Behavioral activation and HIV risk reduction for MSM with crystal meth abuse

这是一项关于新调查员R03的建议，旨在为行为治疗的随机对照试验奠定基础，该试验旨在降低与滥用冰毒(冰毒)并有感染艾滋病毒风险的男性(MSM)发生性关系的男性的性风险。该治疗将结合最先进的行为风险降低咨询方法(例如，信息-动机-行为技能建设，IMB；Fisher&Fisher，1992；Fisher&Fisher，1993)与治疗抑郁症的行为激活疗法(IMB模型中的一种调节因素)。行为激活是一种治疗抑郁症的方法，其重点是帮助个体重新投入他们的生活(Martell，2001,2002)。我们为滥用冰毒的男男性接触者选择了这一策略，因为我们的形成性定性工作显示，许多滥用冰毒的男男性接触者变得无法享受他们以前喜欢的活动。在不涉及冰毒使用和/或性行为的活动中缺乏享受，助长了继续使用冰毒和潜在的不安全性行为的动机。虽然干预的主要结果将是减少性风险，但其他结果将是减少冰毒的使用和抑郁的减少。前6个月将是干预发展阶段，未来一年半将在20名未感染艾滋病毒的男男性行为者中进行干预试点。这项研究将使我们能够展示参与者的接受度、招募能力、与治疗师一起提供治疗的可行性，以及临床上显著的参与者改善。它将允许进一步评估所有研究程序的可行性，调整治疗手册，并将为初始随机对照试验的功率分析提供试点数据。这些目标与NIH关于心理社会治疗发展阶段模式的指南是一致的(Rounaville等人，2001年)。PHS 398/2590(09/04版)页面延续格式页面首席调查员/项目总监(最后、第一、中间)：Mimiaga，Matthew

This is a proposal for a new investigator R03 to lay the groundwork for a randomized controlled trial of a behavioral treatment to reduce sexual risk taking in men who have sex with men (MSM) who abuse crystal methamphetamine (crystal meth), and are at risk for HIV acquisition. The treatment will incorporate state of the art behavioral risk reduction counseling approaches (e.g. information-motivation-behavioral skills building, IMB; Fisher & Fisher, 1992; Fisher & Fisher, 1993) with behavioral activation therapy to treat depression (a moderator in the IMB model). Behavioral activation is a treatment of depression that focuses on helping individuals reengage in their life (Martell, 2001, 2002). We chose this strategy for MSM who abuse crystal meth because our formative qualitative work revealed that many MSM who abuse crystal meth become unable to enjoy activities that they had previously enjoyed. This lack of enjoyment in activities that do not involve crystal meth use and / or sex contributes to the motivation for continued crystal use and potentially unsafe sex. While the main outcome of the intervention will be to reduce sexual risk taking, additional outcomes will be reduced crystal meth use and reduced depression. The first 6-months will be an intervention development phase, and the next year and a half will be a pilot of the intervention among 20 HIV-uninfected MSM. The study will allow us to demonstrate participant acceptance, ability to recruit, feasibility of treatment delivery with therapists, and clinically significant participant improvement. It will allow for further evaluation of the feasibility of all study procedures, adaptation of the treatment manual, and will provide pilot data for a power analysis for an initial randomized controlled trial. These goals are consistent with NIH guidelines for a stage model of psychosocial treatment development (Rounsaville et al., 2001). PHS 398/2590 (Rev. 09/04) Page Continuation Format Page Principal Investigator/Program Director (Last, First, Middle): Mimiaga, Matthew