Behavioral interventions to reduce heavy drinking in HIV-infected men in primary care.
减少初级保健中艾滋病毒感染男性酗酒的行为干预措施。
基本信息
- 批准号:8838920
- 负责人:
- 金额:$ 43.32万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2015
- 资助国家:美国
- 起止时间:2015-09-01 至 2020-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAlcohol consumptionAlcohol dependenceAlcoholsAnusBehavior TherapyBehavioralCD4 Lymphocyte CountCaringCellular PhoneClinicCollaborationsCounselingDataDiseaseEffectivenessFeedbackFunctional disorderHIVHIV InfectionsHeavy DrinkingInfectionInflammationInsulin ResistanceInterventionLeadLifeLiver Function TestsLiver diseasesLocationMetabolicMonitorMotivationNeurocognitiveOutcomeOxidative StressParticipantPatientsPhasePopulationPrimary Health CarePublishingRandomized Clinical TrialsRandomized Controlled TrialsReadinessRecruitment ActivityRelative (related person)ResearchRiskSamplingSerumSystemTechnologyTelemedicineTestingTextTimeViralVoiceWorkalcohol interventionalcohol use disorderantiretroviral therapybasebiobehaviorbrief advicebrief motivational interventionclinical carecognitive functioncostcost effectivenessdesigndrinkingfollow-uphazardous drinkingimprovedindexingindividualized medicineliver functionmenmen who have sex with menproblem drinkerpublic health prioritiesresponsesecondary outcomesexsex risksexual risk takingtherapy adherencetreatment as usualvirology
项目摘要
PROJECT SUMMARY
Heavy drinking in HIV-infected patients can lead to low antiretroviral therapy adherence and poor virologic
control, greater sexual risk taking, increased risk of liver disease, and decreased cognitive function. Therefore,
reductions in drinking may have particularly positive and widespread effects in HIV-infected patients. Men who
have sex with men (MSM) continue to represent the majority of new HIV infections, and HIV-infected MSM
have rates of hazardous drinking as high as 33%. Therefore, developing and testing interventions to reduce
heavy drinking in HIV-infected MSM is a very high public health priority. There have been relatively few alcohol
interventions tested that focus on MSM, and only two have addressed drinking in HIV-infected MSM. Although
recent studies indicate that behavioral interventions can reduce heavy drinking in HIV-infected patients, much
remains unknown about the efficacy of different approaches to behavioral intervention and their unique and
combined effects. The purpose of the present study is to conduct a fully-crossed 2 X 2 X 2 factorial randomized
controlled trial with a diverse sample of 224 MSM recruited from 2 urban HIV primary care clinics (one in the
Northeast and one in the South). The first study factor will compare brief advice (BA) vs. a motivation
intervention (MI) that contains detailed personalized normative and HIV-specific feedback. The second factor
compares an interactive text messaging (ITM) intervention vs. no text messaging. The final factor compares
intervention of low intensity and duration (two sessions over 1 month) to extended intervention (EI) entailing 5
sessions over 9 months. BA and MI will be delivered by a core set of interventionists from a central location
using a webcam-enabled telemedicine system, which can facilitate larger-scale implementation. The design
will allow us to test the hypothesis that MI compared to BA, ITM compared to no ITM, and EI compared to no
EI, will result in significantly greater reductions in number of alcoholic drinks consumed and number of heavy
drinking days at 6- and 12-month follow-ups. Secondary outcomes include engagement in unprotected anal
intercourse, ART adherence and viral suppression, CD4 cell count, liver function tests, and neurocognitive
function. We also will test the hypothesis that the effects of MI, ITM, and EI on drinking will be moderated by
alcohol use disorder status and readiness to change drinking such that these interventions will be relatively
more efficacious in those with a current disorder and those with low readiness. The study will provide crucial
evidence regarding which intervention approaches, alone or in combination, are likely to be most efficient to
implement on a large scale in HIV care settings.
项目总结
HIV感染者大量饮酒可导致抗逆转录病毒治疗依从性低和病毒学差
控制,更大的性风险,肝脏疾病的风险增加,以及认知功能下降。因此,
减少饮酒可能会对艾滋病毒感染患者产生特别积极和广泛的影响。男人们
男男性行为(MSM)仍然是新感染艾滋病毒的大多数,感染艾滋病毒的MSM
危险饮酒率高达33%。因此,开发和测试干预措施以减少
