Reducing HIV Risk Among Pregnant Women in Drug Treatment

描述(由申请人提供)： 艾滋病毒对美国女性来说是一个严重且代价高昂的健康问题。在怀孕的吸毒者中，与性和毒品相关的艾滋病毒危险行为以惊人的速度发生。虽然激励性增强的艾滋病毒危险行为干预在类似人群中证明了有效性，但针对药物滥用治疗中的孕妇的工作很少。这项研究计划的长期目标是通过开发和建立结合励志访谈、心理教育和技能培养练习的干预效果来减少接受药物滥用治疗的孕妇的艾滋病毒危险行为。此外，我们寻求增进对干预措施减少艾滋病毒危险行为的行动机制的了解。在目前的应用中，我们建议开发和试点测试一种干预措施，在药物治疗中同时解决孕妇中与性和药物相关的艾滋病毒危险行为。在研究的第一阶段，我们将对接受药物治疗的孕妇进行重点小组，并与她们的治疗提供者进行重点小组，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开发艾滋病毒危险行为干预，对20名妇女进行干预试点，并征求她们对干预的反馈。在改进干预措施后，我们将进行一项小型随机试验(n=60)，以检验相对于标准护理(SC)的干预效果。我们预计，与SC相比，随机进入干预条件的参与者与性和药物相关的艾滋病毒风险行为水平将较低。我们还将研究干预措施减少艾滋病毒风险行为的潜在机制。如果证实有效，这种干预措施将有助于减少怀孕吸毒者感染艾滋病毒的机会，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，以减少将怀孕吸毒者置于艾滋病毒感染风险中的性和药物相关行为。如果成功，这种干预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.