HIV and Sober Intimate Behavior (HSIB)

描述（由申请人提供）：药物滥用相关行为仍然是美国艾滋病毒/艾滋病传播的一个重要因素-直接和间接。注射和非注射非法药物以及酒精的使用会影响决策和性冒险，从而增加艾滋病毒传播的风险。为了解决这个问题，State of the Art，Inc.（SOTA）建议为药物滥用治疗中的男同性恋者开发一种名为“艾滋病毒和清醒的亲密行为”（HSIB）的互动教育资源，以解决恢复过程中艾滋病毒风险和药物使用的交叉问题。在HSIB包的中心是一个基于计算机的，互动的模拟程序，使观众不仅学习重要的技能，但实践中的虚拟环境。HSIB致力于提供在清醒的情况下重新参与亲密行为和关系的技能建设信息，以帮助那些在恢复中的人减少他们的艾滋病毒风险，并避免在面对心理社会挑战时复发。为了实现这一长期目标，HSIB材料旨在1）增加有关健康亲密行为和降低艾滋病毒风险的知识，2）教授有关健康亲密行为的技能，这将有助于恢复中的人克服障碍，保持清醒，并降低艾滋病毒风险，3）为恢复中的男性提供练习这些技能的机会，并围绕它们建立自我效能。在第二阶段，将根据第一阶段的研究和原型材料制作HSIB材料，并进行定性和定量评估。在材料开发阶段，将与正在康复的男同性恋者进行深入访谈，并与药物滥用专业人员进行重点小组访谈，以帮助确保HSIB材料符合这些受众的价值观和需求。将由经过培训的访谈员/主持人使用标准定性研究方法（Krueger，1998）进行访谈和焦点小组，并在治疗组之间进行跨组比较。项目顾问对材料的内容审查将补充研究，并突出需要修订的任何其他领域。在修订和制作最终的HSIB材料后，定量评估将衡量他们在教育男同性恋者恢复保持清醒和减少艾滋病毒感染/传播风险方面的有效性，以及建立他们的动机，自我效能和参与预防性健康行为的意图。[使用随机对照试验设计，恢复中的男同性恋者将被随机分配到一个研究组，并在暴露后一周和一个月进行干预后问卷调查。比较干预组和对照组在四点量表上的得分，将确定反应是否显著地向材料中表达的观点迁移。 艾滋病毒/艾滋病的流行对药物滥用治疗产生了巨大的影响。通过共用针头，艾滋病毒暴露与注射毒品直接相关，但非注射毒品也是一个因素，因为它们通过无保护的性接触、更多的临时伴侣、血清状态未知的伴侣、以性换取毒品和其他高风险行为损害判断力并增加风险。由于认识到药物滥用治疗在减少艾滋病毒传播方面的重要性，目前的重点是使药物滥用者接受治疗，防止重新陷入以前的高风险行为。对康复者的艾滋病毒预防工作必须解决性传播风险以及与注射毒品有关的风险。通过在恢复的背景下促进艾滋病毒预防，HSIB的研究和资源有可能帮助男性开始积极的健康行为，促进保持清醒和减少艾滋病毒风险;从而减少艾滋病毒传播，复发的流行，及其相关费用。

DESCRIPTION (provided by applicant): Drug abuse-associated behavior continues to be a significant factor in the spread of HIV/AIDS in the United States - both directly and indirectly. The use of injection and non-injection illicit drugs, as well as alcohol, can increase HIV transmission risk through its impact on decision making and sexual risk taking. To address this issue, State of the Art, Inc. (SOTA) proposes the development of an interactive educational resource entitled "HIV and Sober Intimate Behavior" (HSIB) for gay men in substance abuse treatment that addresses the intersection of HIV risk and substance use within the context of the recovery process. At the center of the HSIB package is a computer-based, interactive simulation program that allows audiences to not only learn important skills, but to practice them within a virtual environment. HSIB strives to provide skill-building information for re-engaging in intimate behavior and relationships within a sober context, in order to help those in recovery reduce their HIV risk and avoid relapse in the face of psychosocial challenges. To accomplish this long-term objective, HSIB materials aim to 1) increase knowledge around healthy intimate behavior and reducing HIV risk, 2) teach skills around healthy intimate behavior that will help those in recovery to navigate obstacles, to maintain sobriety, and to reduce HIV risk, and 3) provide an opportunity for men in recovery to practice these skills and build self-efficacy around them. In Phase II, HSIB materials will be produced based on research and prototype materials developed in Phase I, and qualitative and quantitative evaluations will be conducted. In-depth interviews with gay men in recovery and a focus group with substance abuse professionals will take place during the materials developmental stage in order to help ensure that HSIB materials match the values and needs of these audiences. Interviews and focus groups will be conducted by trained interviewers/moderators using standard qualitative research methods (Krueger, 1998), and cross-group comparisons will be made between treatment groups. A content review of materials by project advisors will supplement research and highlight any additional areas in need of revision. After revisions and production of the final HSIB materials, a quantitative evaluation will measure their effectiveness in educating gay men in recovery about maintaining sobriety and reducing their risk of HIV infection/transmission, as well as building their motivation, self-efficacy, and intent to engage in preventive health behaviors. [Using a randomized control trial design, gay men in recovery will be randomized to a study group and post-intervention questionnaires will be administered one week and one-month after exposure. A comparison of intervention and control group scores on four-point scale measures will determine if responses significantly migrate toward opinions expressed in the materials.] PUBLIC HEALTH RELEVANCE The HIV/AIDS epidemic has had a dramatic effect on substance abuse treatment. HIV exposure has been directly linked to injection drugs through needle sharing, however non-injection drugs are also a factor as they impair judgment and elevate risk through unprotected sexual contact, a greater number of casual partners, partners of unknown serostatus, an exchange of sex for drugs, and other high-risk behaviors. As the importance of drug abuse treatment in reducing the spread of HIV is recognized, emphasis is being placed on getting substance abusers into treatment and preventing relapse into prior high-risk behaviors. HIV prevention efforts for those in recovery must address sexual transmission risks as well as risks associated with injection drugs. By promoting HIV prevention within the context of recovery, HSIB research and resources have the potential to help men initiate positive health behaviors that promote the maintenance of sobriety and the reduction of HIV risk; thereby reducing the prevalence of HIV transmission, relapse, and their associated costs.