Intervention to Reduce Internalized Stigma (IRIS) among People Living with HIV who use Substances

减少使用药物的艾滋病毒感染者的内在耻辱 (IRIS) 的干预措施

基本信息

项目摘要

ABSTRACT Different facets of stigma (anticipated, enacted, internalized) associated with substance use disorder (SUD) and with HIV positive status impede cessation of substance use and HIV health outcomes including antiretroviral therapy adherence and viral load suppression.1-6 Although public stigma is pervasive surrounding both, individuals can learn to reduce its internalization and mitigate stigma’s negative impacts on their health. However, interventions promoting this are non-existent in the published literature. To this end, we propose to adapt an evidence-based stigma-impact reduction intervention, Ending Self- Stigma (ESS) to reduce stigma and its negative impacts on health. ESS has shown efficacy in reducing internalized and anticipated stigma in populations experiencing mental health conditions.7 The 9-session group-based intervention, which uses cognitive behavioral therapy strategies and social cognitive theory constructs, employs didactic learning and interactive activities to facilitate reductions in internalized and anticipated stigma. The purpose of the proposed study is to adapt the ESS intervention for people living with HIV (PLWH) who also have opioid use disorder (OUD) and/or cocaine use disorder (CUD). In the first year, we will use an iterative process that starts with formative interviews with service delivery key informants and people living with PLWH with OUD and/or CUD, and ends with two successive pilot studies with the study population. Through this process, intervention content will be adapted for this population and intervention delivery will be adapted for a virtual format via a web-based platform. Then, in years 2-3, a small randomized clinical trial of the resulting Ending Self-Stigma intervention adapted for PLWH with Substance Use disorder (ESS-HSU) will be conducted with 70 participants to determine its feasibility and acceptability in addition to collecting data on proximal outcomes including internalized and anticipated stigma, depressive symptoms, anxiety and perceived stress associated with stigma. We will also measure distal outcomes including ART adherence, viral load and substance use (SU) at 6-month follow-up. The ESS-HSU intervention has the potential for high public health impact by reducing the negative effects of internalized and anticipated stigma resulting from the pervasive public stigmatization of HIV seropositive status and SUD on HIV health outcomes and cessation of SU. ESS-HSU would be the first virtual intervention of this type to be evaluated in a randomized clinical trial. If results are promising, we will seek R01 funding for a full-scale test of this innovative intervention to determine its effects on a range of health outcomes and characterize mechanisms of intervention effects.
摘要 与物质使用障碍(SUD)相关的污名的不同方面(预期,制定,内化) 艾滋病毒阳性状态阻碍停止药物使用和艾滋病毒健康结果,包括 抗逆转录病毒治疗依从性和病毒载量抑制。1 -6虽然公众的耻辱是普遍存在的周围 个人可以学会减少其内在化,减轻耻辱对其健康的负面影响。 然而,在已发表的文献中并不存在促进这一点的干预措施。 为此,我们建议采用一种基于证据的减少污名影响的干预措施,结束自我, 污名化(ESS),以减少污名化及其对健康的负面影响。ESS显示出降低 有心理健康问题的人群中内化和预期的耻辱感。 基于小组的干预,它使用认知行为治疗策略和社会认知理论 构建,采用教学式学习和互动活动,以促进减少内化和 预期的耻辱。 拟议研究的目的是调整ESS干预艾滋病毒感染者(PLWH), 阿片类药物使用障碍(OUD)和/或可卡因使用障碍(CUD)。在第一年,我们将使用 一个迭代过程,首先是对提供服务的关键知情人和与之生活在一起的人进行形成性访谈, PLWH与OUD和/或CUD,并结束了两个连续的试点研究与研究人群。通过 在这一过程中,将针对这一人群调整干预内容,并调整干预措施的提供 通过一个基于网络的平台进行虚拟格式。然后,在第2-3年,一个小型的随机临床试验, 结果结束自我羞辱干预适应PLWH与物质使用障碍(ESS-HSU)将 进行了70名参与者,以确定其可行性和可接受性,除了收集数据, 近端结果包括内化和预期的耻辱、抑郁症状、焦虑和感知 与耻辱相关的压力。我们还将测量远端结局,包括ART依从性、病毒载量和 6个月随访时的物质使用(SU)。 ESS-HSU干预措施通过减少负面影响,具有潜在的高公共卫生影响 由于艾滋病毒血清反应阳性者普遍受到公众的鄙视, 状态和SUD对艾滋病毒健康结果和停止SU的影响。ESS-HSU将是第一个虚拟干预 在随机临床试验中进行评估。如果结果是有希望的,我们将寻求R 01资金, 对这种创新干预措施进行全面测试,以确定其对一系列健康结果的影响, 描述干预效果的机制。

项目成果

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Jesse Bradford Fletcher其他文献

Jesse Bradford Fletcher的其他文献

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{{ truncateString('Jesse Bradford Fletcher', 18)}}的其他基金

Development and Testing of an Identity Measure for Transgender and Gender Diverse Persons
跨性别者和性别多元化人士身份测量的开发和测试
  • 批准号:
    10548085
  • 财政年份:
    2022
  • 资助金额:
    $ 21.21万
  • 项目类别:
Development and Testing of an Identity Measure for Transgender and Gender Diverse Persons
跨性别者和性别多元化人士身份测量的开发和测试
  • 批准号:
    10698182
  • 财政年份:
    2022
  • 资助金额:
    $ 21.21万
  • 项目类别:

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