Exploring HIV Prevention in Brief Alcohol Detox Programs

描述（由申请人提供）：PA-03-107，题为“NIH探索/发展研究资助奖”，在第2页指出“R21机制旨在鼓励新的探索和发展研究项目。... [An]这方面的例子可以包括独特和创新地利用现有方法来探索新的科学领域。“这一目标完全符合这项建议的意图。我们将把现有的预防方法转移到一个新的领域，即从长期的酒精治疗环境转移到为预防艾滋病毒而进行的短暂的4天酒精解毒环境。我们的第一阶段发展工作将探索在一个新的场所（短暂的酒精解毒）使用动机访谈（BMI）的简短适应，与传统上获得艾滋病毒预防干预措施有限的高危人群。我们将使用BMI来预防HIV/STD，这是一群服务不足的人，他们还不太可能有动力去解决HIV/STD预防问题。我们将增加生物反馈，以提高激励的影响，并将探索我们的新方法在文化多样性的设置（45%阿拉斯加原住民）。在第一阶段（第1a阶段发展阶段），我们将通过焦点小组和主要知情人访谈制定会议大纲和干预手册。在第二阶段（第1阶段B探索阶段），我们将测试简单的动机干预的新应用的可行性和实用性，以预防艾滋病毒在文化多样性的客户在短暂的酒精戒毒治疗。我们将探索三种干预措施，每种情况25人，并进行3个月的随访：（a）风险评估干预：参与者对标准风险评估方案作出反应，接受标准的艾滋病毒/性病风险降低信息，并转介到社区服务;（B）动机访谈干预：参与者响应风险评估协议，并接受基于动机访谈的简短改编的HIV/STD预防干预，包括个性化的风险反馈，个性化的风险降低计划、行为技能培训和转介到相关社区服务;和（c）动机访谈和生物反馈干预：参与者接受干预（B）和测试前咨询，并提供用于STD测试的生物标本，随后是测试后咨询、STD测试反馈和转介治疗。所有人将在三个月后接受评估。我们的探索性工作将产生会议大纲和手册，并为RO 1提案奠定基础，该提案将使用严格的实验设计来测试当前研究中开发的新策略。

DESCRIPTION (provided by applicant): PA-03-107, entitled "NIH Exploratory/Developmental Research Grant Award", indicates on page 2 that "the R21 mechanism is intended to encourage new exploratory and developmental research projects. ... [An] example could include the unique and innovative use of an existing methodology to explore a new scientific area." This objective perfectly matches the intent of this proposal. We will shift existing prevention methodologies to a new area, namely, from long-term alcohol treatment settings to a brief 4-day alcohol detoxification setting for HIV prevention purposes. Our Stage 1 developmental work will explore the use of brief adaptations of motivational interviewing (BMI) in a new venue (brief alcohol detoxification), with high-risk individuals who traditionally have had limited access to HIV prevention interventions. We will use BMI for HIV/STD prevention with this underserved group of individuals who are not yet likely to be motivated to address the issue of HIV/STD prevention. We will add biological feedback to enhance motivational impact and will explore our novel methods in a culturally diverse setting (45% Alaska Native). During Phase One (Stage 1a developmental phase), we will develop session outlines and intervention manuals through focus groups and key informant interviews. During Phase Two (Stage 1 b exploratory phase), we will test feasibility and utility of the novel application of brief motivational interventions to HIV prevention in culturally diverse clients in brief alcohol detoxification treatment. We will explore three interventions with 25 individuals per condition and with a 3-month follow-up: (a) Risk Assessment Intervention: participants respond to a standard risk assessment protocol, receive standard HIV/STD risk reduction information and referral to community services; (b) Motivational Interviewing Intervention: participants respond to a risk assessment protocol and receive an HIV/STD prevention intervention based on brief adaptations of motivational interviewing, including personalized risk feedback, personalized risk reduction plans, behavioral skills training, and referral to relevant community services; and (c) Motivational Interviewing and Biological Feedback Intervention: participants receive intervention (b) AND pre-test counseling AND provide a biological specimen for STD testing, followed by post-test counseling, STD test feedback, and referral for treatment. All individuals will be assessed after three months. Our exploratory work will produce session outlines and manuals as well as laying the foundation for an RO1 proposal that will use a rigorous experimental design to test the novel strategies developed in the current study.