Intervening with HIV+ Alcohol Abusers: Influence of Neuro-Behavioral Factors

描述（由申请人提供）：拟议的随机对照研究将尝试降低 HIV 性传播风险和物质使用，增加初级 HIV 护理服务的利用率，并改善 320 名酗酒的 HIV 个体样本中的社会心理健康。实验性干预措施将包括对整体健康恢复计划（HHRP；Margolin 等，2003）的改编，这是唯一基于证据的艾滋病毒干预措施，用于改善成瘾人群的性风险和依从性结果。在本研究中，干预措施将适用于文化多元化的酗酒样本。 HHRP 将与健康促进比较 (HPC) 条件进行比较，后者解决常见的健康问题，包括个人卫生和健康生活。具体目标包括： 1) 将调整后的 HHRP 与 HPC 条件进行比较，以评估 HHRP 是否可以降低 HIV 性传播风险、酒精和其他药物的使用，并提高初级 HIV 护理服务和心理社会健康的利用率； 2) 评估信息、动机、行为技能如何调节干预对安全性行为结果的影响； 3) 评估关键的神经心理学和分子遗传因素如何调节干预措施对艾滋病毒传播风险结果的影响。招募地点主要位于人口稠密、多元文化、低收入的迈阿密城市地区，这些地区的 AOD 滥用、艾滋病毒、暴力和贫困率很高，绝大多数人口没有保险并遭受多重健康差距。该研究是一项前瞻性、随机队列两组设计。预定的程序顺序为： a) 知情同意、筛选和基线评估； b) 每周进行一次 120 分钟的 HHRP 或 HPC 小组课程，连续 12 周； c) 干预后评估。后续评估方案将在干预后 3、6 和 12 个月进行。还将进行分子/基因分型的神经心理学和血液测试，以帮助确定可能影响干预研究效果的因素。 拟议的研究将尝试降低酗酒、艾滋病毒个体样本中的艾滋病毒性传播风险和药物使用。在研究本研究个体的记忆、信息处理、执行功能以及遗传因素时，研究人员将能够更好地辨别那些可能影响治疗效果的因素。因此，这项研究有可能确定可能有助于具体减少该样本中危险行为的个体特征。

DESCRIPTION (provided by applicant): The proposed randomized controlled study will attempt to reduce HIV sexual transmission risk and substance use, increase the utilization of primary HIV care services, and improve psychosocial health among a sample of 320 alcohol abusing, HIV+ individuals. The experimental intervention will include an adaptation of the Holistic Health Recovery Program (HHRP; Margolin et al., 2003) that is the only evidence-based, HIV+ intervention for improving sexual risk and adherence outcomes for an addicted population. For this study, the intervention will be adapted for use in a culturally diverse, alcohol abusing sample. HHRP will be compared to a Health Promotion Comparison (HPC) condition, which addresses common health problems, including personal hygiene and healthy living. Specific aims include: 1) comparing the adapted HHRP to the HPC condition to evaluate if HHRP reduces HIV sexual transmission risk, alcohol and other drug use, and improves the utilization of primary HIV care services and psychosocial health; 2) evaluating how Information, Motivation, Behavioral Skills mediate intervention effects on safe sex outcome; and 3) evaluating how key neuropsychological and molecular-genetic factors moderate the effect of the intervention on HIV transmission risk outcomes. Recruitment sites are primarily located in densely populated, multicultural, low income, urban areas of Miami with high rates of AOD abuse, HIV, violence and poverty, with the vast majority of the population being uninsured and suffering from multiple health disparities. The study is a prospective, randomized by cohort two-group design. The scheduled sequence of procedures will be: a) informed consent, screening, and baseline assessment; b) a 120 minute group session of HHRP or HPC sessions administered once a week for 12 consecutive weeks; and c) a post- intervention assessment. Follow-up assessment protocols will be administered at 3, 6, and 12 months post-intervention. Neuropsychological and blood tests for molecular/genetic typing will also be conducted to assist in identifying factors which may influence the impact of the intervention study. The proposed study will attempt to reduce HIV sexual transmission risk and substance use among a sample of alcohol abusing, HIV+ individuals. In studying the memory, information processing, executive functioning as well as genetic factors of the individuals of this study, researchers will be better able to discern those factors which may have an impact on treatment effects. This study therefore has the potential to identify individual characteristics that may contribute to specific reductions in risky behaviors in this sample.