MMT CARE For HIV Prevention: A Randomized Controlled Trial

描述(申请人提供)：我们提出了一项为期5年的随机对照试验，目标是中国的美沙酮维持治疗(MMT)计划。应用联合预防的原则，拟议的干预措施(MMT CARE)将心理社会和行为成分整合到美沙酮维持的药理学框架中。将从四个省随机抽取68家MMT诊所。每个诊所将招募6家服务提供商和36名客户，总计408家提供商和2448名客户参与研究。68家诊所将被随机分为：1)MMT护理干预组，或2)对照组(各34家诊所)。完成培训的服务提供商将与客户进行三次个人激励增强会议。干预的效果将在基线以及3、6、12、18和24个月的随访中进行评估。服务提供商的结果将通过以下几个方面来衡量：1)更好地遵守MMT协议；2)减少偏见态度；3)增加与客户的互动；以及4)增加与客户关于降低风险的沟通。客户的结果将通过以下几个方面来衡量：1)改善治疗坚持/保留；2)减少同时使用药物；3)增加改变行为的动机；4)改善心理健康；5)增加积极支持；6)减少艾滋病毒危险行为。

DESCRIPTION (provided by applicant): We propose a 5-year randomized controlled trial that targets methadone maintenance treatment (MMT) programs in China. Applying the principles of combination prevention, the proposed intervention (MMT CARE) integrates psychosocial and behavioral components into a pharmacological framework for methadone maintenance. A total of 68 MMT clinics will be randomly selected from four provinces. From each clinic, 6 service providers and 36 clients will be recruited, totaling 408 providers and 2,448 clients in the study. The 68 clinics will be randomized to: 1) a MMT CARE intervention group, or 2) a control group (34 clinics each). Service providers who complete the training will conduct three individual motivational enhancement sessions with clients. Efficacy of the intervention will be evaluated at baseline and at 3, 6, 12, 18, and 24-month follow- ups. The outcomes for service providers will be measured by: 1) improved adherence to MMT protocols; 2) decreased prejudicial attitudes; 3) increased interaction with clients; and 4) increased communications with clients about risk reduction. The outcomes for clients will be measured by: 1) improved treatment adherence/retention; 2) decreased concurrent drug use; 3) increased motivation for behavior change; 4) improved mental health; 5) increased positive support; and 6) reduced HIV risk behaviors.