Family Therapy Mechanisms in HIV+ Women in Drug Recovery

描述(由申请人提供)：本申请建议调查结构性生态系统疗法(SET；Mitrani等人，2000年)在药物康复过程中对艾滋病毒妇女产生影响的家庭机制。这项拟议的研究是NIDA Grant DA15004(SETA协议)的补充，该协议在一项针对正在接受药物康复的艾滋病毒妇女的临床试验中调查SET的疗效。在SETA议定书中，176名妇女被随机分配到SET或艾滋病毒健康组。干预持续4个月。SET致力于改变家庭系统，以加强戒酒，提高对艾滋病毒医疗护理的依从性，并减少目标女性的性传播风险行为。SETA方案只评估SET对康复妇女的影响，而不是她的家人。由于设定的目标将改变整个家庭作为帮助妇女的一种手段，我们假设对整个家庭(家庭功能)和个别家庭成员的影响将有助于解释妇女的结果。这项拟议的研究将把这些妇女及其家人纳入《东南亚经济共同体议定书》。预计将有528名家庭成员参加。家庭评估每隔4个月进行一次，为期12个月。SET被假设为影响家庭功能(通过自我报告法和观察法测量)。家庭功能的变化假定会影响妇女的药物滥用、艾滋病毒用药依从性、艾滋病毒危险行为以及其家庭成员的个人功能(心理困扰、药物使用和父母对儿童问题行为的报告)。这些假设将使用潜在增长曲线模型进行检验。了解这些机制将有助于为艾滋病毒妇女制定下一代以家庭为基础的药物恢复干预措施。这将是这位调查员获得的第一个R01奖项。

DESCRIPTION (provided by applicant): This application proposes to investigate the family mechanisms by which Structural Ecosystems Therapy (SET; Mitrani et al, 2000) has its impact on HIV+ women in drug recovery. This proposed study is a companion to NIDA Grant DA15004 (SETA Protocol), which investigates the efficacy of SET in a clinical trial with HIV+ women who are in drug recovery. In the SETA Protocol, 176 women are randomly assigned to either SET or an HIV health group. The interventions last 4 months. SET works to transform the family system to reinforce sobriety, increase adherence with HIV medical care, and decrease sexual transmission risk behaviors in the target woman. The SETA Protocol only assesses the effect of SET on the recovering woman, not her family. Because SET targets changing the whole family as a means of helping the woman, we hypothesize that effects on the family as a whole (family functioning) and on individual family members will help to explain the woman's outcomes. The proposed study will enroll the women in the SETA Protocol and their families. A total of 528 family members are anticipated. Families are assessed at 4-month intervals for a period of 12 months. SET is hypothesized to affect family functioning (measured by self-report and observational methods). Changes in family functioning are hypothesized to affect the woman's drug abuse, HIV medication adherence, and HIV risk behaviors as well as the individual functioning of her family members (psychological distress, drug use and parent report of problem behaviors in children). The hypotheses will be tested using Latent Growth Curve Modeling. Understanding these mechanisms will facilitate the development of the next generation of family-based interventions for HIV+ women in drug recovery. This will be the first R01 award for this investigator.