一个令人不快的特点，那就是它是美国异性恋新感染率最高的城市。休斯顿异性恋者中的流行主要集中在非洲裔美国人社区。大约三分之一的新感染非裔美国人是女性。非裔美国人社区的这种疾病与快克可卡因的流行有直接和间接的联系。