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Prevention among HIV+ Crack Users in the Hospital

医院内 HIV 破解用户的预防

基本信息

批准号：
7546856
负责人：
Lisa R Metsch
金额：
$ 3.95万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-06-06 至 2010-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7546856
关键词：
AIDS prevention Accident and Emergency department Acquired Immunodeficiency Syndrome Acute Adult Advocate Ambulatory Care Ambulatory Care Facilities American Attention Behavioral Caring Centers for Disease Control and Prevention (U.S.)Cities Coitus Communicable Diseases Condition Continuity of Patient Care Control Groups Counseling Crime Data Disease Drug abuse Drug usage Drug user Epidemiology Experimental Designs Failure Family Florida Functional disorder Funding Guide prevention HIV HIV Infections HIV Seropositivity Hospitalization Hospitals Illicit Drugs Individual Infection Inpatients Institute of Medicine (U.S.)Intervention Knowledge Learning Left Life Medical Medicine Monitor Motivation National Institute of Mental Health Numbers Outcome Outcome Study Outpatients Participant Patients Persons Pharmaceutical Preparations Physicians Population Poverty Prevention Prevention intervention Primary Health Care Primary Prevention Principal Investigator Provider Public Health Publishing Randomized Rate Readiness Recruitment Activity Reporting Research Risk Risk Behaviors Sampling Self Efficacy Services Severities Sexual Partners Sexual Transmission Site Syphilis Testing Treatment Efficacy USA Georgia United States United States Health Resources and Services Administration Universities Unsafe Sex Violence Viral Load result Western Asia Georgia Woman Work base care seeking design follow-up high risk sexual behavior inner city interest medical schools peer person centered programs response sex skills transmission process ward

项目摘要

HTV prevention messages have typically targeted uninfected, at-risk individuals and have focused on forestalling the acquisition of HIV. Recently, a shift in the HIV prevention field has recognized the importance of developing intervention strategies for HIV-positive individuals, since each new infection begins with someone who is already HIV-infected. Prior studies show that many HIV-positive individuals are continuing to engage in unsafe risk behaviors and that crack use is significantly associated with these risk behaviors. These data also show thai crack use is negatively associated with the use of primary outpatient HIV care. The hospital or inpatient ward may be an important, yet largely untapped setting to provide prevention interventionsto high-risk, HIV-positive crack users. Hospitals also provide an important setting for HIV prevention interventions with infected crack users, because hospitalization may serve as a "teachable moment" when patients are open to behavioral change interventions. Our multi-site study between the University of Miami and Emory University will be conducted at Jackson Memorial Hospital in Miami, Florida and Grady Memorial Hospital in Atlanta, Georgia. We will evaluate the efficacy of a brief, theoretically-guided, "Prevention Care Advocate" intervention with HIV-positivecrack users recruited from the HIV inpatient hospital wards at Jackson and Grady hospitals. We will provide a multi- component, skills-building intervention that encourages participants to advocate for prevention and receipt of primary care services for themselves and their peers. These intervention strategies are adapted from strategies recently developed and tested in previous CDC-funded multi-site studies. We will eTiploy a randomized experimental design to compare the intervention'sefficacy with an attention-control group. Participants will be assessed at baseline and 6 and 12 months after completing the intervention. The primary outcome of the study will be to reduce unprotected sex. Secondary outcomes will include increasingthe use of HIV primary outpatient cars and increasing readiness for and entry to drugtreatment.

HIV预防信息通常针对未感染的高危人群，预防艾滋病病毒的感染。最近，艾滋病毒预防领域的一个转变是认识到以下方面的重要性：为艾滋病毒阳性者制定干预战略，因为每一个新的感染都是从某人开始的，已经感染艾滋病病毒的人先前的研究表明，许多艾滋病毒阳性者继续从事不安全危险行为和使用快克与这些危险行为显著相关。这些数据还显示泰国快克的使用与初级门诊艾滋病护理的使用呈负相关。医院或住院病房可能是一个重要的，但在很大程度上尚未开发的环境，以提供预防干预，高风险，艾滋病毒阳性，吸毒者医院也提供了一个重要的设置艾滋病毒预防干预与感染裂纹用户，因为住院治疗可以作为一个“可教的时刻”，当病人是开放的行为改变干预措施。我们在迈阿密大学和埃默里大学之间的多中心研究将在杰克逊进行佛罗里达的迈阿密纪念医院和格鲁吉亚的亚特兰大格雷迪纪念医院。我们将评估一个简短的、理论指导的“预防保健倡导者”对HIV阳性吸毒者干预的有效性从杰克逊和格雷迪医院的艾滋病住院病房招募。我们将提供一个多- 技能建设干预措施，鼓励参与者倡导预防和接受为自己和同伴提供初级保健服务。这些干预策略是根据最近开发并在以前的CDC资助的多站点研究中进行了测试。我们将使用一个随机实验设计，以比较干预的有效性与注意力控制组。参与者将被在基线和完成干预后6个月和12个月进行评估。该研究的主要结果就是减少无保护的性行为次要结果将包括增加HIV初级门诊的使用汽车和增加准备和进入戒毒治疗。