在感染艾滋病毒的男男性接触者中大量饮酒是一个非常高的公共卫生优先事项。酒精含量相对较少。
针对男男性接触者的干预措施进行了测试,只有两种干预措施解决了感染艾滋病毒的男男性接触者饮酒问题。虽然
最近的研究表明,行为干预可以大大减少艾滋病毒感染患者的大量饮酒
关于不同行为干预方法的有效性以及它们独特的
综合效应。本研究的目的是进行完全交叉的2×2×2因子随机设计
对从2家城市艾滋病毒初级保健诊所招募的224名MSM进行了不同样本的对照试验(其中一家在
东北和南部各有一个)。第一个研究因素将比较简短的建议(BA)和动机
干预(MI),包含详细的、个性化的、规范性的和针对艾滋病毒的反馈。第二个因素
将交互式短信(ITM)干预与不使用短信进行比较。最后一个因素是比较
低强度和低持续时间的干预(为期一个月的两次会议)到延长干预(EI),需要5
疗程超过9个月。BA和MI将由一组核心干预者从中央位置提供
使用支持网络摄像头的远程医疗系统,这可以促进更大规模的实施。设计
将允许我们检验这样的假设:MI与BA相比,ITM与非ITM相比,EI与NO相比
EI,将显著减少酒精饮料的消费量和重度酒精饮料的消费量
在6个月和12个月的随访中饮酒天数。次要结果包括接触无保护肛门
性交、ART依从性和病毒抑制、CD4细胞计数、肝功能测试和神经认知
功能。我们还将测试这一假设,即MI、ITM和EI对饮酒的影响将通过以下方式缓和
酒精使用障碍的状态和改变饮酒的准备情况,使这些干预措施将相对
对于那些患有当前障碍和准备程度较低的人,效果更好。这项研究将提供至关重要的
关于哪种干预方法单独或联合使用可能最有效的证据
在艾滋病毒护理环境中大规模实施。
项目成果
期刊论文数量(0)
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Christopher W. Kahler其他文献
Gedragsrelatietherapie versus individuele therapie voor vrouwen met alcoholafhankelijkheid: een gerandomiseerde klinische trial
Gedragsrelatiethapie 与个体疗法 voor vrouwen metoolafhankelijkheid:een gerandomiseerde klinische 试验
- DOI:
10.1007/s12440-016-0024-2 - 发表时间:
2016 - 期刊:
- 影响因子:64.8
- 作者:
Jeremiah A. Schumm;Timothy J. O'Farrell;Christopher W. Kahler;M. Murphy;Patrice Muchowski - 通讯作者:
Patrice Muchowski
The effects of switching to the standardized research electronic cigarette in people with HIV who smoke in the United States
在美国,对于吸烟的艾滋病毒感染者改用标准化研究电子烟的影响
- DOI:
10.1016/j.ypmed.2025.108309 - 发表时间:
2025-07-01 - 期刊:
- 影响因子:3.200
- 作者:
Patricia A. Cioe;William V. Lechner;Garrett S. Stang;Christopher W. Kahler;Karen T. Tashima;Thomas Eissenberg;Jennifer W. Tidey - 通讯作者:
Jennifer W. Tidey
Intolerance for withdrawal discomfort and motivation predict voucher-based smoking treatment outcomes for smokers with substance use disorders
- DOI:
10.1016/j.addbeh.2014.12.003 - 发表时间:
2015-04-01 - 期刊:
- 影响因子:
- 作者:
Damaris J. Rohsenow;Jennifer W. Tidey;Christopher W. Kahler;Rosemarie A. Martin;Suzanne M. Colby;Alan D. Sirota - 通讯作者:
Alan D. Sirota
Pain Severity and Experiences with Pain Management Predict Alcohol Use Among Men Who Have Sex with Men Living with HIV
- DOI:
10.1007/s10461-025-04652-8 - 发表时间:
2025-02-10 - 期刊:
- 影响因子:2.400
- 作者:
Erin Ferguson;David W. Pantalone;Peter M. Monti;Kenneth H. Mayer;Christopher W. Kahler - 通讯作者:
Christopher W. Kahler
Effects of optimism and stage of change on alcohol use and problems among sexual minority men with HIV participating in a brief motivational interviewing intervention
- DOI:
10.1016/j.josat.2024.209599 - 发表时间:
2025-02-01 - 期刊:
- 影响因子:
- 作者:
Benjamin L. Berey;Nadine R. Mastroleo;David W. Pantalone;Kenneth H. Mayer;Peter M. Monti;Christopher W. Kahler - 通讯作者:
Christopher W. Kahler
Christopher W. Kahler的其他文献
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{{ truncateString('Christopher W. Kahler', 18)}}的其他基金
Development and pilot testing of a multimodal web-based program to address heavy drinking during smoking cessation
开发和试点测试多模式网络计划,以解决戒烟期间酗酒问题
- 批准号:
9226007 - 财政年份:2016
- 资助金额:
$ 43.32万 - 项目类别:
Development and pilot testing of a multimodal web-based program to address heavy drinking during smoking cessation
开发和试点测试多模式网络计划,以解决戒烟期间酗酒问题
- 批准号:
9017537 - 财政年份:2016
- 资助金额:
$ 43.32万 - 项目类别:
Positive Psychotherapy for Smoking Cessation Enhanced with Text Messaging: A Randomized Controlled Trial
通过短信增强戒烟积极心理治疗:随机对照试验
- 批准号:
9310231 - 财政年份:2016
- 资助金额:
$ 43.32万 - 项目类别:
Web-facilitated intervention for heavy drinking and HIV risk
针对酗酒和艾滋病毒风险的网络辅助干预
- 批准号:
8921751 - 财政年份:2015
- 资助金额:
$ 43.32万 - 项目类别:
Web-facilitated intervention for heavy drinking and HIV risk
针对酗酒和艾滋病毒风险的网络辅助干预
- 批准号:
9265364 - 财政年份:2015
- 资助金额:
$ 43.32万 - 项目类别:
Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions
酒精-艾滋病毒干预措施的行为改变资源核心机制
- 批准号:
8452403 - 财政年份:2012
- 资助金额:
$ 43.32万 - 项目类别:
Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions
酒精-艾滋病毒干预措施的行为改变资源核心机制
- 批准号:
8548212 - 财政年份:2012
- 资助金额:
$ 43.32万 - 项目类别:
Mechanisms of Behavior Change Resource Core for Alcohol-HIV Interventions
酒精-艾滋病毒干预措施的行为改变资源核心机制
- 批准号:
8719887 - 财政年份:2012
- 资助金额:
$ 43.32万 - 项目类别:
Development of Positive Psychotherapy for Smoking Cessation
戒烟积极心理疗法的发展
- 批准号:
8207864 - 财政年份:2011
- 资助金额:
$ 43.32万 - 项目类别:
Development of Positive Psychotherapy for Smoking Cessation
戒烟积极心理疗法的发展
- 批准号:
8039348 - 财政年份:2011
- 资助金额:
$ 43.32万 - 项目类别:
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