Intervention for HIV+ Adults With Childhood Sexual Abuse

描述(由申请者提供)：本申请提供了一个研究和培训计划，重点是将艾滋病毒预防策略整合到创伤的精神健康治疗中。具体地说，拟议的项目旨在为儿童期性虐待(CSA)中艾滋病毒阳性的成年幸存者开发和试点测试干预措施，这些幸存者性行为活跃，并表现出与创伤有关的精神痛苦。CSA在HIV+成年人中的广泛流行令人担忧，因为CSA与精神健康不良、药物滥用、艾滋病毒危险行为以及糟糕的治疗依从性和结果有关。培训目标是发展专业知识：(1)为创伤和CSA制定具有文化敏感性和经验性支持的精神健康治疗；(2)将艾滋病毒预防战略纳入创伤和CSA的精神健康治疗；(3)学习用于纵向数据和结果分析的高级量化数据分析技能。凯瑟琳·西科马博士和约翰·布里尔博士将监督培训。拟议项目的主要目标是：(1)根据自我创伤理论，为有CSA病史的HIV+成年人开发16次个人认知行为干预，以满足艾滋病毒携带者的需求；(2)以80名参与者为样本进行初步测试，其中40人将被随机进入初始治疗状态，随后进行4个月的随访，40人将被随机进入4个月的等待名单，然后进行研究干预治疗；以及(3)评估干预措施减少痛苦和艾滋病毒传播风险行为的能力，并为未来的研究收集效果大小的估计。这一奖项将导致一项干预措施，将艾滋病毒预防战略纳入艾滋病毒阳性成年人的心理健康治疗，这些成年人经历过CSA，这是一组艾滋病毒传播行为风险较高的群体，可以在随机、受控干预试验中进行评估。该奖项还将支持PI的长期目标，即将艾滋病毒预防战略纳入脆弱人群的心理健康护理，如创伤幸存者。

DESCRIPTION (provided by applicant): This application presents a program of research and training that focuses on integrating HIV-prevention strategies into mental health treatments for trauma. Specifically, the proposed project aims to develop and pilot test an intervention for HIV-positive adult survivors of childhood sexual abuse (CSA) who are sexually active and exhibit psychiatric distress related to trauma. The widespread prevalence of CSA among HIV+ adults is concerning as CSA has been linked to poor mental health, substance abuse, HIV risk behavior, and poor treatment adherence and outcome. The training objectives are to develop the PI's expertise in: (1) developing culturally sensitive empirically supported mental health treatments for trauma and CSA, (2) integrating HIV-prevention strategies into mental health treatments for trauma and CSA, and (3) learning advanced quantitative data analytic skills for longitudinal data and outcome analysis. Drs. Kathleen Sikkema and John Briere will supervise the training. The primary goals of the proposed project are to: (1) develop a 16 session individual cognitive-behavioral intervention for HIV+ adults with a history of CSA based on self- trauma theory and tailored to meet the needs of those living with HIV; (2) pilot test this intervention with a sample of 80 participants, 40 who will be randomized into an initial treatment condition followed by a four- month follow-up, and 40 who will be randomized into a four-month waitlist condition followed by treatment with the study intervention; and (3) evaluate the intervention's ability to reduce distress and HIV transmission risk behavior, and collect estimates of effect size for future research. This award will result in a intervention that integrates HIV-prevention strategies into mental health treatment for HIV-positive adults who have experienced CSA, a group with elevated risk for HIV-transmission behavior, that can be evaluated in a randomized, controlled intervention trial. The award will also support the PI's long term goal of integrating HIV-prevention strategies into the mental health care of vulnerable populations, such as survivors of trauma.