Reducing HIV Risk Among Pregnant Women in Drug Treatment

描述（由申请人提供）： 艾滋病毒对美国妇女来说是一个严重和昂贵的健康问题。在怀孕的吸毒者中，性行为和与毒品有关的艾滋病毒危险行为的发生率令人震惊。虽然动机增强的艾滋病毒危险行为干预措施已证明对类似人群有效，但很少有工作针对孕妇进行药物滥用治疗。这项研究计划的长期目标是通过开发和建立一种结合动机访谈、心理教育和技能培养练习的干预措施的有效性，减少从事药物滥用治疗的孕妇的艾滋病毒风险行为。此外，我们寻求提高干预措施减少艾滋病毒风险行为的作用机制的知识。在本申请中，我们提出开发和试点测试一种干预措施，该干预措施解决了药物治疗中孕妇中与性和药物相关的HIV风险行为。在研究的第一阶段，我们将与接受药物治疗的孕妇以及其治疗提供者进行重点小组讨论，以确定在这一人群中进行干预的重点领域。然后，我们将为接受药物治疗的孕妇制定一项艾滋病毒风险行为干预措施，对20名妇女进行试点干预，并征求她们对干预措施的反馈。在完善干预措施后，我们将进行一项小型随机试验（n=60），以检查干预措施相对于标准治疗（SC）的疗效。我们预计，相对于SC，随机分配到干预条件的参与者将具有较低水平的性和药物相关的HIV风险行为。我们还将研究干预措施减少HIV风险行为的潜在机制。如果发现有效，这种干预措施将有助于减少怀孕吸毒者感染艾滋病毒，改善妇女及其子女的健康状况。与公共卫生的相关性：这项拟议的研究旨在开发和测试一种干预措施，以减少性和药物相关行为，使怀孕的药物滥用者处于感染艾滋病毒的风险之中。如果成功，这种干预措施可以降低这些妇女及其子女的艾滋病毒感染率。

DESCRIPTION (provided by applicant): HIV is a critical and costly health problem for American women. Among pregnant drug abusers, sex and drug-related HIV risk behavior occur at alarming rates. While motivationally-enhanced HIV risk behavior interventions have demonstrated efficacy with similar populations, very little work has been directed toward pregnant women in drug abuse treatment. The long-term objective of this research program is to reduce HIV risk behavior among pregnant women engaged in drug abuse treatment by developing and establishing the efficacy of an intervention that combines motivational interviewing, psychoeducation, and skill building exercises. Furthermore, we seek to advance knowledge of the mechanism of action by which interventions reduce HIV risk behavior. In the present application, we propose to develop and pilot test an intervention that addresses both sex- and drug-related HIV risk behavior among pregnant women in drug treatment. In the first phase of the study, we will conduct focus groups with pregnant women in drug treatment, as well as a focus group with their treatment providers, in order to determine key areas of emphasis for an intervention in this population. We will then develop an HIV risk behavior intervention for pregnant women in drug treatment, pilot the intervention with 20 women, and elicit their feedback regarding the intervention. Following refinement of the intervention, we will conduct a small randomized trial (n=60) to examine the efficacy of the intervention relative to standard care (SC). We expect that, relative to SC, participants randomized to the intervention condition will have lower levels of sex- and drug-related HIV risk behavior. We will also examine the potential mechanisms by which the intervention produces a reduction in HIV risk behavior. If found to be efficacious, this intervention will help to reduce the acquisition of HIV among pregnant drug abusers, improving health outcomes for the women and their children. Relevance to Public Health: The proposed study is designed to develop and test an intervention to reduce sex- and drug-related behavior that places pregnant drug abusers at risk for HIV infection. If successful, this intervention could reduce the rate of HIV infection in these women and their children.