Mobile Substance Use Intervention for HIV Prevention

描述(申请人提供)：大脑疾病，如药物滥用(毒品和酒精)和精神问题，在贫穷的肯尼亚人中非常普遍，当地生产的物质(酒精、大麻和阿拉伯茶)丰富，缺乏针对药物滥用或精神问题的循证治疗，以及这些大脑疾病与艾滋病毒/艾滋病之间的联系，这使这成为一个需要创新解决方案的重大公共卫生问题。未经治疗的药物滥用与推理和判断力下降有关，在性传播和感染艾滋病毒/艾滋病方面发挥重要作用，也与药物依从性低、疾病易感性和发展为艾滋病有关。我们的研究团队发现，激励访谈(MI)是一种基于证据的药物滥用治疗方法，传统上是面对面提供的，在肯尼亚文化背景下对减少酒精滥用是有效的。这个R21应用程序的目标是开发一种由接受过MI培训的肯尼亚临床医生提供的基于手机的药物滥用干预(“移动MI”)，作为一种降低成本、缩短治疗时间并缩小与训练有素的临床医生互动的贫困肯尼亚人的治疗差距的创新方法。针对PA-11-031，发展中世界的脑部疾病，我们提出了以下目标：1)评估使用手机向滥用药物的成年人提供MI的可行性、可接受性和有效性，以及2)量化有精神问题的参与者对MI治疗的不同反应，并确定未来干预的领域。

DESCRIPTION (provided by applicant): Brain disorders, such as substance abuse (drugs and alcohol) and psychiatric problems, are highly prevalent among impoverished Kenyans, and the abundance of locally produced substances (alcohol, cannabis, and khat), absence of evidence-based treatment for substance abuse or psychiatric problems, and associations between these brain disorders and HIV/AIDS, makes this a major public health concern in need of innovative solutions. Untreated substance abuse is associated with decreased reasoning and judgment, playing an important role in sexual transmission and acquisition of HIV/AIDS, and is also linked with low medication adherence, disease susceptibility, and progression to AIDS. Our research team has found motivational interviewing (MI), an evidence-based substance abuse treatment traditionally delivered in-person, to be effective at decreasing alcohol abuse in the Kenyan cultural context. The objective of this R21 application is to develop a mobile phone-based ("mobile MI") intervention for substance abuse provided by MI-trained Kenyan clinicians, as an innovative approach to lowering the cost, decreasing time to treatment, and reducing the treatment gap for impoverished Kenyans who rarely interact with highly trained clinicians. In response to PA- 11-031, Brain Disorders in the Developing World, we propose the following aims: 1) Assess feasibility, acceptability, and efficacy of using mobile phones to provide MI to substance abusing adults, and 2) Quantify the varying response to MI treatment for participants with psychiatric problems and identify areas for future intervention.