Multi-level HIV Prevention for Pregnant Drug Abusers

描述（由申请人提供）：拟议的研究，针对治疗中的妊娠药物滥用者，是一项随机试验，旨在将增强行为技能训练（E-BST）与时间和注意力匹配的健康促进比较（HPC）条件进行比较。E-BST是对原始BST干预的改编（Eldridge，St. Lawrence et al. 1997），旨在加强原始BST基于关系的社会能力技能，这些技能在维持对保护行为的坚持方面至关重要。E-BST强调与性伴侣/重要他人的谈判/沟通技巧以及寻求帮助和利用服务的社会生态技能。这种生态增强在多个互动的水平，在原来的BST试验中指出，潜在的促进拒绝技能，可以提供持续的强化行为的变化，即使在干预结束。BST是唯一有效的行为干预药物治疗的妇女之一;然而，只有适度的，短期的收益被证明。越来越多的证据表明，影响将继续是最小的，直到干预措施超越个人，以解决背景因素，可以赋予妇女在其实际生活情况，并解决采取和维持保护行为的困难。参与者将是320名文化多样性（30%西班牙裔，60%非裔美国人）的妊娠药物滥用者，随机分配到E-BST和HPC治疗组。我们将使用HIM来探索理论上相关的个体认知行为（例如，信息动机行为;费舍尔和费舍尔，1992年）和上下文（例如，药物滥用，服务和社会支持利用）因素和调节的关键背景因素：认知功能和创伤性滥用史。拟议的项目响应国家卫生研究院优先转化研究，以适应有效的研究为基础的干预策略，以“真实的世界”的条件。如果成功，这项研究将提供一个可实现的艾滋病毒干预战略，将研究和实践联系起来，可以在其社区内对怀孕的吸毒者实施。

DESCRIPTION (provided by applicant): The proposed study, targeting Pregnant Drug Abusers in treatment, is a randomized trial of Enhanced- Behavioral Skills Training (E-BST) compared to a time- and attention-matched Health Promotion Comparison (HPC) condition. E-BST is an adaptation of the original BST intervention (Eldridge, St. Lawrence et al. 1997), designed to strengthen relationship-based social competency skills of the original BST were crucial in sustaining adherence to protective behavior. The E-BST emphasizes negotiation/communication skills with sexual partners/significant others and social ecological skills of help- seeking and service utilization. Such ecological enhancements at multiple interactive levels-pointed to in the original BST trial as potentially facilitative of refusal skills-may provide continued reinforcement of behavioral change even after the intervention has ended. BST is one of the only effective behavioral interventions for women in drug treatment; however, only modest, short-term gains were demonstrated. Growing evidence indicates that impacts will continue to be minimal until interventions go beyond the individual to address contextual factors that can empower women in their actual life situations and address the difficulty of adopting and sustaining protective behavior. Participants will be 320 culturally diverse (30% Hispanic, 60% African American) pregnant drug abusers in treatment with random assignment to the E-BST and HPC. We will use HIM to explore how intervention effects are mediated by theoretically relevant Individual Cognitive-Behavioral (e.g., Information-Motivation-Behavior; Fisher and Fisher, 1992) and Contextual (e.g., Drug Abuse, Service and Social Support Utilization) factors and moderated by key background factors: cognitive functioning and traumatic abuse history. The proposed project responds to the NIH priority on translational research to adapt effective research-based intervention strategies to "real world" conditions. If successful, this research will offer a realizable HIV intervention strategy, bridging research and practice, that can be implemented for pregnant drug abusers within their communities.